Citation Nr: 21042114 Decision Date: 07/12/21 Archive Date: 07/12/21 DOCKET NO. 13-00 556 DATE: July 12, 2021 ORDER Entitlement to service connection for hypothyroidism is GRANTED. FINDING OF FACT The preponderance of the evidence favors a finding that the Veteran's hypothyroidism was incurred in service in the United States Army. CONCLUSION OF LAW The criteria for service connection for hypothyroidism have been met. 38 U.S.C. §§ 1110, 1111, 1116 (a)(2), 5103, 5103A, 5107 (West 2014); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.310 (2020). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served honorably on active duty in the United States Army from July 1963 to January 1964. The military personnel records (MPRs) indicate that the Veteran was stationed at Fort Chaffee, Arkansas on three occasions during military service. Entitlement to service connection for hypothyroidism is granted. In July 2014, the Veteran submitted a VA From 21-526b. Therein, the Veteran initiated a claim for service connection for hypothyroidism. To substantiate a claim of service connection, there must be evidence of a current disability; evidence of incurrence or aggravation of a disease or injury in service; and evidence of a nexus between the current disability and the disease or injury in service. See Shedden v. Principi, 381 F.3d 1153, 1166-1167 (Fed. Cir. 2004). The determination as to whether these requirements are met is based on an analysis of all the evidence of record and the evaluation of its credibility and probative value. Baldwin v. West, 13 Vet. App. 1 (1999); 38 C.F.R. § 3.303 (a). VA regulations provide that certain diseases associated with exposure to herbicide agents may be presumed to have been incurred in service even if there is no evidence of the disease in service, provided the requirements of 38 C.F.R. § 3.307 (a)(6) are met. 38 C.F.R. § 3.309 (e). The term "herbicide agent" means a chemical in an herbicide, including Agent Orange, used in support of the United States and allied military operations in the Republic of Vietnam during the Vietnam era. If a Veteran was exposed to an herbicide agent during active service, the following diseases shall be service-connected if the requirements of 38 C.F.R. § 3.307 (a)(6) are met, even though there is no record of such disease during service, provided further that the rebuttable presumption provisions of 38 C.F.R. § 3.307 (d) are also satisfied: AL amyloidosis; chloracne or other acneform disease consistent with chloracne; Type 2 diabetes (also known as Type II diabetes mellitus or adult-onset diabetes); Hodgkin's disease; all chronic B cell leukemias; multiple myeloma; non-Hodgkin's lymphoma; Parkinson's disease; early-onset peripheral neuropathy; porphyria cutanea tarda; prostate cancer; respiratory cancers (cancer of the lung, bronchus, larynx or trachea); soft-tissue sarcoma (other than osteosarcoma, chondrosarcoma, Kaposi's sarcoma, or mesothelioma); and ischemic heart disease, (including, but not limited to, acute, subacute, and old myocardial infarction); atherosclerotic cardiovascular disease including coronary artery disease (including coronary spasm) and coronary bypass surgery; and stable, unstable and Prinzmetal's angina), shall be service-connected if the requirements of 38 C.F.R. § 3.307 (a)(6) are met, even though there is no record of such disease during service, provided further that the rebuttable presumption provisions of 38 C.F.R. § 3.307 (d) are also satisfied. 38 C.F.R. § 3.309 (e). The Board notes that the National Defense Authorization Act for Fiscal Year 2021 has added three disorders to the list of diseases presumptively associated with exposure to herbicide agents. Specific to this analysis, the Act amended 38 U.S.C. § 1116 (a)(2) to include hypothyroidism. It is the policy of VA to administer the law under a broad interpretation, consistent with the facts in each case, with all reasonable doubt to be resolved in favor of the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. When all of the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the appellant prevailing in either event, or whether a fair preponderance of the evidence is against the claim, in which case the claim is denied. Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990). In January 2016, the agency of original jurisdiction (AOJ) issued a rating decision. Therein, the AOJ relayed that, "(i)t was previously established that you were stationed at Fort Chaffee, Arkansas during a time herbicide spraying was conducted. Therefore, exposure to herbicides is conceded . . .." In July 2018, the Veteran's attorney submitted a Brief in Support of Appeal. Therein, counsel raised the theory of direct service connection. Counsel noted that it had been established that the Veteran was exposed to herbicide agents in service (while stationed at Fort Chafee, Arkansas). The Veteran's Counsel requested that, based on this evidence, consideration be given as to whether the Veteran's hypothyroidism may be related to his in-service exposure to herbicide agents. In August 2018, the Board addressed the Veteran's claim for service connection for hypothyroidism. The Board remanded the Veteran's claim to the AOJ to obtain a VA examination report that addressed the Veteran's current hypothyroidism and an etiological relationship, if any, to the in-service herbicide agent exposure. In April 2019, the Veteran underwent a VA examination that addressed the nature and etiology of thyroid and parathyroid conditions. The VA examiner noted a current diagnosis for hypothyroidism. The VA examiner opined that the Veteran's hypothyroidism was less likely or not (less than 50 percent probability) incurred in, or caused by, an in-service injury, event, or illness. The VA examiner supplied the following rationale: "VA has not recognized hypothyroidism as one of the medical conditions related to herbicide agent exposure. Therefore, it is opinion of this examiner it is less likely than not that hypothyroidism is related to in-service herbicide exposure to Agent Orange. In November 2020, the Board addressed the Veteran's claim for service connection for hypothyroidism. At that time, the Board found that the April 2019 VA examination report was not adequate, because the examiner did not address any medical literature or the report from the National Academies of Sciences, Engineering, and Medicine. The Board remanded the claim for an addendum report to address an etiological relationship, if any, between the Veteran's hypothyroidism and the in-service exposure to herbicide agents. In April 2021, an addendum VA opinion / report was associated with the claims file. Therein, the examiner relayed that, "(t)hough there are articles available indicating a possible correlation between herbicide exposure and hypothyroidism. There is no conclusive evidence to indicate that hypothyroidism results from herbicide exposure." After review of the government and non-government treatment records, the Board observes that the Veteran maintains a current diagnosis for hypothyroidism. In January 2016, the AOJ conceded the Veteran's exposure to a tactical herbicide agent at Fort Chaffee, Arkansas. Early this year, the VA regulations were amended to include hypothyroidism to the presumptive list of disorders that can be attributed to exposure to Agent Orange during service. Ultimately, the Board concludes the elements are substantiated for the Veteran's claim for presumptive service connection for a hypothyroidism disability. Consequently, this service connection claim must be granted. DAVID L. WIGHT Veterans Law Judge Board of Veterans' Appeals Attorney for the Board RLBJ, Counsel The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.