Citation Nr: 18141217
Decision Date: 10/10/18	Archive Date: 10/09/18

DOCKET NO. 15-38 415
DATE:	October 10, 2018
REMANDED
Entitlement to service connection for a leukemia/lymphoma disorder, is remanded.
Entitlement to service connection for an acquired psychiatric disorder, to include adjustment disorder, is granted.  
Entitlement to service connection for tinnitus is remanded.
Entitlement to service connection for headaches is remanded.
Entitlement to service connection for hypertension is remanded.
REASONS FOR REMAND
The Veteran served on active military duty from August 1967 to July 1969.  
This matter comes before the Board of Veterans’ Appeals (Board) on appeal from rating decisions of December 2013 and June 2015 of a Regional Office (RO) of the Department of Veterans Affairs (VA).
The undersigned has, pursuant to 38 C.F.R. § 20.900, advanced the Veteran’s claim on the Board’s document because of his health.
Remand is warranted for several reasons.
First, the undersigned desires to clarify what type(s), if any, of B-cell leukemia and lymphoma the Veteran has had during the pendency of the appeal.  The Veteran claimed service connection for “acute myelogenous leukemia/lymphoma” in April 2013.  VA denied the claim finding that acute myelogenous leukemia is ineligible for presumptive service connection under 38 C.F.R. § 3.309(e).  The Veteran’s treating cancer physician has indicated several times that the Veteran’s cancer is acute myelogenous leukemia (AML).  VA treatment records, however, note the Veteran’s reported history of non-Hodgkin’s lymphoma, which is a presumptive disease.  Although those references in the VA treatment records were based on the Veteran’s own report, and were recorded by a social worker and a psychiatrist, the Board finds that a VA examination is necessary to determine the precise nature of the claimed malignancy. 
Second, the psychiatric claim is inextricably intertwined with the B-cell leukemia and lymphoma issues, as reflected in the August 2017 compensation examination.  Namely, the VA psychologist, after noting that these “medical diagnoses [were] relevant to the understanding or management of the mental health disorder” in Section 2 B on the examination report, found the “symptoms of adjustment disorder include, depression, anxiety, disturbed sleep, and feelings of frustration related to his medical issues.”  Thus, resolution of the direct service connection claims impacts the psychiatric claim.
Third, VA treatment records, which VA considered in the May 2016 Statement of the Case, appear incomplete, so remand is warranted to attempt to obtain them. 
The matters are REMANDED for the following action:
1. Arrange for an oncologist to review the Veteran’s file to answer the following questions:
a)	Identify the type of leukemia and/or lymphoma the Veteran has had at any time since 2013.
b)	Is it at least as likely as not that the Veteran’s leukemia and/or lymphoma is a B-cell leukemia?
c)	Is it at least as likely as not that the Veteran’s leukemia and/or lymphoma non-Hodgkins lymphoma?
d)	With respect to the Veteran’s leukemia/lymphoma, is it related to service?  
2. Attempt to obtain a complete set of the Veteran’s VA treatment records from the Northport VA Medical Center dated from April 2000 to present.  Please upload to VBMS in a single electronic file.

 
KELLI A. KORDICH
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	M. Sopko, Counsel