ARTERIOSCLEROTIC HEART DISEASE (CORONARY ARTERY DISEASE)

Summary

The veteran, who served in the U.S. Air Force from January 1970 to September 1973 and November 1973 to August 1994, including service in the Southwest Asia theater of operations, appeals the denial of service connection for several conditions. The Board granted service connection for ischemic heart disease, prostate cancer residuals, erectile dysfunction, hypertension, COPD, and sarcoidosis. For ischemic heart disease and prostate cancer, service connection was granted on a basis other than the PACT Act, allowing for earlier effective dates, based on a finding of herbicide agent exposure in Thailand, which was previously established by the Board. For erectile dysfunction, service connection was granted prior to August 10, 2022, as it was secondary to the now service-connected prostate cancer, with an earlier effective date aligned with the primary condition. Hypertension was granted on a direct basis prior to August 10, 2022, with VA examiners opining a link to herbicide exposure in Thailand, and the Board resolving doubt in the veteran's favor. COPD and sarcoidosis were granted service connection presumptively under the PACT Act due to the veteran's service in the Southwest Asia theater of operations and presumed exposure to airborne hazards from burn pits. The Board remanded claims for bilateral hearing loss, blood clots in the right and left legs, fatigue, gastrointestinal disability, and pulmonary disability (on a basis other than the PACT Act) for further development, including obtaining specific VA medical opinions addressing etiology and nexus to service, particularly concerning toxic exposure risk activities and potential undiagnosed illnesses.

Rationale

Granted on basis other than PACT Act for earlier effective date; Veteran served in Thailand and was exposed to herbicide agents; Ischemic heart disease is a presumptive condition linked to herbicide exposure

Full Decision Text

Citation Nr: 26004781
Decision Date: 04/21/26	Archive Date: 04/21/26

DOCKET NO. 20-11 001
DATE: April 21, 2026

ORDER

Service connection for ischemic heart disease on a basis other than the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act (thus, prior to August 10, 2022), is granted. 

Service connection for prostate cancer residuals on a basis other than the PACT Act (thus, prior to August 10, 2022), is granted. 

Service connection for erectile dysfunction on a basis other than the PACT Act (thus, prior to August 10, 2022), is granted. 

Service connection for hypertension on a basis other than the PACT Act (thus, prior to August 10, 2022), is granted. 

Service connection for chronic obstructive pulmonary disease (COPD) is granted pursuant to the PACT Act.

Service connection for sarcoidosis is granted pursuant to the PACT Act.

REMANDED

Service connection for bilateral hearing loss is remanded.

Service connection for a disability manifested by blood clots in the right leg is remanded.

Service connection for a disability manifested by blood clots in the left leg is remanded.

Service connection for a disability manifested by fatigue is remanded.

Service connection for a gastrointestinal disability on a basis other than the PACT Act is remanded.

Service connection for a pulmonary disability on a basis other than the PACT Act is remanded.

FINDINGS OF FACT

1. The Veteran has current prostate cancer residuals and ischemic heart disease that are manifest to a degree of at least 10 percent, and the evidence is at least in approximate balance regarding whether he was exposed to herbicide agents on a facts-found basis while stationed in Thailand during military service.  

2. Veteran's erectile dysfunction was caused by prostate cancer, which is now service-connected on a basis other than the PACT Act. 

3. The Veteran's hypertension is related to his active duty service in the U.S. Air Force.

4. The Veteran has current COPD and sarcoidosis and served on active duty in the Southwest Asia theater of operations after August 2, 1990.  

CONCLUSIONS OF LAW

1. The criteria for service connection for prostate cancer residuals and ischemic heart disease prior to August 10, 2022, have been met.  38 U.S.C. §§ 1110, 1112, 1113, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309.

2. The criteria for service connection for erectile dysfunction prior to August 10, 2022, have been met.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.310.

3. The criteria for service connection for hypertension prior to August 10, 2022, have been met.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304.

4. The criteria for service connection for COPD and sarcoidosis have been met. 38 U.S.C. §§ 1110, 1119, 1120, 5107; 38 C.F.R. §§ 3.102, 3.303; the PACT Act, Pub. L. No. 117-168 § 3373, 136 Stat. 1759 (2022).

