DERMATITIS OR ECZEMA

RYAN T. KESSEL · 2026 · Case ID: A26039661

MIXED

Summary

The Veteran, a Veteran who served from April 1984 to July 1997, including a deployment to the Korean DMZ in October 1986, appeals the denial of service connection for multiple conditions. The Veteran seeks service connection for a skin condition, sleep apnea, a psychiatric disorder (including MDD and PTSD), hypertension, a respiratory disorder (including COPD), a low back disorder, sciatica secondary to the low back disorder, and prostate cancer. The Board granted service connection for dermatitis/eczema, finding the evidence in equipoise and resolving doubt in the Veteran's favor, particularly given the unavailability of service treatment records and the Veteran's credible statements about an in-service chemical exposure in South Korea. The Board noted that while the VA examiner's opinion on the skin condition was mixed, the overall evidence, including post-service treatment records showing ongoing skin issues and lay statements corroborating the in-service incident, supported a grant. The remaining claims were remanded for further development. Specifically, the Board found duty-to-assist errors in the handling of the sleep apnea, psychiatric disorder, hypertension, respiratory disorder, low back disorder, sciatica, and prostate cancer claims. Remand directives include attempting to corroborate the claimed chemical exposure in Korea, obtaining new VA examinations for each of these conditions to determine their nature and etiology, and providing detailed nexus opinions regarding service connection, including consideration of the alleged chemical exposure and any applicable presumptions. The Board also noted the Veteran is currently unrepresented.

Rationale

Evidence in equipoise; Benefit of doubt resolved in Veteran's favor; Credible lay statements regarding in-service chemical exposure

Special Benefit

NO SPECIAL BENEFIT

Docket No.

200615-93465

Full Decision Text

Citation Nr: A26039661
Decision Date: 04/28/26 Archive Date: 04/28/26

DOCKET NO. 200615-93465
DATE: April 28, 2026

ORDER

Service connection for dermatitis/eczema is granted.

REMANDED

Service connection for a sleep disorder, to include sleep apnea and insomnia.

Service connection for a psychiatric disorder, to include major depressive disorder (MDD) and posttraumatic stress disorder (PTSD).

Service connection for hypertension.

Service connection for a respiratory disorder, to include chronic obstructive pulmonary disease (COPD).

Service connection for a low back disorder.

Service connection for sciatica secondary to a low back disorder.

Service connection for prostate cancer.

FINDING OF FACT

The Veteran's dermatitis/eczema is a result of service.

CONCLUSION OF LAW

The criteria for service connection for dermatitis/eczema have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty from April 1984 to July 1997.

The case is on appeal of December 2019 and March 2020 rating decisions.

In his July 2020 notice of disagreement (NOD), the Veteran elected the Hearing docket.

A Board hearing was held in May 2024.

Therefore, the Board may only consider the evidence of record at the time of the December 2019/March 2020 decisions, as well as any evidence submitted by the Veteran or 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 Regional Office (RO) issued the decisions 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. However, because the Board is remanding the claims service connection for sleep apnea, a psychiatric disorder, hypertension, a respiratory disorder, a low back disorder, sciatica, and prostate cancer, any evidence the Board could not consider will be considered by the RO in the adjudication of those claims. 38 C.F.R. § 3.103(c)(2)(ii).

The Board notes that the Veteran's NOD to the March 2020 rating decision is also timely as to the December 2019 rating decision. Thus, and although the March 2020 decision denied readjudicating the claims because no new and relevant evidence was received, as the December 2019 rating decision denied the claims on appeal on the merits, new and relevant evidence is not required to adjudicate the claims.

Although the Veteran initially sought service connection for MDD, as the evidence indicates he may be diagnosed with another psychiatric condition, the Board will consider all diagnosed psychiatric disorders. See Clemons v. Shinseki, 23 Vet. App. 1 (2009). See May 2024 Board Hearing Transcript. In addition, the Board has broadened the claims with respect to COPD and sleep apnea and will consider all diagnosed respiratory and sleep disorders. Id.

The Board notes that the Veteran was most recently represented in this appeal by an attorney. However, in April 2026, the Veteran revoked his appointment of the attorney representative. See April 2026 Correspondence & Third Party Correspondence. The Veteran has not appointed a new representative. As such, the Board recognizes the Veteran as currently unrepresented.

Service connection for a skin condition.

Legal Criteria

Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. §§ § 1110, 1131; 38 C.F.R. § 3.303. A veteran seeking compensation under these provisions must establish three elements: "(1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service." Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)).

