DIABETES MELLITUS

NEELY M. PEDEN · 2026 · Case ID: A26033514

MIXED

Summary

The veteran, who served in the United States Army from December 1968 to July 1970, appeals the denial of service connection for glaucoma and interstitial lung disease, and the remand of hypertension on a direct basis. The Board granted service connection for diabetes mellitus type II, hypertension (presumptively under the PACT Act), and coronary artery disease. It also granted service connection for heart failure secondary to the newly granted coronary artery disease. The Board found the Veteran was exposed to an herbicide agent during service in Korea, resolving reasonable doubt in his favor due to balanced evidence, including his consistent testimony and that of fellow service members, despite a lack of specific records from the relevant period. This presumptive exposure led to the grant of service connection for diabetes, coronary artery disease, and hypertension. However, the claim for glaucoma was denied, as the Board found no competent medical opinion linking it to service-connected diabetes or herbicide exposure, and no positive association between glaucoma and herbicide exposure exists per VA regulations. The Board also noted that the Veteran's lay testimony regarding glaucoma was not medically competent. The claims for hypertension on a direct basis and interstitial lung disease were remanded for the agency of original jurisdiction to obtain medical opinions regarding the nexus to herbicide exposure, as required by the PACT Act.

Rationale

Veteran diagnosed with diabetes; Diabetes is presumptively linked to herbicide exposure per 38 CFR 3.309(e); Reasonable doubt resolved in Veteran's favor regarding herbicide exposure

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

260113-612689

Full Decision Text

Citation Nr: A26033514
Decision Date: 04/10/26 Archive Date: 04/10/26

DOCKET NO. 260113-612689
DATE: April 10, 2026

ORDER

Entitlement to service connection for diabetes mellitus type II (diabetes) is granted.

Entitlement to service connection for hypertension is granted, pursuant to the PACT ACT.

Entitlement to service connection for coronary artery disease is granted.

Entitlement to service connection for heart failure, secondary to service-connected coronary artery disease, is granted.

Entitlement to service connection for glaucoma, claimed as related to in-service herbicide agent exposure, also claimed as secondary to service-connected diabetes, is denied.

REMANDED

Entitlement to service connection for hypertension on a direct basis is remanded

Entitlement to service connection for interstitial lung disease, claimed as related to in-service herbicide agent exposure, is remanded.

FINDINGS OF FACT

1. The evidence is evenly balanced as to whether the Veteran was exposed to an herbicide agent during active service.

2. The Veteran has been diagnosed with diabetes.

3. The Veteran has been diagnosed with hypertension.

4. The Veteran has been diagnosed with coronary artery disease.

5. The Veteran's heart failure is due to service-connected coronary artery disease.

6. The Veteran's glaucoma is not due to or aggravated by service-connected diabetes and not otherwise related to active service, to include in-service exposure to an herbicide agent.

CONCLUSIONS OF LAW

1. The criteria for entitlement to service connection for diabetes have been met on a presumptive basis. 38 U.S.C. §§ 1110, 1116, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

2. The criteria for entitlement to service connection for hypertension have been met on a presumptive basis, pursuant to the PACT Act. 38 U.S.C. §§ 1110, 1116, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

3. The criteria for entitlement to service connection for coronary artery disease have been met on a presumptive basis. 38 U.S.C. §§ 1110, 1116, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

4. The criteria for service connection for heart failure as secondary to service-connected coronary artery disease are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310.

5. The criteria for service connection for glaucoma, to include as secondary to service-connected diabetes, are not met. 38 U.S.C. §§ 1110, 1116, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran has active service in the United States Army from December 1968 to July 1970.

These matters come to the Board on appeal from rating decisions issued in August 2025 and October 2025. Each decision constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies.