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from January 1970 to September 1973 and November 1973 to August 1994 in the United States Air Force.

These matters come before the Board of Veterans' Appeals (Board) on appeal from an April 2018 rating decision of the Department of Veterans Affairs (VA) Regional Office.

In November 2023, the Board adjudicated a number of claims, and remanded the issues above for further development.  In accordance with the remand directives, the VA Regional Office obtained additional VA medical opinions and developed the matter of the Veteran's exposure to herbicide agents during military service.  There has been substantial compliance with the Board's remand directives. Stegall v. West, 11 Vet. App. 268 (1998); see also Dyment v. West, 13 Vet. App. 141, 147 (1999) (requiring substantial compliance with Board remand directives).

In the
 appeal from an April 2018 rating decision of the Department of Veterans Affairs (VA) Regional Office.

In November 2023, the Board adjudicated a number of claims, and remanded the issues above for further development.  In accordance with the remand directives, the VA Regional Office obtained additional VA medical opinions and developed the matter of the Veteran's exposure to herbicide agents during military service.  There has been substantial compliance with the Board's remand directives. Stegall v. West, 11 Vet. App. 268 (1998); see also Dyment v. West, 13 Vet. App. 141, 147 (1999) (requiring substantial compliance with Board remand directives).

In the November 2023 adjudication, the Board awarded service connection for diabetes mellitus under the PACT Act.  To the extent the claim was not reopened on another basis, the Veteran appealed that determination to the United States Court of Appeals for Veterans Claims (Court).  In May 2024, the Court vacated the Board's decision regarding diabetes mellitus and remanded the matter to the Board for development consistent with the parties' Joint Motion for Partial Remand (Joint Motion).  In August 2024, the Board granted the claim for service connection for diabetes mellitus on a direct basis.  This claim has thus been fully resolved and will not be addressed below.

As a matter of clarification regarding the claims involving gastrointestinal disabilities, the appeal has been developed to include separate claims for a disability of the bowels, a disability of the colon, and diverticulitis.  These three claims were remanded by the Board in November 2023.  Subsequently, in an October 2024 rating decision, the VA Regional Office granted service connection for irritable bowel syndrome pursuant to the PACT Act.  The Board has thus consolidated the remaining claims (service connection for a disability of the colon and diverticulitis) and recharacterized the matter to include any gastrointestinal disability on a basis other than the PACT Act.  This claim is being remanded for development, as described below.

Similarly, with regard to the pulmonary disabilities, the appeal has been developed to include separate claims for a disability manifested by shortness of breath, as well as for a pulmonary disability including COPD.  In the decision here, the Board is awarding service connection for both COPD and sarcoidosis pursuant to the PACT Act.  The Board has recharacterized the remaining matter as a claim for service connection for a pulmonary disability on a basis other than the PACT Act, and is remanding it for development, as described below.

Service Connection

VA provides compensation for disability resulting from disease or injury incurred in or aggravated by service.  This is referred to as a "service connection."  38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303.  Regulations also provide that service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disability was incurred in service.  38 C.F.R. § 3.303(d).

Generally, in order to show a service connection, there must be competent, credible evidence of (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury.  See, e.g., Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Pond v. West, 12 Vet. App. 341 (1999). 

When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107(b).  Evidence is not in approximate balance or nearly equal, and therefore the benefit-of-the-doubt rule does not apply when the evidence persuasively favors one side or the other.  Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc).

1. Service connection for ischemic heart disease on a basis other than the PACT Act (thus, prior to August 10, 2022), is granted. 

2. Service connection for prostate cancer residuals on a basis other than the PACT Act (thus, prior to August 10, 2022), is granted. 

The Veteran has current prostate cancer residuals and ischemic heart disease.  See, e.g., August 2025 and June 2024 VA examination reports, respectively.

Service connection is currently in effect for both prostate cancer residuals and ischemic heart disease pursuant to the P
 Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc).

