Citation Nr: 22017884 Decision Date: 03/26/22 Archive Date: 03/26/22 DOCKET NO. 17-54 249 DATE: March 26, 2022 REMANDED Entitlement to service connection for the cause of the Veteran's death, for purposes of Dependency and Indemnity Compensation (DIC), is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from March 1962 to December 1978, to include service in the Republic of Vietnam and Thailand. Unfortunately, the Veteran passed away in May 2006. The Appellant is the Veteran's surviving spouse. The Board extends its deepest sympathy to the Appellant and its sincere gratitude for the Veteran's honorable service. In September 2021, the Appellant testified in a virtual hearing before the undersigned Acting Veterans Law Judge. A copy of the hearing transcript has been associated with the claims file. Entitlement to service connection for the cause of the Veteran's death, for purposes of Dependency and Indemnity Compensation (DIC) The Appellant contends that the Veteran was exposed to herbicide agents in the Republic of Vietnam and in Thailand during his active duty service and that such factors caused his death. The Appellant also testified that within a year of discharge, the Veteran began having symptoms and that he had been prescribed medication used to treat Parkinson's disease. Additionally, the Appellant acknowledged that the Veteran's death certificate reflected an immediate cause of death of "rapidly progressive degenerative neurological disease." However, the Appellant endorsed that the doctor who filled out the death certificate was not familiar with the Veteran's medical condition and "didn't write the full condition down." See September 2021 Hearing Transcript. Regrettably, a remand is necessary for proper development of the issue. Specifically, during the virtual hearing, the Appellant identified that there are outstanding VA and private treatment records that are relevant to the matter before the Board. On remand, such records should be obtained. Moreover, the Board finds that a VA opinion would be helpful as the evidence is unclear regarding whether the Veteran had a diagnosis of Parkinson's disease, Parkinsonism, or another similar, yet unrelated, neurological disability. The matters are REMANDED for the following action: 1. Appropriate efforts should be made to obtain any outstanding VA medical records, including those from Fort Stewart (Winn Army Community Hospital) and Walter Reed National Military Medical Center, as well as all outstanding private treatment records, with all necessary assistance from the Appellant. All information obtained must be associated with the claims file. All attempts to secure this evidence must be documented in the claims file. If such medical records are not able to be secured after reasonable efforts, provide the Appellant and her representative with the required notice and opportunity to respond. 2. Request that the Appellant identify all relevant private treatment records and complete the necessary authorization forms. The identified records should be sought. 3. Obtain an opinion, from either a neurologist or another appropriate clinician, to determine the nature and etiology of the Veteran's neurological disability(ies). The electronic claims file must be made available to and reviewed by the examiner. (a) Identify and describe each neurological diagnosis pertaining to the Veteran, including the date of onset, if possible. The examiner is specifically requested to determine whether the Veteran had a diagnosis of Parkinson's disease or parkinsonism, to include any sub-type thereof. Here, the examiner must determine whether the Veteran's noted "rapidly progressive degenerative neurological disease" and Parkinson's disease or parkinsonism are distinct diseases and explain why. (b) Then, the examiner must provide an opinion as to whether it is at least as likely as not (50 percent probability or greater) that the Veteran's "rapidly progressive degenerative neurological disease" had its onset in service or is otherwise etiologically related to his active duty service, to include his conceded exposure to herbicide agents. - In providing the above opinions, the examiner must address the May 2016 Baylor Neurology Case of the Month, which noted that "[t]he most common cause of parkinsonism worldwide is idiopathic Parkinson's disease (IPD), a progressive neurodegenerative condition. . . " - The examiner must also consider the Appellant's testimony that the Veteran was prescribed Busparione prior to his passing, a medication the Appellant asserts is provided for Parkinson's disease. - The examiner should also consider the Appellant's testimony that the Veteran began having symptoms within one year of discharge from service. The examiner must provide a rationale for any proffered opinion. If the examiner determines that the requested opinion cannot be rendered without resorting to speculation, the examiner must state whether the need to speculate is caused by a deficiency in the state of general medical knowledge (i.e. no one could respond given medical science and the known facts) or by a deficiency in the record or the examiner (i.e. additional facts are required, or the examiner does not have the needed knowledge or training). 4. Once the above request has been completed, to the extent possible, readjudicate the appeal. S. SORATHIA Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Hanson, Tiffany 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.