In determining whether service connection is warranted, the Board shall consider the benefit-of-the-doubt doctrine
. § 3.303. A veteran seeking compensation under these provisions must establish three elements: "(1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service." Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)).

In determining whether service connection is warranted, the Board shall consider the benefit-of-the-doubt doctrine. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. The claimant is entitled to the benefit-of-the-doubt when the competing evidence is in "approximate balance" or "nearly equal." That is, exact equipoise is not required to trigger the favorable benefit-of-the-doubt rule. Lynch v. McDonough, 21 F.4th 776, 781 (Fed. Cir. 2021).

Analysis

The Veteran seeks service connection for a skin condition. In his August 2019 Correspondence, he stated that his skin rashes appeared after he was exposed to a chemical sprayed by North Korean aircraft, while deployed to the South Korean demilitarized zone (DMZ).

The Veteran's service personnel records (SPRs) reflect he was deployed to the DMZ in South Korea as part of a security detail in October 1986 during service. See July 2019 Military Personnel Record.

In a July 2019 letter, the RO notified the Veteran that his service treatment records (STRs) were unavailable and that further attempts to try to obtain the records would be futile. See July 2019 Correspondence; December 2019 rating decision. When service records are unavailable through no fault of the veteran, VA has a heightened duty-to-assist, as well as an obligation to explain its findings and conclusions and carefully consider the benefit-of-the-doubt rule. See Washington v. Nicholson, 19 Vet. App. 362, 369-70 (2005), Cuevas v. Principi, 3 Vet. App. 542, 548 (1992); O'Hare v. Derwinski, 1 Vet. App. 365, 367 (1991).

The available STRs provided by the Veteran include records in January 1988 noting an itchy, papular rash distributed about the arms and hands, assessed as possible eczema. Records in March 1988 reflect clusters of bumps/lesions on the right upper extremity with signs of weeping lesions. Records in December 1992 reflect a rash to the back of the neck assessed as tinea corporis. Records in February 1993 note a probable sebaceous cyst in the scalp. A March 1993 examination reflects tinea corporis and notes that intermittent eczema was controlled with topical steroids. Records in March 1997 reflect prescribed medication for eczema.

Non-VA treatment records in May 2024, received within 90 days of the hearing, include August 2018 records reflecting pityriasis rosea since 1987.

VA treatment records in March 2018 note a chronic rash off and on since 1986. Records in September 2018 note prednisone was prescribed for a diagnosis of erythema annulare centrifugum and that the condition had been ongoing since 1996. Records in October 2018 note a chronic skin condition since the Veteran was exposed to chemicals in 1987 in South Korea. December 2019 records note pityriasis rosea and dermatitis.

In a July 2019 Buddy/Lay Statement, B.G. noted the Veteran did not have a skin condition prior to service and recalled the Veteran's contemporaneous account of having been sent from Hawaii to the DMZ in South Korea to assist with the recovery efforts following a helicopter crash, during which the Veteran came into contact with a chemical agent, and after which he developed rashes.

In August 2019 Correspondence, the Veteran stated that the chemical incident at the Korean DMZ triggered a gas mask alarm and thereafter, he was taken to a decontamination area to be decontaminated and ordered to always keep his gas mask with him. He added that a couple of days later, after returning to Camp Humphreys, he felt a burning sensation underneath his skin and started breaking out with open, running lesions in the back of his hair line and neck, which eventually spread to his face, upper abdomen,
from Hawaii to the DMZ in South Korea to assist with the recovery efforts following a helicopter crash, during which the Veteran came into contact with a chemical agent, and after which he developed rashes.

The Veteran was afforded a VA examination in August 2019. The examiner indicated that it was both, at least as likely as not and less than likely, that the Veteran's skin condition is related to service. In addition, although the examination notes that the Veteran's in-service skin rashes resolved, as noted above, post-service treatment records show diagnoses, to include pityriasis rosea and dermatitis. The requirement of a "current disability" is satisfied if a disorder is diagnosed at the time a claim is filed or at any time during the pendency of the appeal; service connection may be awarded even though the disability resolves prior to adjudication of the claim. See McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). The standard is whether a disability exists at the time the claim was filed. See Romanowsky v. Shinseki, 26 Vet. App. 289, 293 (2013). Here, the evidence shows the Veteran had a skin condition at the time of the filing of the December 2019 Form 21-526EZ (Fully Developed Claim (Compensation)).