1. Service connection for ischemic heart disease on a basis other than the PACT Act (thus, prior to August 10, 2022), is granted. 

2. Service connection for prostate cancer residuals on a basis other than the PACT Act (thus, prior to August 10, 2022), is granted. 

The Veteran has current prostate cancer residuals and ischemic heart disease.  See, e.g., August 2025 and June 2024 VA examination reports, respectively.

Service connection is currently in effect for both prostate cancer residuals and ischemic heart disease pursuant to the PACT Act, with effective dates of August 10, 2022.  See December 2025 Rating Decision Code Sheet (most recent code sheet).  When a claim is granted based on the PACT Act, the earliest effective date assignable is August 10, 2022.  As explained by the Board in November 2023, remand for development of these claims was required to determine whether service connection may be awarded under a different theory of entitlement, thus allowing for effective dates earlier than August 10, 2022.

The PACT Act expanded the presumption of in-service herbicide agent exposure to service in Thailand, among other locations.  38 U.S.C. § 1116(d).  Prior to the enactment of the PACT Act, merely having service in Thailand at a United States or Royal Thai base did not establish exposure to herbicide agents.  Rather, such exposure had to be determined on a "facts found or direct basis."  In this regard, VA's Compensation & Pension Service issued information concerning the use of herbicide agents in Thailand during the Vietnam War.  In a May 2010 bulletin, Compensation & Pension Service determined that there was significant use of herbicide agents on the fenced in perimeters of military bases in Thailand intended to eliminate vegetation and ground cover for base security purposes. 

According to the bulletin, if a Veteran served on one of these air bases as a security policeman, security patrol dog handler, member of a security police squadron, or otherwise served near the air base perimeter, as shown by military occupational specialty, performance evaluations, or other credible evidence, then herbicide agent exposure was to be acknowledged on a "facts-found or direct basis."  The designated Thailand bases included the Royal Thai Air Force Bases of U-Tapao, Ubon, Nakhon Phanom, Udorn, Takhli, Korat, and Don Muang.  In other words, special consideration was to be given to veterans serving at one of the specified RTAFBs, including Korat Royal Thai Air Force Base, who had provided credible evidence that they were on or near the perimeter of the base.  

In an August 2024 decision, the Board determined that the Veteran was exposed to herbicide agents during military service in Thailand on a facts-found basis.  The Board noted that the Veteran's military personnel records show that he served on Ubon Royal Thai Air Force Base, and considered his statements that he regularly performed aircraft maintenance near the base perimeter.  See TSGT, SSGT, and SGT Performance Report, July 10, 1973; see also July 18, 2024, correspondence.  The Board found the Veteran's statements in this regard to be both competent and credible.  See 38 C.F.R. §3.159(a)(1) (defining competent lay evidence); 38 U.S.C. § 1154(a) (in each case where a veteran is seeking service-connection for any disability, due consideration shall be given to the places, types, and circumstances of such veteran's service).  The Board thus found that the Veteran served near the air base perimeter of Ubon Royal Thai Air Force Base and conceded his herbicide agent exposure on a direct or facts-found basis.  

Since the issuance of the Board's August 2024 decision, the record has not changed with regard to the matter of the Veteran's herbicide agent exposure on a facts-found basis.  No additional pertinent development has occurred.  Generally, the "law of the case" doctrine prohibits a different finding on an issue that has already been determined by the same body in the same case.  See Davis v. Collins, 38 Vet. App. 447 (2025) (the "law of the case" doctrine provides that, when a case is addressed by an appellate court, remanded, then returned to the appellate court, reconsideration of identical issues is precluded); Hazan v. Gober, 10 Vet. App. 511, 521 (1997) ("the principle of collateral estoppel forbids re-litigation of the same issue on the same facts
 exposure on a facts-found basis.  No additional pertinent development has occurred.  Generally, the "law of the case" doctrine prohibits a different finding on an issue that has already been determined by the same body in the same case.  See Davis v. Collins, 38 Vet. App. 447 (2025) (the "law of the case" doctrine provides that, when a case is addressed by an appellate court, remanded, then returned to the appellate court, reconsideration of identical issues is precluded); Hazan v. Gober, 10 Vet. App. 511, 521 (1997) ("the principle of collateral estoppel forbids re-litigation of the same issue on the same facts"); Browder v. Brown, 5 Vet. App. 268, 270 (1993) ("under the doctrine of 'law of the case,' questions settled on a former appeal of the same case are no longer open for review").  While the Board is not an appellate court, the underlying legal principal applicable here is that identical issues may not be relitigated in the same case where the set of facts is the same.  See also 38 C.F.R. § 20.1303 (the Board strives for consistency in issuing its decisions).  As the set of facts remain the same, the Board here too finds the Veteran was exposed to herbicide agents during service in Thailand on a direct basis, consistent with the August 2024 decision and its reasoning.  