In July 2025, the Veteran submitted a VA Form 20-0996, Decision Review Request: Higher-Level Review (HLR), and requested review of a July 2025 decision which denied service connection for hypertension and service connection for diabetes. In October 2025, the agency of original jurisdiction (AOJ) issued the HLR decision on appeal, which considered the evidence of record at the time of the prior July 2025 decision.

The August 2025 rating decision on appeal denied initial claims for service connection for heart failure, glaucoma, and interstitial lung disease. As will be discussed below, the claim for service connection for coronary artery disease is within the scope of the claim for service connection for heart failure. The August 2025 rating decision considered the evidence of record as of the date of that rating decision.

On his January 13, 2026, VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held on March 5, 2026.

Therefore, regarding the claims for service connection for heart failure, coronary artery disease, glaucoma, and interstitial lung disease,
on appeal denied initial claims for service connection for heart failure, glaucoma, and interstitial lung disease. As will be discussed below, the claim for service connection for coronary artery disease is within the scope of the claim for service connection for heart failure. The August 2025 rating decision considered the evidence of record as of the date of that rating decision.

On his January 13, 2026, VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held on March 5, 2026.

Therefore, regarding the claims for service connection for heart failure, coronary artery disease, glaucoma, and interstitial lung disease, the Board may only consider the evidence of record at the time of the August 2025 AOJ decision on appeal, as well as any evidence submitted by the Veteran or a representative at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801.

Regarding the claims for service connection for hypertension and for diabetes, the Board may only consider the evidence of record at the time of the July 2025 AOJ decision, which was subsequently subject to higher-level review, as well as any evidence submitted by the Veteran or a representative at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the decision, which was subsequently subject to higher-level review and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claims, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

However, because the Board is remanding the claims of service connection for hypertension on a direct basis and service connection for interstitial lung disease, any evidence the Board could not consider will be considered by the AOJ in the adjudication of those claims. 38 C.F.R. § 3.103(c)(2)(ii).

In DeLisio v. Shinseki, 25 Vet. App. 45, 54-55 (2011), the Court of Appeals for Veterans Claims (Court) stated that when a claim is pending and information obtained reasonably indicates that the claimed condition is caused by a disease or disability that may be associated with service, VA must investigate the possibility of secondary service connection; and, if that causal disease or disability is, in fact, related to service, the pending claim reasonably encompasses a claim for benefits for the causal disease or disability, such that no separate filing is necessary to initiate a claim for benefits for the causal disease or disability. Indeed, a claimant need not file a claim for benefits for the precise medical cause of his condition, as the law does not expect the claimant to have the medical or legal expertise to file a claim requesting benefits for each technical disability in the causal chain of disabilities that comprises his condition. See id; see also Brokowski v. Shinseki, 23 Vet. App. 79, 84 (2009); Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009).

In the instant case, the Veteran filed a claim for service connection for heart failure related to in-service exposure to an herbicide agent. A November 2023 VA treatment record documenting the Veteran's treatment for heart failure describes the recent onset of this condition as secondary to "ischemia from severe [coronary artery disease]." Coronary artery disease is form of ischemic heart disease that is presumptively caused by exposure to an herbicide agent. See 38 C.F.R. § 3.309(e). Therefore, the Board finds that a claim for service connection for coronary artery disease was reasonably encompassed by the Veteran's claim for service connection for heart failure.

Service Connection

Service connection may
, 5 (2009).

Service Connection

Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004).

Certain diseases may be presumed to be service-connected if manifested in a Veteran who was exposed to an herbicide agent during service. 38 C.F.R. § 3.307(a)(6).

Certain diseases specified in 38 U.S.C. § 1116 (a)(2), and additional diseases the Secretary determines warrant a presumption of service connection by reason of having positive association with exposure to an herbicide agent, listed in 38 C.F.R. § 3.309(e), are considered to have been incurred in or aggravated in the line of duty in the active military, naval, air, or space service, notwithstanding that there is no record of evidence of such disease during the period of such service. 38 U.S.C. § 1116B (a)(1). 38 U.S.C. § 1116B extended the presumption of herbicide agent exposure to veterans who, during active military, naval, or air service, served in or near the Korean DMZ during the period beginning on September 1, 1967, and ending on August 31, 1971. Even if a veteran did not serve in an area with presumed exposure to an herbicide agent, they may show that they were exposed to an herbicide agent on a facts-found basis.