The Board notes that although an October 2018 pathology report was negative for pityriasis rosea and dermatitis, non-VA treatment records in February 2019 reflect that the results of a biopsy included pustular dermatitis suggestive of an involuting lesion of psoriasis, and differential diagnoses were pityriasis rosea, tinea corporis, and psoriasis.

At this juncture, the Board could remand the claim for another VA opinion. However, a request for an opinion could be construed as obtaining additional evidence for the sole purpose of denying the claim, which is impermissible. 38 C.F.R. § 3.304(c) ("The development of evidence in connection with claims for service connection will be accomplished when deemed necessary but it should not be undertaken when evidence present is sufficient for this determination"); Andrews v. McDonough, 34 Vet. App. 216 (2021) ("Remand is inappropriate where the predominant purpose is not to allow the Board to make a fully informed decision unencumbered by error but to allow VA to obtain more evidence so that it can properly deny the claim"). Here, there's probative evidence that the Veteran's current skin condition had its onset during, or is otherwise related to, service.

Although the Veteran is not competent to diagnose himself with a skin condition or to provide a medical nexus opinion, he is competent to attest to the symptoms he experiences and the duration of those symptoms. See Jandreau v. Nicholson, 492?F.3d 1372 (Fed. Cir. 2007). In addition, he has consistently reported that he has had skin symptoms since service.

The Board notes that the Veteran's burden of proof is one of equipoise and not certainty. As noted above, the Veteran is entitled to the benefit of the doubt when the evidence is in an approximate balance, i.e., nearly equal, and does not require the evidence to be in exact equipoise. See Lynch, 999 F.3d at 1391. Additionally, as noted above, the Veteran's STRs are unavailable and in addition to the Veteran's credible statements, and other lay statements, there is evidence tending to establish that his skin condition had its onset during, or is otherwise related to, service.

Here, the Board determines that the evidence has reached a level of equipoise as to the nexus element. This is particularly so when reasonable doubt is resolved in the Veteran's favor. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. Thus, service connection for dermatitis/eczema is warranted.

REASONS FOR REMAND

The Board notes that the summary of the remanded claims and remand directives below do not make any implicit findings regarding the competency or credibility of any of the evidence of record.

1. Service connection for sleep apnea.

The Veteran
to establish that his skin condition had its onset during, or is otherwise related to, service.

REASONS FOR REMAND

The Board notes that the summary of the remanded claims and remand directives below do not make any implicit findings regarding the competency or credibility of any of the evidence of record.

1. Service connection for sleep apnea.

The Veteran seeks service connection for sleep apnea. At the Board hearing, the Veteran's representative stated that the Veteran's sleep disorder, including sleep apnea and insomnia, is a result of service, to include exposure to chemicals while deployed to the South Korean DMZ.

The copies of the STRs provided by the Veteran in February 1993 reflect frequent early morning awakenings for six months, as well as trouble falling back asleep, with morning fatigue. The assessment was a sleep disorder.

VA treatment records in October 2018 reflect a diagnosis of sleep apnea. Records in June 2018 note insomnia.

In addition, the Veteran was afforded a VA examination in August 2019. The examination notes that the Veteran's sleep apnea was at least as likely as not related to service. However, the December 2019 rating decision states that sleep apnea had not been confirmed by sleep study. In that respect, an August 2019 sleep study states that the Veteran's sleep time was only 12 minutes and there was insufficient information to interpret sleep apnea.

In view of the evidence, the August 2019 VA examination relating sleep apnea to service is not adequate, particularly when resolving doubt in the Veteran's favor. In other words, in the absence of a sufficient sleep study, the record is unclear as to whether the Veteran suffers from a diagnosed sleep disorder or has symptoms that cause functional impairment. The RO's failure to afford the Veteran an adequate examination, to include a sleep study in this case, is a pre-decisional duty-to-assist error. Thus, remand for a VA examination is warranted. 38 C.F.R. § 20.802(a).

In addition, as noted above, the Veteran's SPRs reflect he was deployed to the DMZ in South Korea as part of a security detail in October 1986 during service. A March 2024 VA Memorandum reflects the Veteran did not participate in a TERA during service, including exposure to herbicides. However, there is no indication that the Veteran's assertion with respect to exposure to chemicals while deployed to the DMZ in South Korea in 1986 was considered. The Board notes that ineligibility for presumptive service connection does not preclude the Veteran from establishing service connection on a direct basis due to actual exposure to environmental toxins. See e.g. Combee v. Brown, 34 F.3d 1039, 1043-44 (Fed. Cir. 1994). As noted above, the Veteran's STRs are unavailable through no fault of his own. Here, the Board finds the RO's failure to attempt to verify the alleged in-service chemical exposure incident in Korea is a pre-decisional duty to assist error. Thus, remand to verify the alleged in-service chemical exposure incident is also warranted. 38 C.F.R. § 20.802(a).

