Citation Nr: 18151194 Decision Date: 11/16/18 Archive Date: 11/16/18 DOCKET NO. 16-44 356 DATE: November 16, 2018 REMANDED Entitlement to service connection for neck disability is remanded. Entitlement to service connection for left foot disability, claimed as feet, is remanded. Entitlement to service connection for right foot disability, claimed as feet, is remanded. Entitlement to service connection for left shoulder disability is remanded. Entitlement to service connection for right shoulder disability is remanded. Entitlement to service connection for left wrist disability is remanded. Entitlement to service connection for right wrist disability is remanded. Entitlement to service connection for a bilateral hearing loss disability is remanded. Entitlement to service connection for chronic traumatic encephalopathy (CTE) is remanded. Entitlement to service connection for an acquired psychiatric disability, to include depression with anger and aggression, is remanded. Entitlement to service connection for sleep disorder is remanded. REASONS FOR REMAND The record shows that the Veteran served on active duty from January 1986 to April 1986. The Veteran claims additional periods of service, which will be discussed further below. The issue previously characterized as entitlement to service connection for mental illness, also claimed as depression with anger and aggression, has been expanded pursuant to the Federal Circuit’s decision in Clemmons v. West, 206 F.3d 1401, 1403 (Fed. Cir. 2000). The issue has been recharacterized accordingly, as noted on the title page. 1. Entitlement to service connection for neck disability is remanded. 2. Entitlement to service connection for left foot disability, claimed as feet, is remanded. 3. Entitlement to service connection for right foot disability, claimed as feet, is remanded. The Board finds that additional development is needed prior to final adjudication of the issues on appeal. First, the Board seeks clarification of the Veteran’s periods of active service. The Veteran has argued that he has had a total of anywhere between four to five years of active service. Specifically, the Veteran has written that he enlisted in 1986 for eight years of service, four years active and four years inactive. See Statement from Veteran, April 2018. The record contains a DD-214, which indicates a period of Active Duty for Training (ACDUTRA) service from January 1986 to April 1986, and additional records showing service with the Army National Guard and reserve points from April 1985 to April 1993. However, it is unclear whether the Veteran had multiple periods of active duty service during that time as he alleges he did. There is February 2016 administrative decision in the file, which states that the Veteran does not have qualifying service for VA purposes. However, the Board notes that the Veteran has been awarded service connection for tinnitus. In addition, the copy of this administrative decision on file appears to be incomplete. Upon remand the AOJ should clearly identify the Veteran’s periods of active duty service. If additional periods of active duty service are identified, then the AOJ should obtain any outstanding military personnel and service treatment records that may exist from previously unidentified service periods. The record shows that the Veteran has not been afforded a VA examination regarding his claimed disabilities of the neck and right and left foot. The Veteran claims that he was injured in service because of items he wore, including his military helmet and combat boots, as well as surfaces he walked on, such as pavement and cement and metal tanks and artillery. See Notice of Disagreement (NOD), November 2017. Upon remand, the Board asks that an examination be completed that addresses these claims. 4. Entitlement to service connection for left shoulder disability is remanded. 5. Entitlement to service connection for right shoulder disability is remanded. 6. Entitlement to service connection for left wrist disability is remanded. 7. Entitlement to service connection for right wrist disability is remanded. Similarly, the Veteran seeks service connection for his left and right shoulder, as well as his left and right wrists, but he has not been afforded an examination regarding these claimed disabilities. The Veteran believes his claimed disabilities were caused by “training as a combat medic and handling heavy artillery shells.” See NOD, February 2017. Upon remand, the Veteran should be afforded an examination that addresses these claims. 8. Entitlement to service connection for a bilateral hearing loss disability is remanded. The Board finds that a new examination is needed regarding the Veteran’s claimed bilateral hearing loss disability. The Veteran was afforded a VA examination in October 2014, which noted a speech discrimination score of 96 percent in both ears using the Maryland CNC word list, as required by federal regulation. However, there are additional notations on a separate October 2014 examination sheet from a D.H.C.C., which note different results, for example, an “unaided recognition score” of 88 percent in the left ear. Unfortunately, this report does not state whether the Maryland CNC was used. Accordingly, the Board will remand to afford the Veteran a new examination. 9. Entitlement to service connection for CTE is remanded. In addition, the Board finds that an examination is needed regarding the Veteran’s claimed disability of CTE. The Veteran states that he trained around tanks and heavy artillery, which exposed him to very loud blasts. See C&P Application, September 2015. Upon remand, the Veteran should be scheduled for an examination that addresses his contention. 