1. Service Connection for Diabetes

The Veteran is seeking service connection for diabetes, claimed as related to in-service exposure to an herbicide agent.

Favorable findings made by the AOJ are binding on the Board unless rebutted by evidence of clear and unmistakable error. 38 C.F.R. § 3.104(c). The October 2025 rating decision on appeal made the favorable finding that the Veteran is diagnosed with diabetes. The Board accepts this finding of the AOJ. Diabetes is an enumerated disease listed in 38 C.F.R. § 3.309(e) as presumptively related to any presumed or proven in-service exposure to an herbicide agent. Therefore, the question remaining before the Board is whether the Veteran was exposed to an herbicide agent during his active service.

The evidence against the Veteran's claim includes an April 2025 records research response from the Veterans Benefits Administration, Field Operations, Records Acquisition and Research office. According to this report, a professional researcher from this office completed comprehensive research on the Veteran's claimed exposure while assigned to 260th Military Police Company Korea from June 1, 1969, to September 1, 1969. The researcher was unable to locate the 1969 unit history or operational reports-lessons learned for 260th Military Police Company or the 1969 unit history for 83rd Ordnance Battalion. The records they were able to locate did not mention the use or storage of herbicides or document any specific duties performed by the Veteran's unit along the DMZ.

The evidence in support of the Veteran's claim includes the Veteran's statements regarding his observations during his deployment to Korea from May 1969 to July 1970 as well as lay statements from other service members and the Veteran's family members. The Veteran has submitted multiple written statements since September 2009 as well as oral testimony at his March 2026 Board hearing. He has consistently described his primary duty in Korea as guarding an ammunition depot which had vegetation cleared from around its perimeter to allow clear lines of sight for the guards inside the perimeter. The Veteran described the dirt roads to and from this depot as free of vegetation. Although the Veteran did not observe anyone applying herbicides to this area, he believes that they were used because the area was consistently kept clear of vegetation and it was an uneven area where other common methods such as mowing would be impractical. Finally, he reported occasional temporary assignments accompanying convoys, flying in helicopters, and participating in trainings that occurred in various other parts of Korea. Although he did not know the exact locations, he believed one particular training was near or possibly inside the DMZ. Veterans AG and JB both wrote that they were assigned to the same location around the same time as the Veteran, although neither of them knew the Veteran at the time. Both gave descriptions of the area around the ammunition depot consistent with the Veteran's reports and JB reported personally observing use of an unknown chemical "weed killer" to keep the perimeter clear of vegetation. The Veteran's family members wrote that they remembered receiving a letter from the Veteran during his deployment saying that he would be participating in a training in or near the DMZ.

The Board notes that the report from the Records Acquisition and Research office covered only the three month period from June 1, 1969, to September 1, 1969, not considering the period from September 2, 1969, to the Veteran's departure from the area around July 1970. The report also mentioned being unable to locate several potentially relevant records. The Board finds that the Veteran's consistent descriptions of the vegetation free zone around the ammunition depot, consistent with the descriptions provided by JB and AG, and specifically JB's description of observing chemicals sprayed on vegetation in the area, are sufficient to put the evidence evenly balanced as to whether the Veteran was exposed to an herbicide agent during his service in Korea. Resolving reasonable doubt in favor of the Veteran, the Board finds that he was exposed to an herbicide agent during active service.

Because the Veteran was exposed to an herbicide agent during active service and has a currently diagnosed disability of diabetes mellitus type II, service connection for diabetes is warranted on a presumptive basis. See 38 C.F.R. §§ 3.307, 3.309(e).