2. Service connection for a psychiatric disorder, to include MDD and PTSD.

The Veteran seeks service connection for a psychiatric disorder. At the May 2024 Board hearing, he stated that his psychiatric disorder, to include MDD and PTSD, is a result of service, to include exposure to chemicals while deployed to the Korean DMZ, which caused him to be constantly on guard.

The December 2019 rating decision reflects a diagnosis of MDD.

VA treatment records in June 2019 note the Veteran had had depression for years. Records in September 2018 note MDD.

As noted above, the Veteran's SPRs reflect he was deployed to the DMZ in South Korea as part of a security detail in October 1986 during service. See July 2019 Military Personnel Record. A March 2024 VA Memorandum reflects the Veteran did not participate in a TERA during service, including exposure to herbicides. As noted above, although the Veteran's service was not during a presumptive period, a veteran may also establish service connection based on environmental exposures with proof of actual direct causation. See Combee, 34 F.3d at 104
records in June 2019 note the Veteran had had depression for years. Records in September 2018 note MDD.

As noted above, the Veteran's SPRs reflect he was deployed to the DMZ in South Korea as part of a security detail in October 1986 during service. See July 2019 Military Personnel Record. A March 2024 VA Memorandum reflects the Veteran did not participate in a TERA during service, including exposure to herbicides. As noted above, although the Veteran's service was not during a presumptive period, a veteran may also establish service connection based on environmental exposures with proof of actual direct causation. See Combee, 34 F.3d at 1043-1044. In addition, as noted above, the Veteran's STRs are unavailable through no fault of his own. Here, the Board finds the RO's failure to attempt to verify the alleged in-service chemical exposure incident at the Korean DMZ is a pre-decisional duty to assist error. Thus, remand to verify the alleged in-service chemical exposure incident is warranted. 38 C.F.R. § 20.802(a).

In addition, the Board finds that the evidence reflects a diagnosis of a psychiatric disorder but there is insufficient evidence of record to adjudicate the claim. Thus, the low threshold under McLendon v. Nicholson, 20 Vet. App. 79 (2006) has been met. The RO's failure to afford the Veteran an examination is a pre-decisional duty-to-assist error. Thus, remand for a VA examination is also warranted. 38 C.F.R. § 20.802(a).

3. Service connection for hypertension.

The Veteran seeks service connection for hypertension. At the May 2024 Board hearing, he asserted that hypertension is related to service, to include exposure to chemicals while deployed to the Korean DMZ as part of a security detail in October 1986 or is secondary to sleep apnea and a back disorder.

The December 2019 rating decision reflects favorable findings to include a current diagnosis of hypertension. See also December 2019 CAPRI (reflecting hypertension).

As noted above, the Veteran's STRs are unavailable through no fault of his own. Although the Veteran's service was not during a presumptive period, a veteran may also establish service connection based on environmental exposures with proof of actual direct causation. See Combee, 34 F.3d at 1043-1044. Here, the Board finds the RO's failure to attempt to verify the alleged in-service chemical exposure incident in South Korea is a pre-decisional duty to assist error. Thus, remand to verify the alleged in-service chemical exposure incident is warranted. 38 C.F.R. § 20.802(a).

Additionally, the Board finds the evidence of record, as indicated above, reflects a diagnosis of hypertension but there is insufficient evidence of record to adjudicate the claim. Thus, the low threshold under McLendon has been met. The RO's failure to afford the Veteran a VA examination is a pre-decisional duty-to-assist error. Thus, remand for a VA examination is also warranted. 38 C.F.R. § 20.802(a).

4. Service connection for a respiratory disorder, to include COPD.

The Veteran seeks service connection for a respiratory condition. At the May 2024 Board hearing, he asserted that his COPD had its onset in 1986 due to exposure to a chemical agent while deployed to the Korean DMZ in during service.

In addition, non-VA treatment records in March 2010 reflect asthma.

VA treatment records in October 2018 note that the Veteran's asthma was managed by Dr. Metter, a non-VA pulmonologist. See February 2019 STR. Records in December 2019 note the Veteran's history of pleuritic chest pain when coughing.

