Citation Nr: 18158682 Decision Date: 12/18/18 Archive Date: 12/17/18 DOCKET NO. 17-07 176 DATE: December 18, 2018 REMANDED Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to service connection for tinnitus is remanded. Entitlement to service connection for an acquired psychiatric disorder, claimed as posttraumatic stress disorder (PTSD) and an anxiety disorder, is remanded. REASONS FOR REMAND The Veteran served on active duty in the Air Force from January 1971 to August 1971. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Providence, Rhode Island (Agency of Original Jurisdiction (AOJ)). 1. Entitlement to service connection for bilateral hearing loss is remanded. 2. Entitlement to service connection for tinnitus is remanded. The record reflects that the Veteran has not received VA examinations for either his bilateral hearing loss or tinnitus. Furthermore, there are no medical opinions of record that suggest an etiology for either condition. The Board will therefore remand to afford the Veteran an opportunity to present for these examinations and to obtain an opinion as to the etiology of any bilateral hearing loss and/or tinnitus. 3. Entitlement to service connection for PTSD, also claimed as an anxiety disorder, is remanded. The Veteran previously filed a claim for a paranoid personality/nervous condition in November 1971 (within one year of discharge from service). The AOJ denied him service connection in a December 1971 rating decision. Thereafter, the Veteran filed his claim for entitlement to service connection for PTSD/anxiety in March 2015. The Veteran contends that during service, he was prescribed medication that affected his behavior; he also provides an account of military sexual trauma (MST). A review of the record reveals that the Veteran has not received proper notice for an MST claim; as such, the AOJ is instructed to provide the appropriate notice on remand. Furthermore, the Veteran has not received a VA examination for this condition, despite evidence suggesting the presence of an acquired psychiatric condition. The Board will therefore remand to afford the Veteran an opportunity to present for this examination and to obtain an opinion as to the etiology of any acquired psychiatric disorder. The matters are REMANDED for the following action: 1. The AOJ shall associate the Veteran’s most recent outstanding VA medical treatment records with his file. 2. The AOJ should directly request hospitalization records from Wilford Hall U.S. Air Force Hospital for the time period from July to August 1971. 3. Ask the Veteran to complete a VA Form 21-4142 for any private treatment providers that have treated him for a psychiatric condition and/or bilateral hearing loss and tinnitus. Thereafter, obtain and associate with the claims folder any private treatment records identified. 4. Furnish the Veteran with the required notice regarding military sexual trauma pursuant to 38 C.F.R. §3.304(f)(5). 5. After allowing time for the Veteran’s response to the military sexual trauma notice, conduct any necessary development based on additional information received as to this reported stressor. 6. Then, the Veteran should be afforded an appropriate VA examination in order to determine the current nature and etiology of any bilateral hearing loss and tinnitus. The claims file must be made available to and be reviewed by the examiner. The examiner should specifically indicate whether the Veteran has bilateral hearing loss and/or tinnitus, and provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that any such bilateral hearing loss and/or tinnitus occurred in or is otherwise etiologically related to the Veteran’s military service, to include his exposure to loud noises as part of his military occupational specialty of being a meat cutter. The examiner is requested to discuss the significance, if any, of any threshold shifts during service. The examiner must provide all findings, along with a complete rationale for his or her opinion(s) in the examination report. If any of the above requested opinions cannot be made without resort to speculation, the examiner must state this and provide a rationale for such conclusion. 7. The Veteran should be afforded an appropriate VA examination in order to determine the current nature and etiology of his acquired psychiatric disorder. The claims file must be made available to and be reviewed by the examiner. The VA examiner must answer the following questions: (a) Determine whether the Veteran manifests PTSD. If so, is it at least as likely as not (i.e., 50 percent or more probable) the Veteran exhibited any behavioral changes during service or after service that are reflective of the occurrence of military sexual trauma during service and, if so, is it at least as likely as not (i.e., 50 percent or more probable) any current PTSD symptomatology is attributable to the occurrence of in-service military sexual trauma? Examples of behavior changes that may constitute credible evidence of the stressor include, but are not limited to: a request for a transfer to another military duty assignment; deterioration in work performance; substance abuse; episodes of depression, panic attacks, or anxiety without an identifiable cause; or unexplained economic or social behavior changes. (b) Determine whether the Veteran manifests an ancquired psychiatric disorder other than PTSD. For any such diagnosis/es, is it at least as likely as not (i.e., 50 percent or more probable) that the disorder first manifested in service or is otherwise causally or etiologically related to the Veteran’s military service, to include any military sexual trauma that is deemed credible? In answering this question, please explain the in-service treatment for symptoms diagnosed as a personality disorder and the validity of that diagnosis when looking at the record in its entirety. The examiner should consider the following: • the Veteran’s March 2015 Statement in Support of Claim; • the Veteran’s military personnel record and service treatment records; • the Veteran’s May 2015 Statement in Support of Claim for PTSD; • the June 2016 Notice of Disagreement; and • the Veteran’s VA Form 9. The examiner must provide all findings, along with a complete rationale for his or her opinion(s) in the examination report. If any of the above requested opinions cannot be made without resort to speculation, the examiner must state this and provide a rationale for such conclusion. (continued on next page) 8. Thereafter, readjudicate the claims. If any benefit sought on appeal remains denied, furnish the Veteran and his representative, if any, a supplemental statement of the case and an appropriate period of time to respond. T. MAINELLI Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Victoria A. Narducci, Associate Counsel