2. Service Connection for Hypertension

The Veteran is seeking service connection for hypertension, claimed as related to in-service exposure to an herbicide agent.

Favorable findings made by the AOJ are binding on the Board unless rebutted by evidence of clear and unmistakable error. 38 C.F.R. § 3.104(c). The October 2025 rating decision on appeal made the favorable finding that the Veteran is diagnosed with hypertension. The Board accepts this finding of the AOJ. Under the PACT Act, hypertension has been added to the list of diseases that may be presumptively granted for veterans who were exposed to herbicide agents. See 38 U.S.C. § 1116; 38 C.F.R. §§ 3.307, 3.309; Honoring our PACT Act of 2022, Public Law No: 117-168, § 404, 136 STAT. 1759 (2022). Therefore, the question remaining before the Board is whether the Veteran was exposed to an herbicide agent during his active service.

As discussed in the previous section of this decision, the Board has resolved reasonable doubt in favor of the Veteran and found that he was exposed to an herbicide agent during active service. Accordingly, the Board finds that service connection for hypertension is warranted on a presumptive basis pursuant to the PACT Act.

In conclusion, because the Veteran was exposed to an herbicide agent during active service and has a currently diagnosed disability of hypertension, service connection for hypertension is warranted on a presumptive basis, pursuant to the PACT Act. See 38 U.S.C. § 1116; 38 C.F.R. §§ 3.307, 3.309; Honoring our PACT Act of 2022, Public Law No: 117-168, § 404, 136 STAT. 1759 (2022).

Entitlement to service connection for hypertension on a direct basis will be addressed in the remand section below.

3. Service Connection
hypertension is warranted on a presumptive basis pursuant to the PACT Act.

Entitlement to service connection for hypertension on a direct basis will be addressed in the remand section below.

3. Service Connection for Coronary Artery Disease

The Veteran's claim for service connection for heart failure reasonably encompasses a claim for service connection for coronary artery disease.

A November 2023 VA treatment record notes the Veteran's diagnosis of severe coronary artery disease. Coronary artery disease is a form of ischemic heart disease, an enumerated disease listed in 38 C.F.R. § 3.309(e) as presumptively related to any presumed or proven in-service exposure to an herbicide agent.

As discussed in the section of this decision addressing service connection for diabetes, above, the Board has resolved reasonable doubt in favor of the Veteran and found that he was exposed to an herbicide agent during active service.

Because the Veteran was exposed to an herbicide agent during active service and has a currently diagnosed disability of coronary artery disease, service connection for diabetes is warranted on a presumptive basis. See 38 C.F.R. §§ 3.307, 3.309(e).

4. Service Connection for Heart Failure

The Veteran is seeking service connection for heart failure, claimed as related to in-service exposure to an herbicide agent. Although the Veteran did not claim heart failure secondary to coronary artery disease, this theory of entitlement was raised by the record.

The Veteran's VA treatment records, including a November 2023 primary care provider note, describe the Veteran's treatment for heart failure with reduced ejection fraction as being secondary to ischemia from severe coronary artery disease. There is no competent medical opinion contradicting this finding or providing another explanation for the onset of the Veteran's heart failure.

The Board therefore finds that service connection for heart failure, secondary to service-connected coronary artery disease, is warranted. See 38 C.F.R. § 3.310.

5. Service Connection for Glaucoma

The Veteran is seeking service connection for glaucoma, claimed as secondary to service-connected diabetes, also claimed as related to in-service exposure to an herbicide agent.

Favorable findings made by the AOJ are binding on the Board unless rebutted by evidence of clear and unmistakable error. 38 C.F.R. § 3.104(c). The August 2025 rating decision on appeal made the favorable finding that the Veteran is diagnosed with glaucoma. The Board accepts this finding of the AOJ. As discussed in the section of this decision addressing service connection for diabetes, above, the Board has resolved reasonable doubt in favor of the Veteran and found that he was exposed to an herbicide agent during active service. In the same section of this decision, the Board granted service-connection for diabetes.