The Board finds that the evidence of record, as indicated above, reflects a diagnosis of a respiratory condition but there is insufficient evidence of record to adjudicate the claim. Thus,
cisional duty to assist error. Thus, remand to verify the alleged in-service chemical exposure incident is warranted. 38 C.F.R. § 20.802(a).

In addition, non-VA treatment records in March 2010 reflect asthma.

The Board finds that the evidence of record, as indicated above, reflects a diagnosis of a respiratory condition but there is insufficient evidence of record to adjudicate the claim. Thus, the low threshold under McLendon has been met. The RO's failure to afford the Veteran a VA examination is a pre-decisional duty-to-assist error. Thus, remand for a VA examination is also warranted. 38 C.F.R. § 20.802(a).

5. Service connection for a low back disorder, to include as secondary to sleep apnea.

6. Service connection for sciatica secondary to a low back disorder.

The Veteran seeks service connection for a low back condition and associated sciatica. At the May 2024 Board hearing, he stated that he began having muscle spasms in his back in 1996 as a result of heavy lifting in association with funeral detail during service and noted back surgery in 2023 and associated sciatica/lower extremity symptoms.

The December 2019 rating decision notes no diagnosis of a low back disorder. The Board notes that disability for VA purposes includes functional impairment, even in the absence of underlying pathology. See Saunders, 886 F.3d at 1356 (holding that pain causing functional impairment can constitute a current disability, even without an identifiable underlying pathology, provided that such pain is productive of functional impairment). More recently, the Court expanded this ruling and held that Saunders is not limited to pain, such that a disability for VA purposes includes any condition that results in functional impairment of earning capacity. See Martinez-Bodon v. Wilkie, 32 Vet. App. 393 (2020).

VA treatment records in July 2007 note back pain on and off since service. Records in December 2019 reflect prescribed medication for back pain/muscle spasm. Records in September 2018 note chronic low back pain. Further, private treatment records in May 2024, received within 90 days of the Board hearing, reflect degenerative disc disease at L5-S1.

The Board finds that the evidence of record, as indicated above, reflects a diagnosis of at least functional impairment due to a back condition but there is insufficient evidence of record to adjudicate the claim. Thus, the low threshold under McLendon has been met. The RO's failure to afford the Veteran a VA examination is a pre-decisional duty-to-assist error. Thus, remand for a VA examination is warranted. 38 C.F.R. § 20.802(a). The issue of service connection for sciatica is intertwined with the remanded back claim. Thus, that issue is also remanded.

7. Service connection for prostate cancer.

The Veteran seeks service connection for prostate cancer. At the May 2024 Board hearing, he asserted that his prostate cancer was a result of service, to include exposure to chemicals while deployed to the Korean DMZ during service in 1986.

The December 2019 rating decision reflects a diagnosis of prostate cancer. See also December 2019 CAPRI (reflecting prostate cancer).

As noted above, the Veteran's SPRs reflect he was deployed to the Korean DMZ as part of a security detail in October 1986 during service. A March 2024 VA Memorandum reflects the Veteran did not participate in a TERA during service, including exposure to herbicides. As noted above, a veteran may also establish service connection based on environmental exposures with proof of actual direct causation. See Combee, 34 F.3d at 1043-1044. Here, the Board finds the RO's failure to attempt to verify the alleged in-service chemical exposure incident in Korea is a pre-decisional duty to assist error. Thus, remand to verify the alleged in-service chemical exposure incident is warranted. 38 C.F.R. § 20.802(a).

In addition, as noted above, the Veteran's STRs are unavailable and the Board finds the evidence reflects a diagnosis of a prostate disorder but there is insufficient evidence of record to adjudicate the claim. Thus, the low threshold under McLendon has been met. The RO's failure to afford the Veteran an examination is a pre-decisional duty-to-ass
F.3d at 1043-1044. Here, the Board finds the RO's failure to attempt to verify the alleged in-service chemical exposure incident in Korea is a pre-decisional duty to assist error. Thus, remand to verify the alleged in-service chemical exposure incident is warranted. 38 C.F.R. § 20.802(a).

The matters are REMANDED for the following action:

1. Attempt to corroborate the Veteran's claimed in-service incident with respect to chemical exposure while deployed to the South Korean DMZ between in October 1986.

2. Then, schedule the Veteran for a VA examination by a qualified medical professional to determine the nature and etiology of the Veteran's sleep apnea. The claims file must be made available to and reviewed by the examiner. Any indicated studies should be performed, and all findings should be reported in detail.

