BVA9508093 DOCKET NO. 93-14 915 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUE Entitlement to service connection for residuals of lead and chemical exposures, submandibular adenopathy (claimed as a neck disorder), heart disease, an acquired eye disability, and a chronic muscle disorder. REPRESENTATION Appellant represented by: AMVETS ATTORNEY FOR THE BOARD Richard F. Williams, Counsel INTRODUCTION The veteran served on active duty from November 1960 to May 1980. This matter originally comes to the Board of Veterans' Appeals (Board) on appeal from an October 1991 decision by the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida, which denied service connection for residuals of lead and chemical exposures, submandibular adenopathy (claimed as a neck disorder), heart disease, an eye disorder, including presbyopia, and a chronic muscle disorder. REMAND At least some of the veteran's claims for service connection are well-grounded, meaning they are not inherently implausible, and a review of the file reveals there is a further duty to assist him in developing facts pertinent to these claims. 38 U.S.C.A. § 5107(a) (West 1991); 38 C.F.R. §§ 3.103, 3.159 (1994). The veteran alleges that he has residuals of exposure to lead and various toxic chemicals, particularly UDMH, identified as a missile propellant fluid, during his more than 20 years of active service. He also states that his duties during service included welding, soldering, painting, and working with batteries that contained lead and acid. He further avers, in essence, that the recurrent swollen and painful joints, neck and muscle aches, and other symptoms first reported during service represented the early manifestations of some of his current chronic disabilities. It is requested on behalf of and by the veteran that he be accorded a thorough examination by a specialist to determine if he has residuals of lead and chemical exposures. A review of the service medical records shows that the veteran was seen on numerous occasions throughout his more than 20 years of service for musculoskeletal complaints, including multiple joint pain. While lead or chemical exposure was not implicated and a history of minor trauma was at times noted, the etiology of his musculoskeletal symptoms was reported as unknown on a number of occasions. Moreover, the record does confirm some of the claimed exposure, including UDMH. (See service medical records dated in March 1976.) The veteran has undergone fairly extensive examinations in recent years to evaluate the symptoms which he now attributes to incidents of service, including neurological and rheumatologic evaluations. While a definitive diagnosis was not established, an organic disease of unknown etiology was suspected and further investigation was recommended. (See reports of neurological and rheumatologic examinations dated from April to July 1990.) It is my judgment that a thorough VA examination, including examination by a specialist in toxicology is warranted. Green v. Derwinski, 1 Vet.App. 121 (1991); Hyder v. Derwinski, 1 Vet.App. 221 (1991). The veteran also alleges service connection is warranted for an eye disorder. While the RO held that presbyopia is a refractive error and, therefore, is not a disability for VA compensation purposes, 38 C.F.R. § 3.303(c) (1994), it is argued on behalf of the veteran that a contemporaneous eye examination is indicated because the service medical records show that he sustained a penetrating eye injury while on active duty. A review of the record confirms that he was treated for a foreign body in the left eye (See service medical records dated in April 1973 and March 1980.) The Board agrees that a contemporaneous ophthalmological examination is indicated. Green, 1 Vet.App. 121. It is also apparent that there may be additional VA and private clinical evidence available that is relevant to this appeal. The duty to assist includes obtaining all relevant records. Murphy v. Derwinski, 1 Vet.App. 78 (1990); Littke v. Derwinski, 1 Vet.App. 90 (1990). Hence, the case is REMANDED to the RO for the following actions: 1. The RO should ask the veteran, with the assistance of his representative, to prepare a detailed list of all sources (VA or non-VA) of examination and treatment for the disabilities at issue. Names and addresses of the medical providers, and dates of examination and treatment, should be listed. After obtaining any needed release forms from him, the RO should directly contact the medical providers and obtain all relevant records that are not currently on file. 38 C.F.R. § 3.159. 2. The veteran should undergo a VA examination performed by a specialist in toxicology for the purpose of determining the etiology and severity of all symptoms and clinical findings that he is alleging are due to lead and chemical exposures during service. The examiner should opine whether it is at least as likely as not that any pathology that is identified began during or as the result of any incident of service, including the exposure to UDMH and other alleged exposures. All indicated studies or tests should be conducted. Any recommended additional examinations (i.e., orthopedic, neurologic, rheumatologic, etc.) should be performed. A copy of this Remand and the claims file must be made available to and reviewed by the examiner prior to the requested examination. 3. The veteran should undergo a VA eye examination for the purpose of determining the etiology and extent of any eye disability currently present. All indicated studies or tests should be conducted. The examiner should note the presence or absence of any residuals of a left eye injury. A copy of this Remand and the claims file must be made available to and reviewed by the ophthalmologist prior to the requested examination. 4. Thereafter, the RO should review the claims for service connection for residuals of lead and chemical exposures, submandibular adenopathy (claimed as a neck disorder), heart disease, an acquired eye disability, and a chronic muscle disorder. If any claim remains denied, the veteran and his representative should be issued a supplemental statement of the case, and they should be provided an opportunity to respond. Then the case should be returned to the Board. J. E. DAY Member, Board of Veterans' Appeals The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___ (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. Under 38 U.S.C.A. § 7252 (West 1991), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Veterans Appeals. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (1994).