The questions that remain before the Board are whether the Veteran's glaucoma was caused or aggravated by his service-connected diabetes, and whether his glaucoma is related to any in-service injury, event, or disease.

There is no competent medical opinion of record supporting the Veteran's claims that his glaucoma was due to or aggravated by his service-connected diabetes or that it was caused by his in-service exposure to an herbicide agent.

The Veteran's service treatment records are silent for complaint, diagnosis, or treatment of glaucoma. Although years of post-service treatment records document treatment for glaucoma, they do not contain medical opinions as to the cause or aggravation of this condition.

The AOJ did not provide an examination or obtain medical opinions to assess the Veteran's claim.

The Veteran has participation in a toxic exposure risk activity (TERA) due to his exposure to an herbicide agent during active service. See 38 U.S.C. § 1119. However, although VA has an obligation to obtain medical opinions for any service connection claim which cannot be granted where there is evidence of a TERA and of a disability, VA has identified several exceptions to this general obligation where there is no indication of an association between the disability and the TERA. See 38 U.S.C. § 1168(b). Specifically, a TERA opinion is not required for disabilities that have not been shown to have any positive association with herbicide exposure. See VBA Letter 20-22-10 at 10-13, Processing Claims Involving the
risk activity (TERA) due to his exposure to an herbicide agent during active service. See 38 U.S.C. § 1119. However, although VA has an obligation to obtain medical opinions for any service connection claim which cannot be granted where there is evidence of a TERA and of a disability, VA has identified several exceptions to this general obligation where there is no indication of an association between the disability and the TERA. See 38 U.S.C. § 1168(b). Specifically, a TERA opinion is not required for disabilities that have not been shown to have any positive association with herbicide exposure. See VBA Letter 20-22-10 at 10-13, Processing Claims Involving the PACT Act, 87 Fed. Reg. 78,543 (Dec. 22, 2022). In this case, the Veteran's glaucoma is a disability of the eyes, which the Secretary has determined to have no positive association with herbicide exposure. Id. Thus, an exception to the TERA opinion requirements applies, and remand for an examination is not warranted on this basis.

A VA examination may also be necessary prior to final adjudication of a claim when there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability, (2) evidence establishing that an event, injury, or disease occurred in service, or evidence establishing certain diseases manifested during an applicable presumption period for which the Veteran qualifies, (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the Veteran's service or with another service-connected disability, but (4) there is insufficient competent medical evidence of record for VA to make a decision on the claim. 38 U.S.C. § 5103A(d); 38 C.F.R. § 3.159(c)(4); McLendon v. Nicholson, 20 Vet. App. 79 (2006).

At the time of the July 2025 rating decision, the Veteran's diabetes was not yet service-connected and the lay statement from JB describing application of an herbicide agent was not before the AOJ. The Veteran has not claimed, and the evidence at the time did not indicate, that any other service-connected disability caused or aggravated the Veteran's glaucoma, or that any in-service injury, event, or disease caused the Veteran's glaucoma. Therefore, the Board finds that the AOJ committed no error in choosing not to provide an examination or obtain medical opinions to further develop the Veteran's claim, and a remand on this basis is not required.

The Veteran believes his claimed glaucoma is related to his now service-connected diabetes, or to his in-service exposure to an herbicide agent. AG and JB generally expressed similar opinions. However, the Veteran and his co-servicemembers in this case are not competent to provide a nexus opinion regarding this issue. The issue is medically complex, as it requires knowledge of the interaction between multiple organ systems in the body, pathology, and interpretation of complicated diagnostic medical testing. Therefore, it is outside the competence of the Veteran and his co-servicemembers in this case because the record does not show that they have the medical training or credentials to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011).