The examiner should provide an opinion as to whether it is at least as likely as not (at least an approximate balance of positive and negative evidence) that sleep apnea had its onset during or within the initial year after service or is otherwise related to an in-service injury, event, or disease, including any hazardous environmental exposures while deployed to the South Korea DMZ in 1986.

The examiner should not rely on silence in the medical records unless it can be explained: (a) why the silence in the available records can be taken as proof that the symptoms did not occur, including why the fact would have normally been recorded if present, or (b) why the absence of medical records is medically significant.

Rationale for all opinions expressed should be provided. If the examiner is unable to provide the requested opinions without resort to speculation, it must be so stated, and he or she must provide the reasons why an opinion would require speculation.

3. Schedule the Veteran for a VA examination and opinion by a qualified psychiatrist to determine the nature and etiology of the Veteran's diagnosed psychiatric disorder, to include MDD and PTSD. The examiner should review the entire claims file and this remand in conjunction with the examination.

The examiner should identify all current psychiatric diagnoses. For any identified psychiatric condition, to include MDD and PTSD, the examiner should opine as to whether it is at least as likely as not that the condition had its onset during service or is etiologically related to an in-service stressor, to include a hazardous environmental exposure while deployed to the Korean DMZ in 1986.

If PTSD is diagnosed, the examiner should clearly identify the stressor used to support the diagnosis.

A rationale should be provided for opinions expressed. If an opinion cannot be offered without resorting to speculation, the reason for this should be fully explained in the opinion.

4. Schedule the Veteran for a VA examination by a qualified medical professional to determine the nature and etiology of the Veteran's hypertension. The claims file must be made available to and reviewed by the examiner. Any indicated studies should be performed, and all findings should be reported in detail.

The examiner should provide an opinion as to whether it is at least as likely as not (at least an approximate balance of positive and negative evidence) that hypertension had its onset during or within the initial year after service or is otherwise related to an in-service injury, event, or disease, including any hazardous chemical exposure while deployed to the Korean DMZ in 1986 during service, or was caused by or aggravated by, any disorder determined to be related to service, to include sleep apnea and a low back disorder.

Aggravation is an increase in severity of the disease.

If aggravation is found, the examiner should identify a baseline level of severity of the Veteran's hypertension by medical evidence created before the onset of aggravation or by the earliest medical evidence created at any time between the onset of aggravation and the receipt of medical evidence establishing the current level of severity of hypertension.

The examiner should not rely on silence in the medical records unless it can be explained: (a) why the silence in the available records can be taken as proof that
chemical exposure while deployed to the Korean DMZ in 1986 during service, or was caused by or aggravated by, any disorder determined to be related to service, to include sleep apnea and a low back disorder.

Aggravation is an increase in severity of the disease.

5. Schedule the Veteran for a VA examination by a qualified medical professional to determine the nature and etiology of the Veteran's respiratory disorder. The claims file must be made available to and reviewed by the examiner. Any indicated studies should be performed, and all findings should be reported in detail.

The examiner should provide an opinion as to whether it is at least as likely as not (at least an approximate balance of positive and negative evidence) that a respiratory disorder, to include COPD, had its onset during or within the initial year after service or is otherwise related to an in-service injury, event, or disease, including any chemical exposure while deployed to the Korean DMZ in 1986 during service.

6. Schedule the Veteran for a VA examination by a qualified medical professional to determine the nature and etiology of the Veteran's low back disorder and sciatica. The claims file must be made available to and reviewed by the examiner. Any indicated studies should be performed, and all findings should be reported in detail.

The examiner should provide an opinion as to whether it is at least as likely as not (at least an approximate balance of positive and negative evidence) that a low back disorder or sciatica had its onset during or within the initial year after service or is otherwise related to an in-service injury, event, to include heavy lifting.

7. Schedule the Veteran for a VA examination by a qualified medical professional to determine the nature and etiology of the Veteran's prostate cancer. The claims file must be made available to and reviewed by the examiner. Any indicated studies should be performed, and all findings should be reported in detail.

The examiner should provide an opinion as to whether it is at least as likely as not (at least an approximate balance of positive and negative evidence) that prostate cancer had its onset during or within the initial year after service or is otherwise related to an in-service injury, event, or disease, including any chemical exposure while deployed to the Korean DMZ in 1986 during service.

RYAN T. KESSEL

Veterans Law Judge

Board of Veterans' Appeals

Att

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