10. Entitlement to service connection for an acquired psychiatric disability, to include depression with anger and aggression, is remanded. Further, the Board finds that an examination is needed regarding the Veteran’s claim for an acquired psychiatric disability. The Veteran states that the stress and fear of going to war caused him to become depressed. See C&P Application, October 2015. Upon remand, the Veteran should be afforded a VA examination regarding his claimed acquired psychiatric disability. 11. Entitlement to service connection for sleep disorder is remanded. Finally, the Board notes that a VA examination and opinion were obtained in March 2018. A Statement of the Case was noti issued thereafter. ON remand, one should be issued. The matters are REMANDED for the following action: 1. Clarify all periods that the Veteran served on active duty, and associate with the record any outstanding DD-214s, or other military personnel records, which would clarify the Veteran’s service. If additional periods of service are identified, then outstanding military personnel and service treatment records from this period should be obtained and associated with the claim file. In addition, the Board notes that there is an administrative decision in the file from February 2016, stating that the Veteran does not have qualifying service for VA purposes, but the copy of the decision in the file appears to be incomplete. A complete copy should be obtained and associated with the claim file. In addition, after securing any necessary consent forms from the Veteran, obtain any outstanding treatment records, to include any VA and/or private treatment records, pertaining to the issues on appeal. All efforts to comply with this remand directive, including clarifying the Veteran’s dates of service and obtaining any outstanding records, should be documented in the claim file. If any records could not be obtained, this should be noted in the claim file. 2. Upon completion of the above, schedule the Veteran for the following VA examinations: (a) VA examinations to clarify the diagnosis of his claimed neck and right and left foot disabilities and to address the etiology of any diagnosed disabilities. For each disability diagnosed, the examiner is asked to address whether it is at least as likely as not (i.e., a 50 percent or greater probability) that it was caused by the Veteran’s active duty service or, if preexisting service, was aggravated therein. The examiner is asked to specifically address the Veteran’s claims that he was injured in service because of items he wore, including his military helmet and combat boots, as well as surfaces he walked on, such as pavement and cement and metal tanks and artillery. See NOD, November 2017. (b) VA examinations to clarify the diagnosis of his claimed disabilities of the left and right shoulder, as well as his left and right wrists, and to address the etiology of any diagnosed disabilities. For each disability diagnosed, the examiner is asked to address whether it is at least as likely as not (i.e., a 50 percent or greater probability) that it was caused by the Veteran’s active duty service or, if preexisting service, was aggravated therein. The examiner is asked to specifically address the Veteran’s contentions that his claimed disabilities were caused by “training as a combat medic and handling heavy artillery shells.” See NOD, February 2017. (c) A VA examination to clarify the diagnosis of his claimed bilateral hearing loss disability and to address the etiology of any diagnosed disabilities. For each disability diagnosed, the examiner is asked to address whether it is at least as likely as not (i.e., a 50 percent or greater probability) that it was caused by the Veteran’s active duty service or, if preexisting service, was aggravated therein. In particular, the examiner is asked to note use of the Maryland CNC word list when conducting speech discrimination testing. (d) A VA examination to clarify the diagnosis of his claimed CTE and to address the etiology of any diagnosed disabilities. For each disability diagnosed, the examiner is asked to address whether it is at least as likely as not (i.e., a 50 percent or greater probability) that it was caused by the Veteran’s active duty service or, if preexisting service, was aggravated therein. In particular, the examiner is asked to address the Veteran’s contentions that he trained around tanks and heavy artillery, which exposed him to very loud blasts. See C&P Application, September 2015. (e) A VA examination to clarify the diagnosis of his claimed acquired psychiatric disability and to address the etiology of any diagnosed disabilities. For each disability diagnosed, the examiner is asked to address whether it is at least as likely as not (i.e., a 50 percent or greater probability) that it was caused by the Veteran’s active duty service or, if preexisting service, was aggravated therein. In particular, the examiner is asked to address the Veteran’s contentions that the stress and fear of going to war caused him to become depressed. See C&P Application, October 2015. For all examinations, all necessary development should be taken. The VA examiner should be given access to the claim file. The examiner should state that a review of the claim file was completed. The examiner must provide a comprehensive report including complete rationales for all opinions and conclusions reached, citing the objective medical findings leading to the conclusions. A detailed rationale is requested for all opinions provided. 3. Issue a Statement of the Case for the issue of service connection for obstructive sleep apnea with consideration of all the evidence of record. 4. If upon completion of the above action the issues are denied, the case should be returned to the Board after compliance with appellate procedures. E. I. VELEZ Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD K. Foster, Associate Counsel