Where herbicide-agent-exposed veterans develop certain diseases, those diseases are presumed to be due to that exposure.  38 C.F.R. §§ 3.307(a)(6), 3.309(e).  Throughout the appeal period (stemming from a January 2018 underlying claim), these diseases have included prostate cancer and ischemic heart disease.  Consequently, evidence of a nexus is not required.  With respect to the requirement that the disability manifests to a degree of 10 percent disabling or more as set forth under 38 C.F.R. § 3.307(a)(6)(ii), the Board notes that such has already been established.  See December 2025 Rating Decision Code sheet (most recent code sheet).  Accordingly, service connection for prostate cancer residuals and ischemic heart disease is warranted prior to August 10, 2022.

3. Service connection for erectile dysfunction on a basis other than the PACT Act (thus, prior to August 10, 2022), is granted. 

In addition to the above regulations, service connection may be granted for a disability that is proximately due to or the result of a service-connected disease or injury.  38 C.F.R. § 3.310(a).  Such secondary service connection is also warranted for any increase in severity of a nonservice-connected disability that is proximately due to or the result of a service-connected disability.  38 C.F.R. § 3.310(b).  In Spicer v. McDonough, 61 F.4th 1360 (Fed. Cir. 2023), the Federal Circuit Court of Appeals held 38 U.S.C. § 1110 employs only "but-for" causation in direct and secondary service connection claims.  Therefore, a service-connected disability need only be a contributing cause, not the contributing cause, to establish secondary service connection.

Here, service connection is already in effect for the Veteran's erectile dysfunction as secondary to his prostate cancer.  See October 2023 rating decision.  However, the effective date for an award of service connection on a secondary basis cannot precede the effective date for the primary condition on which the secondary condition is based.  See Ellington v. Peake, 541 F.3d 1364, 1369 (Fed. Cir. 2008) 

 (noting that effective dates for primary and secondary disabilities are afforded the same treatment under 38 C.F.R. § 3.400 and that secondary disabilities arise at the same time or after primary disabilities); see also 38 C.F.R. § 3.400(b)(2)(i). 

Here, the effective date for the award of service connection for erectile dysfunction has been constrained by that assigned to the primary disability of prostate cancer under the PACT Act.  As service connection for prostate cancer on a basis other than the PACT Act is being awarded herein, service connection for erectile dysfunction prior to August 10, 2022, must also be granted.  

4. Service connection for hypertension on a basis other than the PACT Act (thus, prior to August 10, 2022), is granted. 

The Veteran has current hypertension.  See, e.g., June 2024 VA examination report.   Service connection is currently in effect for this disability pursuant to the PACT Act's
)(2)(i). 

Here, the effective date for the award of service connection for erectile dysfunction has been constrained by that assigned to the primary disability of prostate cancer under the PACT Act.  As service connection for prostate cancer on a basis other than the PACT Act is being awarded herein, service connection for erectile dysfunction prior to August 10, 2022, must also be granted.  

4. Service connection for hypertension on a basis other than the PACT Act (thus, prior to August 10, 2022), is granted. 

The Veteran has current hypertension.  See, e.g., June 2024 VA examination report.   Service connection is currently in effect for this disability pursuant to the PACT Act's addition of hypertension to the list of diseases eligible for presumptive service connection based on herbicide agent exposure, and thus an effective date of August 10, 2022, has been assigned.  See December 2025 Rating Decision Code Sheet (most recent code sheet).  As above, the Board must undertake an analysis of whether service connection may be awarded on a basis other than the PACT Act so as to enable an earlier effective date.

