Citation Nr: 18139986 Decision Date: 10/02/18 Archive Date: 10/02/18 DOCKET NO. 14-27 824 DATE: October 2, 2018 ORDER Entitlement to service connection for pseudofolliculitis barbae (PFB) is granted. REMANDED Entitlement to service connection for a neck condition is remanded. Entitlement to service connection for a lower back condition is remanded. Entitlement to service connection for shortness of breath is remanded. Entitlement to service connection for a sleeping disorder is remanded. Entitlement to a compensable initial rating for bilateral hearing loss is remanded. Entitlement to an initial rating in excess of 30 percent for unspecified depressive disorder (posttraumatic stress disorder (PTSD)) is remanded. FINDINGS OF FACT The Veteran’s PFB began during active service. CONCLUSIONS OF LAW The criteria for service connection for PFB are met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service from August 1980 to August 1983. Entitlement to service connection for pseudofolliculitis barbae Service connection may be established for a disease or injury incurred in or aggravated during service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. To prevail on the issue of service connection, there must be (1) evidence of a current disability; (2) evidence of in-service incurrence or aggravation of a disease or injury; and (3) evidence of a nexus between the claimed in-service disease or injury and the present disability. Hickson v. West, 12 Vet. App. 247 (1999). After considering all information including the lay and medical evidence of record in a case with respect to benefits under laws administered by the Secretary, when there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the benefit of the doubt will be given to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. The benefit of the doubt rule is inapplicable when the evidence preponderates against the claim. Ortiz v. Principi, 274 F.3d 1361 (Fed. Cir. 2001). The Veteran contends that his PFB began during his active service. The Board concludes that the Veteran has a current diagnosis of PFB that began during active service. 38 U.S.C. §§ 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). A June 2017 VA examination report, conducted at the Veteran’s request and apparently submitted by him, shows the Veteran maintains a ¼ inch beard and has papules on his face as a result of his PFB that he reported was diagnosed while he was on active duty and for which he was placed on a shaving profile. Service treatment records (STRs) also submitted by the Veteran confirm that he was placed on a shaving profile during his active service. Consequently, service connection is appropriate. REMANDED ISSUES 1. The issues of entitlement to service connection for a neck condition and entitlement to service connection for a lower back condition are remanded. With regard to the Veteran’s claims for a neck condition and a back condition, the only medical opinion as to the etiology of these conditions comes from an October 2012 VA examination which appears to have been rendered without the benefit of the Veteran’s STRs that he provided at least a partial copy of in response to the fact that his records could not be located. As a result, the examiner’s opinion is based on the understanding that there was only a single subjective report for both conditions during the Veteran’s active service. However, the STRs submitted by the Veteran document other instances of treatment, including an April 1983 sports injury that he identifies as related to his back and neck conditions in August 2018 correspondence. Consequently, the VA examination and opinion from October 2012 is no longer responsive to the evidence of record in this case, and a new opinion as to whether these conditions were present in-service or were caused by the Veteran’s service is necessary. In the case of the neck condition, the October 2012 VA examination also indicated that there was no clinical evidence of a neck condition, however, additional evidence received since that time indicates the existence of a neck condition. See Reonal v. Brown, 5 Vet. App. 458, 461 (1993) (an opinion based upon an inaccurate factual premise has no probative value). 2. The issues of entitlement to service connection for shortness of breath and entitlement to service connection for a sleeping disorder are remanded. With regard to the Veteran’s claims for service connection for shortness of breath and to a sleeping condition, the Board cannot make a fully-informed decision on the issue of service connection for shortness of breath because no VA examiner has opined whether there is a relationship between the Veteran’s shortness of breath documented in his VA treatment records and the upper respiratory infections documented in his STRs as he claims in his appeal to the Board. Additionally, the Veteran has also reported that he has had difficulty breathing recurrently several times per week since working in a dusty warehouse during his service in an August 2018 statement. The examiner should consider this evidence as well. Similarly, in his appeal to the Board, the Veteran asserts a connection between his present obstructive sleep apnea (OSA) and his reports of other sleep conditions while in-service including sleep walking and difficulty sleeping. No opinion as to whether there is such a link has been provided. Additionally, the argument submitted by the Veteran’s attorney in August 2018 provides articles that suggest a link between psychiatric conditions and OSA, and requests that VA obtain an opinion as to whether the Veteran’s OSA is secondary to his acquired psychiatric condition. 3. The issues of entitlement to increased ratings for bilateral hearing loss and an unspecified depressive disorder (posttraumatic stress disorder) are remanded. With regard to these conditions, the Veteran and his attorney have asserted in August 2018 correspondence that his symptoms have increased in severity since the most recent VA examinations were conducted. Consequently, the Veteran should be scheduled for examinations to ascertain the current severity of these two conditions. With regard to the Veteran’s psychiatric condition, the VA examination report from January 2017 refers to outpatient treatment records from 2016 that do not appear to be of record. On remand, these records should be found and associated with the claims file. The matters are REMANDED for the following actions: 1. Obtain and associate with the claims file any updated/outstanding VA treatment records not already associated with the claims file, to include the records of outpatient psychiatric treatment referred to in the January 2017 VA examination report. 2. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s neck, lower back, shortness of breath, and a sleep disorder conditions are at least as likely as not related to the treatment records and symptoms reported in the Veteran’s STRs previously discussed. 3. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s OSA is at least as likely as not related to, proximately due to, or aggravated beyond its natural progression by service-connected unspecified depressive disorder (posttraumatic stress disorder). 4. If it is determined that any of the requested opinions in Instructions #2 & #3 may not be provided without an examination of the Veteran, such should be scheduled. 5. Schedule the Veteran for examinations by appropriate clinicians to determine the current severity of his service-connected psychiatric and hearing loss conditions. A. ISHIZAWAR Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Steven H. Johnston, Associate Counsel