Citation Nr: 24006331 Decision Date: 02/06/24 Archive Date: 02/06/24 DOCKET NO. 20-21 675 DATE: February 6, 2024 REMANDED Entitlement to service connection for diabetes mellitus, to include as due to exposure to herbicide agents and other toxins, is remanded. Entitlement to service connection for glaucoma secondary to service-connected disability is remanded. Entitlement to service connection for diabetic retinopathy secondary to service-connected disability is remanded. Entitlement to service connection for a skin disorder, to include as due to exposure to herbicide agents and other toxins, is remanded. Entitlement to service connection for peripheral neuropathy of the right lower extremity, to include as due to exposure to herbicide agents and other toxins and as secondary to service-connected disability, is remanded. Entitlement to service connection for peripheral neuropathy of the left lower extremity, to include as secondary to service-connected disability, is remanded. REASONS FOR REMAND The Veteran had active service from December 1971 to August 1979. The Veteran died in January 2019. The appellant is the Veteran's surviving spouse who has been substituted for the purpose of processing the instant appeal to completion. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a November 2017 rating decision issued in November 2017 by a Department of Veterans Affairs (VA) Regional Office. 1. Entitlement to service connection for diabetes mellitus, to include as due to exposure to herbicide agents and other toxins, is remanded. 2. Entitlement to service connection for glaucoma secondary to service-connected disability is remanded. 3. Entitlement to service connection for diabetic retinopathy secondary to service-connected disability is remanded. 4. Entitlement to service connection for a skin disorder, to include as due to exposure to herbicide agents and other toxins, is remanded. 5. Entitlement to service connection for peripheral neuropathy of the right lower extremity, to include as due to exposure to herbicide agents and other toxins and as secondary to service-connected disability, is remanded. 6. Entitlement to service connection for peripheral neuropathy of the left lower extremity, to include as secondary to service-connected disability, is remanded. The Veteran contended that while stationed at Fort McClellan, Alabama in 1979, he was exposed to a variety of chemicals, to include herbicides and other toxins, that caused him to develop diabetes mellitus and associated glaucoma and retinopathy, a skin disorder, and peripheral neuropathy of the bilateral lower extremities. The Veteran has submitted a report titled "Likelihood of exposure to herbicide agents used in the Vietnam War by Veterans who served on Fort McClellan in Anniston, AL" authored by H.M., Ph.D., a report titled "Combined Environmental Exposure Report" prepared by the Veteran's representative, and other argument supported by medical treatises regarding the military use of herbicide agents and/or other toxins similar to those used in Vietnam, generally at Fort McClellan and in the city of Anniston, Alabama. However, these documents do not definitively establish whether herbicide agents were present at Fort McClellan when the Veteran was stationed there. Thus far, a request for such clarification has not been sent to the appropriate service agency. Such should be accomplished on remand. Moreover, while H.M. opined that it was, "her professional opinion as a weed scientist that it is more likely than not, and even to a reasonable degree of certainty, that those serving and/or living at Fort McClellan between 1974-1976 were exposed to the herbicide agents and/or toxins similar to the ones used in Vietnam and discussed within her report," as the Veteran was stationed at Fort McClellan in 1979, and because this report does not take into account the Veteran's specific circumstances of service, clarification of exposure is necessary. Moreover, as the record does not include a medical opinion as to the etiology of the Veteran's disorders that addresses his specific clinical history and circumstances of service, such should be obtained on remand. The matters are REMANDED for the following actions: 1. Contact the appropriate service agency or historical records agency to determine whether the Veteran was exposed to herbicide agents within the meaning of 38 C.F.R. § 3.307(a)(6)(i) while stationed at Fort McClellan, Alabama in 1979 (a date after such herbicide agents were used but may nonetheless have still been present at this site as the Veteran contends). The agency should be directed to review the Combined Environmental Exposure Report submitted for Fort McClellan; the report and opinion of Dr. H.M. entitled Likelihood of exposure to herbicide agents used in the Vietnam War by Veterans who served on Fort McClellan in Anniston, AL; and other medical treatises of record regarding the military's use of herbicide agents and/or other toxins. 2. Forward the record, to include a copy of this Remand, to an appropriate clinician for an opinion addressing the nature and etiology of the Veteran's diabetes mellitus, glaucoma, retinopathy, skin disorder, and bilateral lower extremity peripheral neuropathy. Following a review of the record, the clinician is asked to address the following: (a.) Identify all disorders associated with the Veteran's diabetes mellitus, type II, that have been diagnosed during the appeal, to include those proximate to his April 2017 claim, even if such was asymptomatic or had since resolved. (b.) Offer an opinion as to whether it is at least as likely as not (i.e., an approximately 50 percent or greater probability) that the Veteran's diabetes mellitus, type II, any skin disorder, and/or peripheral neuropathy of the lower extremities were related to his military service, to include any confirmed exposure to herbicide agents and/or toxins. (c.) Identify whether the Veteran had diagnoses of chloracne or other acneform consistent with chloracne. (d.) Identify whether the Veteran had early-onset peripheral neuropathy. In providing the foregoing, the clinician must address the Combined Environmental Exposure Report submitted for Fort McClellan; the report and opinion of Dr. H.M. entitled Likelihood of exposure to herbicide agents used in the Vietnam War by Veterans who served on Fort McClellan in Anniston, AL; and the other medical treatises of record regarding the military's use of herbicide agents and/or other toxins. A rationale should be provided for any opinion offered. M. M. Celli Acting Veterans Law Judge Board of Veterans' Appeals R. Erdheim, Counsel Department of Veterans Affairs 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.