Citation Nr: 18157645 Decision Date: 12/13/18 Archive Date: 12/13/18 DOCKET NO. 16-53 610 DATE: December 13, 2018 ORDER New and material evidence has been received, and the claim of entitlement to service connection for posttraumatic stress disorder (PTSD) is reopened. New and material evidence has been received, and the claim of entitlement to service connection for residual injury to hands and arms, claimed as severe hands and arms lacerations (previously claimed as other medical disorders) is reopened. REMANDED Entitlement to service connection for an acquired psychiatric disability, to include PTSD, is remanded. Entitlement to service connection for residual injury to hands and arms, claimed as severe hands and arms lacerations, including as secondary to PTSD, is remanded. Entitlement to service connection for hypertension, including as secondary to PTSD, is remanded. FINDINGS OF FACT 1. A July 1998 rating decision declined to reopen a previously denied claim for service connection for PTSD because the evidence submitted in connection with the claim did not constitute new and material evidence; it was essentially duplicated evidence, which was previously considered and was merely cumulative; the Veteran did not appeal that denial or submit new and material evidence within a year of the decision, and the July 1998 decision became final. 2. An October 1991 (notice sent in November 1991) rating decision denied the Veteran’s claim of entitlement to service connection for residual injury to hands and arms, finding a lack of evidence to show hand and arm disorders were related to or caused by service; the Veteran did not appeal that denial or submit new and material evidence within a year of the decision, and the October 1991 decision became final. CONCLUSIONS OF LAW 1. New and material evidence has been received, and the claim of entitlement to service connection for PTSD is reopened. 38 U.S.C. §§ 5108, 7105; 38 C.F.R. § 3.156. 2. New and material evidence has been received, and the claim of entitlement to service connection for residual injury to hands and arms, claimed as severe hands and arms lacerations, is reopened. 38 U.S.C. §§ 5108, 7105; 38 C.F.R. § 3.156. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active military service from June 1967 to March 1971. He received the Combat Infantry Badge. PTSD Pertinent evidence received since the July 1998 final unappealed rating decision, regarding the claim of entitlement to service connection for PTSD includes a November 2011 mental health assessment by a private practice clinical counselor which notes that the Veteran’s current level of functioning is a direct result of his psychiatric disability originating from the atrocities and trauma he suffered during his service in Vietnam. Diagnoses included chronic PTSD secondary to military service, recurrent major depressive disorder secondary to military service and PTSD, and a history of drug and alcohol abuse secondary to military service and PTSD. The Board finds this evidence to be new and material. This follows because it is not cumulative or redundant of the evidence previously of record, and it tends to show that the Veteran has a diagnosis of PTSD, and such diagnosis may be etiologically related to his active military service. Accordingly, the claim of entitlement to service connection for PTSD is reopened. The claim is remanded for further development. Residual Injury to Hands and Arms Pertinent evidence received since the October 1991 final unappealed rating decision, regarding the claim of entitlement to service connection for residual injury to hands and arms, claimed as severe hands and arms lacerations, includes a May 1996 VA psychiatric evaluation. During the psychiatric evaluation, it was revealed that the Veteran’s severe lacerations to his hands and arms from broken glass in the door through which he put his arms, was a suicide attempt, which the Veteran relates to his experiences in Vietnam. To establish whether new and material evidence has been submitted, the credibility of this evidence is to be presumed. Fortuck v. Principi, 17 Vet. App. 173, 179-80 (2003). Moreover, when viewing this evidence in the light most favorable to the Veteran, and considering the “low threshold” standard for reopening a claim per Shade v. Shinseki, 24 Vet. App. 110 (2010), the Board finds the evidence to be new and material. This follows because it is not cumulative or redundant of the evidence previously of record, and it tends to show the Veteran’s residual injury to hands and arms, claimed as severe hands and arms lacerations may be etiologically related to service. Accordingly, the claim of entitlement to service connection for residual injury to hands and arms, claimed as severe hands and arms lacerations, is reopened. The claim is also remanded for further development. REASONS FOR REMAND Regarding the claim of entitlement to service connection for PTSD, the Board has construed the Veteran’s claim broadly, to include any acquired psychiatric disorder. Clemons v. Shinseki, 23 Vet. App. 1 (2009) The Veteran essentially asserts that he has an acquired psychiatric disorder to include PTSD, as a result of his service in Vietnam. The Veteran’s service personnel records show that he served in the Republic of Vietnam and received the Combat Infantry Badge. In July 2012, the Veteran was afforded a VA examination, the examiner determined that the Veteran’s symptoms did not meet the diagnostic criteria for PTSD under DSM-IV criteria. The diagnosis under Axis I was polysubstance dependence, in sustained partial remission. In May 2016 the Veteran was afforded a VA examination, and the examiner determined that the Veteran’s symptoms did not meet the diagnostic criteria for PTSD under DSM-V criteria. The diagnoses were persistent depressive disorder, mild alcohol use disorder and moderate cannabis use disorder. However, additional medical evidence has been associated with the claims file since the July 2012 and May 2016 VA examinations, to include evidence of treatment for psychiatric symptoms, with diagnoses of PTSD, and other acquired psychiatric disorders. Accordingly, on remand, the Veteran should be afforded a psychiatric examination based on a comprehensive review of the claims file. Additionally, as the Veteran’s claims for service connection for residual injury to hands and arms, claimed as severe hands and arms lacerations and hypertension are based on these disabilities being secondary to the Veteran’s acquired psychiatric disorder, including PTSD, they are, therefore, inextricably intertwined with the psychiatric claim and must also be remanded. On remand, the agency of original jurisdiction should obtain all available records of VA treatment for the Veteran’s claimed disabilities, which are not already of record. The matters are REMANDED for the following action: 1. Obtain all available records of VA treatment or evaluation for a psychiatric disorder, including PTSD; severe hands and arms lacerations; and hypertension, which are not already of record. 2. Schedule the Veteran for a VA examination with a psychiatrist or psychologist. The examiner should diagnose any acquired psychiatric disability using the DSM-V, to include PTSD. All pertinent records in the claims file must be made available to and reviewed by the examiner. a) If PTSD pursuant to the DSM-V is found, the examiner should provide an opinion as to whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran’s PTSD is etiologically related to active duty service, including combat service in Vietnam from March 1968 to January 1969. b) If an acquired psychiatric disorder other than PTSD is found, e.g., anxiety, depression, polysubstance dependence, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s acquired psychiatric disorders (other than PTSD) either began during or was otherwise caused by his military service. All opinions must be supported by a rationale. 3. Conduct any further development deemed necessary regarding the claims for service connection for residual injury to hands and arms, claimed as severe hands and arms lacerations, and hypertension. A. C. MACKENZIE Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Young, Counsel