As determined above, the Veteran was exposed to herbicide agents during service in Thailand on a facts-found basis.  As for the etiology of the current hypertension, the record contains two opinions.

On VA examination in December 2023, the examiner opined that it is more likely than not that the Veteran's current hypertension is related to his military service in Thailand.  The examiner stated that Agent Orange exposure is a known risk factor in the development of hypertension, and that the Veteran served in Thailand where herbicide agents were used during the course of his military service.

On VA examination in June 2024, the examiner noted that the Veteran's service separation document (DD Form 214) shows that he served in Thailand for 460 days during military service.  The examiner stated that medical literature has established a positive association between exposure to Tetrachlorodibenzodioxin (an herbicide agent) and the development of hypertension.

There is no evidence to the contrary of the above regarding the matter of direct service connection, and the Court has cautioned VA against seeking a medical opinion where favorable evidence in the record is unrefuted. See Mariano v. Principi, 17 Vet. App. 305, 312 (2003).  Additionally, the opinions of the VA examiners are fully adequate for adjudication as they based their findings on a review of pertinent records and provided a rationale for the conclusions reached.  See Stefl v. Nicholson, 21 Vet. App. 120, 123 (2007).  

Thus, on this record, the evidence is in at least in approximate balance in showing that the Veteran's hypertension is directly attributable to service.  In resolving any doubt in his favor, service connection is warranted.

5. Service connection for COPD is granted pursuant to the PACT Act.

6. Service connection for sarcoidosis is granted pursuant to the PACT Act.

The PACT Act provides that exposure to burn pits and other toxins (BPOT) is presumed for veterans who served in specific locations or after specific dates.  38 U.S.C. § 1119.  Here, the Veteran's service personnel records and service separation document (DD Form 214) establish BPOT exposure as he served in the Southwest Asia theater of operations, as defined by 38 C.F.R. § 3.317(e)(2), for at least one day between August 1, 1991, and September 10, 2001.  See also VA Memoranda dated from December 2022, January 2023, July 2023, and October 2023.  

Certain enumerated diseases will be presumed related to service for veterans with in-service toxic exposure, to include BPOT exposure.  38 U.S.C. § 1120.  Both COPD and sarcoidosis are included among those enumerated diseases, and the shows that the Veteran has a current diagnosis of both disabilities. See August 2025 VA examination reports.  The Board notes that COPD and sarcoidosis are separate and distinct disabilities, rated under separate diagnostic codes.  See 38 C.F.R. § 4.96, Diagnostic Codes 6604 (COPD) and 6846 (sarcoidosis).  Accordingly, separate ratings in this regard are not precluded by 38 C.F.R. § 4.96.  

Accordingly, service connection is warranted for COPD and sarcoidosis on a presumptive basis given the Veteran's presumed BPOT exposure, pursuant to the PACT Act.  See 38 U.S.C. §§ 1119, 1120.  As noted in the Introduction section above, the Veteran's entitlement to service connection
 The Board notes that COPD and sarcoidosis are separate and distinct disabilities, rated under separate diagnostic codes.  See 38 C.F.R. § 4.96, Diagnostic Codes 6604 (COPD) and 6846 (sarcoidosis).  Accordingly, separate ratings in this regard are not precluded by 38 C.F.R. § 4.96.  

Accordingly, service connection is warranted for COPD and sarcoidosis on a presumptive basis given the Veteran's presumed BPOT exposure, pursuant to the PACT Act.  See 38 U.S.C. §§ 1119, 1120.  As noted in the Introduction section above, the Veteran's entitlement to service connection for a pulmonary disability on grounds other than the PACT Act is being remanded below.  

