Citation Nr: 18157952 Decision Date: 12/13/18 Archive Date: 12/13/18 DOCKET NO. 16-63 481 DATE: December 13, 2018 ORDER Entitlement to service connection for an acquired psychiatric disability is granted. REMANDED Entitlement to service connection for hearing loss is remanded. FINDING OF FACT The Veteran has been diagnosed with an acquired psychiatric disability that was more likely than not related to his activities during active duty service. CONCLUSION OF LAW The criteria for entitlement to service connection for an acquired psychiatric disability are met. 38 U.S.C. §§ 1110, 1111, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran has several periods of active duty service: June 1988 to September 1988; May 2002 to February 2003; January 2005 to April 2005; May 2008 to August 2008; May 2012 to November 2012, and; October 2013 to January 2014. He has also served with the Rhode Island Air National Guard. The Veteran has claimed entitlement to service connection for posttraumatic stress disorder (PTSD), but the medical evidence shows he has also been diagnosed with major depressive disorder. Thus, the Board has characterized the claim to include any acquired psychiatric disorder. See Clemons v. Shinseki, 23 Vet. App. 1 (2009). Entitlement to an acquired psychiatric condition The Veteran contends that he developed PTSD as a result of his experiences during active duty service. The Board concludes that the Veteran has current diagnoses that include PTSD and major depressive disorder, and the medical evidence of record shows that the Veteran’s diagnosed conditions at least as likely than not began during active duty service. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). Generally speaking, a medical opinion diagnosing PTSD does not suffice to verify the occurrence of the claimed in-service stressors. See Cohen v. Brown, 10 Vet. App. 128, 142 (1997). That is to say, a stressor usually cannot be established as having occurred merely by after-the-fact medical nexus evidence. Moreau v. Brown, 9 Vet. App. 389 (1996). If a stressor claimed by a veteran is related to the Veteran’s fear of hostile military or terrorist activity and a VA psychiatrist or psychologist, or a psychiatrist or psychologist with whom VA has contracted, confirms that the claimed stressor is adequate to support a diagnosis of PTSD and that the Veteran’s symptoms are related to the claimed stressor, in the absence of clear and convincing evidence to the contrary, and provided the claimed stressor is consistent with the places, types, and circumstances of the Veteran’s service, the Veteran’s lay testimony alone may establish the occurrence of the claimed in-service stressor. 38 C.F.R. § 3.304 (f)(3). The Veteran has referred to several events during his deployments on active duty which he asserts are responsible for his diagnosed psychiatric conditions. In one instance, he stated that in February 2005, while stationed at Balad Air Base in Iraq, he volunteered to help move incoming wounded servicemen to a field hospital. He stated that he worked 12-hour shifts while a constant rotation of helicopters would fly in with wounded servicemen. He stated that he has not been able to properly sleep since this incident. The Veteran’s DD-214 confirms that he was called to active duty service from January to April 2005, and he was deployed to Balad, Iraq in support of Operation Iraqi Freedom. The Board further notes that the Veteran has provided competent, credible lay testimony stating that he experienced stressful events during his period of active duty service that either caused or aggravated a psychiatric condition. In August 2015, the Veteran was afforded a VA examination, where he was diagnosed with “other specified trauma and stressor-related disorder.” The VA examiner noted that the Veteran’s February 2005 stressor event was adequate to support the diagnosis of PTSD, and the stressor was related to the Veteran’s fear of hostile military or terrorist activity. The VA examiner concluded that the Veteran’s identified in-service stressful incidents have had a powerful impact on him and more likely than not have contributed to problems with sleep, irritability, hypervigilance, and social withdrawal. While the Veteran’s symptoms did not meet the diagnostic criteria for PTSD, the examiner stated that the symptoms did meet the criteria for other specified trauma and stressor-related disorder. The examiner further stated that it was more likely than not that the exposure of the Veteran to the identified stressor events was directly related to his current psychiatric symptoms and his diagnosed mental disorder. The evidence of record also includes June 2018 private psychological evaluation which notes the Veteran’s diagnoses of PTSD and major depressive disorder. The private psychologist concluded that it was at least as likely as not that the Veteran’s diagnosed mental disorders began during his military service and were directly related to his active duty. There is no medical opinion to the contrary in the record concerning the etiology of the Veteran’s psychiatric condition. Based on the foregoing evidence, the Board finds that the preponderance of the evidence is in favor of service connection for an acquired psychiatric condition, and the claim is granted. REASONS FOR REMAND Entitlement to service connection for hearing loss is remanded. The Veteran contends that he experiences hearing loss due to traumatic noise exposure while on active duty service. His personnel records confirm that he has been called to active duty service and sent on multiple deployments to Iraq, Afghanistan and Kuwait. He has provided competent, credible lay statements asserting his exposure to noise exposure while on active duty service. As such, remand is needed to afford him a VA examination with opinion on this issue. Since the claims file is being returned it should be updated to include any outstanding VA treatment records. See 38 C.F.R. § 3.159 (c)(2); see also Bell v. Derwinski, 2 Vet. App. 611 (1992). The matter is REMANDED for the following action: 1. Associate with the claims file all outstanding VA treatment records regarding the Veteran. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any diagnosed hearing loss. The examiner must opine whether it is at least as likely as not related to an in-service injury, event, or disease, including exposure to acoustic trauma during active duty service. M. E. Larkin Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Jack S. Komperda, Counsel