Citation Nr: 23007202 Decision Date: 02/03/23 Archive Date: 02/03/23 DOCKET NO. 16-06 566 DATE: February 3, 2023 REMANDED Service connection for a skin disorder of the hands is remanded. Service connection diabetes mellitus type II (DMII) is remanded. Service connection for bilateral peripheral neuropathy of the upper extremities, to include as secondary to DMII, is remanded. Service connection for bilateral peripheral neuropathy of the lower extremities, to include as secondary to DMII, is remanded. Service connection for a heart disorder is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1971 to July 1975. Rash DMII The Board sincerely regrets additional delay and is aware that the Veteran's case has been remanded several times prior. However, after review of the record the Board noted that in July 2021, VA attempted to confirm the Veteran's exposures to herbicides and other toxins while stationed at Pease Air Force Base in New Hampshire from 1973 to 1975. A records research response noted that the military records research center was not able to research the request because the Veteran's unit of assignment was not provided. No further action on resubmitting the request regarding the toxins to which the Veteran was exposed at Pease Air Force Base was undertaken. The Veteran's military personnel record shows that he was assigned to the 509 Munitions Maintenance Squadron while at Pease Air Force Base from at least February 1973 to June 1975. Thus, the information as to the unit of the Veteran's assignment is known and available for confirmation regarding the Veteran's exposures while at Pease Air Force Base. Remand is necessary to conduct a review for confirmation of the Veteran's exposures while at Pease Air Force Base. Furthermore, the medical opinions of evidence did not have benefit of the confirmation of the Veteran's exposures to toxins at Pease Air Force Base. Thus, those opinions are incomplete, and remand is necessary to obtain new examination opinions after the aforementioned research regarding toxic exposure has been conducted. Bilateral Upper & Lower Extremity Neuropathy The Veteran's bilateral upper and lower extremity neuropathy has been specifically linked to his diabetes. See March 2022 VA examination. Thus, service connection for these claims is intertwined with his claim for service connection for diabetes. The appropriate remedy where a pending claim is inextricably intertwined with a claim currently on appeal is to remand the claim on appeal pending the adjudication of the inextricably intertwined claim. Harris v. Derwinski, 1 Vet. App. 180 (1991). Heart As with the Veteran's above claims, the Board finds that the evidence of record is incomplete as to the confirmed exposures to which the Veteran was subjected while stationed at Pease Air Force Base. Furthermore, a May 2019 VA examination found that the Veteran's diabetes was a risk factor for his heart disorders. Thus, the Board finds that the issue of service connection for a heart disorder is intertwined with the Veteran's claim for service connection for diabetes. The appropriate remedy where a pending claim is inextricably intertwined with a claim currently on appeal is to remand the claim on appeal pending the adjudication of the inextricably intertwined claim. Harris v. Derwinski, 1 Vet. App. 180 (1991). The matters are REMANDED for the following action: 1. Undertake any development necessary to determine whether herbicide agents or other toxic chemicals were present in the soil, air, or groundwater at Pease Air Force Base either prior to or during the Veteran's service there. The Veteran's unit of assignment as documented in his military personnel file and noted above as "509 Munitions Maintenance Squadron" must be provided to the researching authorities. All attempts to secure this evidence must be documented in the claims file. All information obtained must be made part of the file. Any information obtained or any response to the requests for the information must be provided to the Veteran and his representative, along with an opportunity to respond. 2. Thereafter, should the response to directive No. 1, above, confirm the Veteran's exposure to herbicides or other toxins while stationed at Pease Air Force Base, and in the event presumptive service connection is not warranted, obtain VA examination opinions as follows: (a.) As to the Veteran's skin disorder, obtain an examination opinion from a dermatologist regarding the etiology of any skin disability of the hands diagnosed at any time during the course of the Veteran's appeal. The claims file should be made available to the examiner for review. The examiner must opine whether it is at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that any skin disability of the hands diagnosed at any time during the Veteran's appeal was incurred in, or due to, the Veteran's service, to include the confirmed toxic exposures as documented in the Veteran's file. (b.) As to the Veteran's diabetes, obtain an examination opinion from an endocrinologist regarding the etiology of the Veteran's diabetes. The claims file should be made available to the examiner for review. The examiner must opine whether it is at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) the Veteran's diabetes was incurred in, or due to, the Veteran's service, to include the confirmed toxic exposures as documented in the Veteran's file. (c.) As to the Veteran's heart, obtain a VA examination opinion from a cardiologist regarding the etiology of the Veteran's heart disorder. The claims file should be made available to the examiner for review. The examiner must opine whether it is at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's heart disorder was incurred in, or due to, the Veteran's service, to include any confirmed toxic exposures as documented in the Veteran's file; or was caused or aggravated by the Veteran's diabetes. The examiner is advised that for secondary service connection, "aggravation" need not be permanent in nature. Ward v. Wilkie, 31 Vet. App. 233, 241-42 (2019). The Veteran's lay statements regarding onset and continuity of symptomology should be recorded and considered. A rationale for all opinions must be provided. John Z. Jones Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Parrish 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.