The Board finds that, while the Veteran has a current diagnosis of glaucoma, he was exposed to an herbicide agent during service, and he has a service-connected disability of diabetes, the evidence of record persuasively weighs against finding that the Veteran's glaucoma began during service, is otherwise related to an in-service injury, event, or disease, or is caused or aggravated by his service-connected diabetes. The Board notes that should the Veteran obtain a medical nexus for the current glaucoma disability to his military service or service-connected disabilities, or any other new and relevant evidence, he can file a supplemental claim seeking to readjudicate the instant claim.

In conclusion, the Board finds that the evidence of record persuasively weighs against the Veteran's claim for service connection for glaucoma. As the evidence of record persuasively weighs against the Veteran's claim, the benefit-of-the-doubt rule does not apply. 38 U.S.C. § 5107(b); 38 C.F.R. §§ 4.3, 4.7; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. Dec. 17, 2021).

REASONS FOR REMAND

1. Service Connection for Hypertension on a Direct Basis

2. Service
file a supplemental claim seeking to readjudicate the instant claim.

REASONS FOR REMAND

1. Service Connection for Hypertension on a Direct Basis

2. Service Connection for Interstitial Lung Disease.

The Veteran is seeking service connection for hypertension on a direct basis and for interstitial lung disease. Although the Board has already granted service connection for hypertension on a presumptive basis under the PACT Act, this claim was filed before the August 10, 2022, effective date of the PACT Act, so service connection on a direct basis can potentially grant a greater benefit and remains an active claim.

Remand of each of these claims is required to obtain medical examinations and opinions pursuant to the PACT Act. See 38 U.S.C. § 1168. The PACT Act requires that, when a veteran whose active service subjected the veteran to participation in a toxic exposure risk activity (TERA) files a claim to service connect a disability and there is evidence of such disability, VA must provide the veteran with a VA examination and obtain a medical opinion addressing the possibility of a nexus between the claimed disability and the TERA. See 38 U.S.C. § 1168(a)(1).

As discussed above, the Board has found that the Veteran was exposed to an herbicide agent during active service. In addition, the August 2025 rating decision on appeal made a favorable finding that the Veteran has a diagnosis of interstitial lung disease and the October 2025 rating decision on appeal made a favorable finding that the Veteran has a diagnosis of hypertension. The Board accepts these findings of the AOJ.

Because the Board is unable to grant these claims at this time, and because the requirements to obtain medical opinions compliant with 38 U.S.C. § 1168 are met, but such opinions have not yet been obtained, a remand of each claim is needed for VA to obtain them.

The matters are REMANDED for the following action:

1. Provide the Veteran's claims file to an appropriate medical professional to obtain a medical opinion regarding the cause of his claimed hypertension. The examiner must review the claims file. At the examiner's discretion, if an in-person examination is necessary to provide the requested opinions, schedule the Veteran for an in-person examination. The examiner should respond to the following questions:

Is the Veteran's hypertension at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) related to the Veteran's in-service exposure to toxins due to in-service exposure to an herbicide agent during service in Korea. When providing this opinion, the examiner must consider:

(a.) the total potential exposure through all applicable deployments; and

(b.) the synergistic, combined effect of all toxic exposure risk activities of the Veteran.

2. Provide the Veteran's claims file to an appropriate medical professional to obtain a medical opinion regarding the cause of his claimed interstitial lung disease. The examiner must review the claims file. At the examiner's discretion, if an in-person examination is necessary to provide the requested opinions, schedule the Veteran for an in-person examination. The examiner should respond to the following questions:

Is the Veteran's interstitial lung disease at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) related to the Veteran's in-service exposure to toxins due to in-service exposure to an herbicide agent during service in Korea. When providing this opinion, the examiner must consider:

(a.) the total potential exposure through all applicable deployments; and

(b.) the synergistic, combined effect of all toxic exposure risk activities of the Veteran.

Neely M. Peden

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Zimmerman, Micah

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.

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