REASONS FOR REMAND

1. Service connection for bilateral hearing loss is remanded.

2. Service connection for a disability manifested by blood clots in the right leg is remanded.

3. Service connection for a disability manifested by blood clots in the left leg is remanded.

4. Service connection for a disability manifested by fatigue is remanded.

5. Service connection for a gastrointestinal disability on a basis other than the PACT Act is remanded.

6. Service connection for a pulmonary disability on a basis other than the PACT Act is remanded.

Pursuant to 38 C.F.R. § 19.31, the VA Regional Office will provide a supplemental statement of the case (SSOC) to the appellant when there are any material changes in or additions to the information included in the statement of the case or any prior SSOC, to include receipt of additional pertinent evidence.  

In January 2026, the Board sent the Veteran a letter asking him whether he waived his right to have the case remanded to the VA Regional Office for the initial review of pertinent evidence, including numerous VA examination reports, associated with the claims file by VA since the VA Regional Office's last readjudication of the claims in October 2024.  The Veteran was advised that the Board would remand the appeal if a response was not received within 45 days.  As no response was received, the appeal must be remanded.

Additionally, on review of the development conducted since the last remand of November 2023, the Board finds that the VA Regional Office has not substantially complied with the remand directives regarding the claim for service connection for hearing loss.  Stegall v. West, 11 Vet. App. 268 (1998).  Specifically, while a VA examination was conducted in August 2024, the examiner failed to address the Veteran's participation in toxic exposure risk activities (TERAs) during military service.  See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007) (when VA undertakes to provide a VA examination, it must ensure that the examination is adequate.)

Section 303 of the PACT Act provides that if a Veteran submits a claim of service connection with evidence of disability and evidence of participation in TERA, then VA shall obtain a medical opinion as to whether it is at least as likely as not that there is a nexus between the disability and the TERA.  38 U.S.C. § 1168; see also 38 U.S.C. §§ 1710(e)(4), 1119; 38 C.F.R. § 3.320.  No exception to the TERA opinion requirements applies to bilateral hearing loss, as this disability is not considered a physical trauma.  As the Veteran participated in a TERA during military service and has current bilateral hearing loss, this opinion must be obtained.  See VA Memoranda dated from December 2022, January 2023, July 2023, and October 2023; February 2020 VA examination report.  

The matters are REMANDED for the following action:

1. Obtain a VA audiological opinion to obtain evidence addressing the etiology of the Veteran's bilateral hearing loss.  A rationale must be provided for all conclusions reached.

(A.) Opine on whether it is approximately at least as likely as not that the Veteran's bilateral hearing loss began during active service or is related to an in-service injury, event, or disease, to particularly include his exposure to fine particulate matter or other toxic risk exposure activity during service in the Southwest Asia theater of operations, herbicide agent exposure, and in-service hazardous noise exposure.  Why or why not?  

In doing so, the examiner must presume that the Veteran was exposed to fine, particulate matter from burn pits due to his service in the Southwest Asia theater of operations and consider (1) the total potential exposure through all applicable deployments; and (2) the synergistic, combined effect of all toxic exposure risk activities of the Veteran. 

(B.)
 whether it is approximately at least as likely as not that the Veteran's bilateral hearing loss began during active service or is related to an in-service injury, event, or disease, to particularly include his exposure to fine particulate matter or other toxic risk exposure activity during service in the Southwest Asia theater of operations, herbicide agent exposure, and in-service hazardous noise exposure.  Why or why not?  

In doing so, the examiner must presume that the Veteran was exposed to fine, particulate matter from burn pits due to his service in the Southwest Asia theater of operations and consider (1) the total potential exposure through all applicable deployments; and (2) the synergistic, combined effect of all toxic exposure risk activities of the Veteran. 

(B.) Opine on whether it is approximately at least as likely as not that the Veteran's bilateral hearing loss disability constitutes an "undiagnosed illness" or a "medically unexplained chronic multisystem illness (MUCMI)."  The examiner is advised that an illness can be a MUCMI where either the etiology or the pathophysiology of the illness is inconclusive.

2. Readjudicate the appeal, considering all evidence added to the claims file since the October 2024 Supplemental Statement of the Case (SSOC).  If the benefits sought are not granted, provide the Veteran and his representative with an SSOC.

 

 

G. E. Wilkerson

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	J. Smith, 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.