Citation Nr: 19102374 Decision Date: 01/10/19 Archive Date: 01/09/19 DOCKET NO. 11-17 477 DATE: January 10, 2019 REMANDED Entitlement to service connection for Parkinson's disease, to include as due to herbicide and other chemical exposure, and as secondary to a service-connected disability, is remanded. REASONS FOR REMAND The Veteran had active service from August 1970 to February 1972. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a November 2010 rating decision of the Department of Veterans Affairs (VA), Regional Office (RO), in Houston, Texas. This matter was previously before the Board in August 2016 at which time it was remanded for additional development. It is now returned to the Board. Entitlement to service connection for Parkinson's disease, to include as due to herbicide and other chemical exposure, and as secondary to a service-connected disability. The Veteran asserts that he has developed Parkinson’s disease as a result of his period of active service as a Chaparral crewman. He contends that his duties in service included driving trucks carrying large drums (some with orange stripes around them-which he asserts indicated they contained Agent Orange) from motor pool to the airfields. In a sworn affidavit, corroborated by a sworn affidavit by a former fellow service member, he reports he was involved in a near-collision with another vehicle, which caused three large drums in the back of his truck to tumble and spill their contents, and that he and another service member righted the drums, wiped away the spillage, and delivered the drums without reporting the incident. He states that one of the three drums that spilled had a pump attached, and an orange band painted around it (indicating Agent Orange), therefore, exposing him to herbicides in service. The Veteran did not have service in the Republic of Vietnam, the Republic of Korea, or in Thailand. He alleges exposure to herbicides while stationed at Ft. Bliss, Texas, from cleaning and maintaining vehicles and equipment being sent home from war missions in Vietnam. He specifically identified vehicles and equipment to include tanks, Vulcan Gatling gun, and Chaparral surface-to-air missile system. He also alleges exposure to herbicides while stationed at Ft. Bliss, Texas, in the incident described above wherein drums in the back of his vehicle tumbled and spilled their contents. In November 2018, the Department of Defense (DOD) provided VA’s Compensation Service with a listing of locations outside Vietnam and the Korean Demilitarized Zone (DMZ) where Agent Orange was used, tested, or stored. The Department of Defense indicated that it had not identified Fort Bliss as a location where Agent Orange was used, tested, stored, or transported. Agent Orange was developed for jungle combat operations in Vietnam and was used there from 1962 to early 1971. There were no combat operations at this location during those years, and so there had been no need for Agent Orange use there. Additionally, this location was not on the Agent Orange shipping supply line, which went directly from storage at Gulfport, Mississippi, to South Vietnam via merchant ships. Also, there is no scientific evidence available to VA showing that being in the vicinity of aircraft or equipment previously used in Vietnam can be considered as exposure to active Agent Orange or can result in long-term health effects. All evidence shows that any herbicide use the claimant or others observed, or were associated with, was the commercial variety, not Agent Orange. Correspondence from the Armed Forces Pest Management Board received in October 2018 shows that the equipment identified by the Veteran was not used for herbicide application. Determining if such equipment posed an occupational health hazard from exposure to herbicides for personnel conducting maintenance was said to be outside the purview of the Armed Forces Pest Management Board. A private medical record from J. A. C., M.D., dated in July 2016 considers the Veteran’s asserted exposure to herbicides, exposure to lead from gun smoke, and his service-connected noise induced hearing loss, to suggest that they combine to accelerate the disease process that resulted in his Parkinson's disease. Dr. C. explained that noise induced hearing loss leads to reduced levels of anti-oxidants setting up the body for neurodegeneration and inflammation which can manifest as Parkinson’s disease. Toxic heavy metal exposure, such as lead from gun smoke exposure, was said to increase oxidative stress further lowering the body’s anti-oxidant levels, and resulting in permanent severe neurological disorders, to include Parkinson’s disease. Dr. C. also explained that environmental chemical exposure is associated with neurodegenerative diseases including Parkinson’s disease. The combined effect of these agents with toxic metals was thought to be logarithmic, thus, accelerating the disease process. Although the Veteran’s speculative belief that he was exposed to Agent Orange during service is contrary to the DOD’s position on where Agent Orange was used and stored, the opinion from Dr. C. raises additional theories of entitlement that were not previously considered by the RO. In this regard, the manifestation of the Veteran’s asserted Parkinson's disease as a result of exposure to lead from gun smoke and as secondary to the service-connected bilateral hearing loss must be further developed. See Robinson v. Peake, 21 Vet. App. 545, 553 (2008), aff’d sub nom. Robinson v. Shinseki, 557 F.3d 1355 (Fed. Cir. 2009); see also Schroeder v. West, 212 F.3d 1265, 1271 (Fed. Cir. 2000) (Upon the filing of a claim for benefits, VA generally must investigate the reasonably apparent and potential causes of the Veteran’s condition and theories of service connection that are reasonably raised by the record or raised by a sympathetic reading of the claimant’s filing, including those unknown to the Veteran.). The matter is REMANDED for the following action: 1. Seek an opinion, report, or other appropriate evidence from an environmental toxicologist specializing in lead from gun smoke to address the question of whether it is at least as likely as not that the Veteran was exposed to toxic heavy metal from gun smoke. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of his asserted Parkinson's disease. The examiner must opine whether it is at least as likely as not related to an in-service injury, event, or disease, including exposure to toxic heavy metal, such as lead, from gun smoke. The examiner must also opine as to whether it is at least as likely as not that the asserted Parkinson's disease either (a) was caused by or (b) is aggravated by a service-connected disability, to specifically include the service-connected bilateral hearing loss. (Continued on the next page)   In rendering the requested opinions, the examiner is directed to consider the July 2016 opinion from Dr. C. L. B. CRYAN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD D. Orfanoudis, Counsel