Citation Nr: 18133004 Decision Date: 09/10/18 Archive Date: 09/07/18 DOCKET NO. 15-42 107 DATE: September 10, 2018 ORDER 1. Entitlement to service connection for diabetes mellitus type 2 is denied. 2. Entitlement to service connection for sleep apnea, secondary to anxiety disorder is granted is granted. 3. Entitlement to service connection for restless leg syndrome of the left lower extremity is denied. 4. Entitlement to service connection for restless leg syndrome of the right lower extremity is denied. 5. Entitlement to an effective date earlier than January 15, 2013, for the award of service connection for anxiety disorder, NOS (claimed as post-traumatic stress disorder (PTSD), and mood swings) is denied. REMANDED Entitlement to an initial rating in excess of 30 percent for anxiety disorder, NOS (claimed as post-traumatic stress disorder (PTSD), and mood swings) is remanded. FINDING OF FACT 1. Diabetes mellitus was not present during the Veteran’s active service, did not manifest to a compensable degree within one year of separation from service, and is unrelated to service. 2. Sleep apnea is caused by serviced connected anxiety disorder. 3. The Veteran does not have restless leg syndrome of the left lower extremity which was incurred in or otherwise related to his active service. 4. The Veteran does not have restless leg syndrome of the right lower extremity which was incurred in or otherwise related to his active service 5. VA received no communication from the Veteran or his representative that constitutes a formal claim or may be construed as an informal claim of service connection for anxiety disorder prior to January 15, 2013. CONCLUSION OF LAW 1. The criteria for entitlement to service connection for diabetes mellitus type 2 have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 1116, 5107 (2012); 38 C.F.R. §§ 3.303, 3.307, 3.309 (2017). 2. The criteria for entitlement to service connection for sleep apnea, secondary to anxiety disorder have been met. 38 U.S.C. §§ 1101, 1110, 5107(b) (2012); 38 U.S.C. §§ 3.102, 3.303, 3.310 (2017). 3. The criteria for entitlement to service connection for restless leg syndrome of the left lower extremity have not been met. 38 U.S.C. §§ 1110, 5107 (2012); 38 C.F.R. §§ 3.303 (2017). 4. The criteria for entitlement to service connection for restless leg syndrome of the right lower extremity have not been met. 38 U.S.C. §§ 1110, 5107 (2012); 38 C.F.R. §§ 3.303 (2017). 5. The criteria for an effective date earlier than January 15, 2013 for the award of service connection for anxiety disorder have not been met. 38 U.S.C. §§ 1155, 5101, 5107, 5110 (2012); 38 C.F.R. §§ 3.151, 3.155, 3.400 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from August 1967 to May 1971. This matter came to the Board of Veterans’ Appeals (Board) on appeal from December 2013, June 2017, and July 2017 rating decisions by the Department of Veterans Affairs (VA) Regional Office (RO). In the December 2013 rating decision, the RO granted service connection for anxiety disorder (claimed as PTSD and mood swings) and assigned an initial 30 percent rating effective January 15, 2013. The Veteran disagreed with the RO’s determination, and a Statement of the Case was issued in November 2015. The Veteran perfected a timely appeal in November 2015. In the June 2017 rating decision, the RO denied service connection for diabetes mellitus type 2 and sleep apnea. The Veteran disagreed with the RO’s determination, and a Statement of the Case was issued on November 15, 2017. The Veteran perfected a timely appeal on November 28, 2017. In the July 2017 rating decision, the RO denied service connection for restless leg syndrome of the lower left and right extremities. The Veteran disagreed with the RO’s determination, and a Statement of the Case was issued on November 6, 2017. In February 2018, the Veteran’s attorney submitted a brief for the issues of entitlement to service connection for restless leg syndrome of the lower left and right extremities. It appears that the RO has deemed the brief a substantive appeal, therefore, the Board waives timeliness pursuant to Percy, as it is clear that the Veteran and his attorney were informed of the relevant information, and have expressed a desire to have all issues decided in the same decision. Percy v. Shinseki, 23 Vet. App. 37, 45 (2009); Beyrle v. Brown, 9 Vet. App. 24 (1996) (lack of a substantive appeal does not deprive the Board of jurisdiction over an appeal initiated by timely notice of disagreement). Under these circumstances, the Board accepts jurisdiction for the issues of entitlement to service connection for restless leg syndrome of the lower left and right extremities. Service Connection Service connection may be established for disability resulting from personal injury suffered or disease contracted in line of duty or for aggravation of a pre-existing injury or disease in the line of duty. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.303, 3.304, 3.306. Service connection may also be granted for any injury or disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease or injury was incurred in service. 38 C.F.R. § 3.303(d). Generally, in order to establish direct service connection, there must be competent, credible evidence of (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury. See, e.g., Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). Service connection for certain chronic diseases, including diabetes mellitus, may be also be established on a presumptive basis by showing that such a disease manifested itself to a degree of 10 percent or more within one year from the date of separation from service. 38 U.S.C. §§ 1112, 1137; 38 C.F.R. §§ 3.307(a)(3), 3.309(a). In such cases, the disease is presumed under the law to have had its onset in service even though there is no evidence of such disease during the period of service. 38 C.F.R. § 3.307(a). A veteran who, during active military, naval, or air service, served in the Republic of Vietnam during the Vietnam era shall be presumed to have been exposed during such service to an herbicide agent, unless there is affirmative evidence to establish that such veteran was not exposed to any such agent during that service. 38 C.F.R. § 3.307(a)(6)(iii). A veteran who was exposed to an herbicide agent during active military, naval, or air service, certain enumerated diseases shall be service connected if the requirements of 38 U.S.C. § 1116, 38 C.F.R. § 3.307(a)(6)(iii) are met, even though there is no record of such disease during service, provided further that the rebuttable presumption provisions of 38 U.S.C. § 1113; 38 C.F.R. § 3.307(d) are also satisfied. 38 C.F.R. § 3.309(e). The enumerated diseases which are deemed to be associated with herbicide exposure include Type 2 diabetes. Id. Service connection may be established on a secondary basis for a disability that is proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a). The standard of proof to be applied in decisions on claims for VA benefits is set forth in 38 U.S.C. § 5107(b). Under that provision, VA shall consider all information and lay and medical evidence of record in a case before the Secretary with respect to benefits under laws administered by the Secretary. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107(b). 1. Diabetes mellitus The Veteran seeks service connection for diabetes mellitus. He contends that such disability is due active service, to include exposure to Agent Orange in Vietnam. The Veteran’s personnel records show that he served in the Navy aboard the USS Carpenter DD-825 and USS Radford DD 446. In a July 2006 response to the RO’s official request for information on dates of service in Vietnam, the 3101 Print response noted that the Veteran served aboard the USS Carpenter DD-825, which sailed in the official waters of Vietnam from July 1, 1970 until July 16, 1970, July 23, 1970 until August 17, 1970 and October 20, 1970 until November 7, 1970. The findings also included that the record did not indicate that the Veteran ever set foot in Vietnam. In a May 2009 U.S. Army and Joint Services Records Research Center (JSRRC) Memorandum, the JSSRC found no evidence that Navy or Coast Guard ships transported tactical herbicides or that ships operating’ off the coast of Vietnam used, stored, tested or transported tactical herbicides. The JSSRC also could not verify that a shipboard veteran was exposed to tactical herbicides based on contact with aircraft that flew over Vietnam or equipment that was used in Vietnam. The Veteran indicated that he was aboard 2 ships that were in the area of Vietnam, and that he was close enough to drink the water or breath the air sprayed with Agent Orange, but he did not make any statements indicating a specific manner of exposure as opposed to general proximity to Agent Orange. However, the statue and regulation define the proximity required to presume exposure to Agent Orange. See Haas v. Peake, 525 F.3d 1168, 118283 (Fed. Cir. 2008) (adopting VA’s interpretation of the statutory phrase “served in the Republic of Vietnam” to exclude from the presumption of Agent Orange exposure those who never actually set foot on land during service). Without a specific allegation of exposure to Agent Orange, the Veteran has not met his burden of proving actual direct causation. Cf. Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994) (Radiation Compensation Act does not preclude a veteran from establishing service connection with proof of actual direct causation). The Veteran himself has only contended that he sailed in the waters of the Gulf of Tonkin and has never claimed to have set foot on Vietnam. He served on the USS Carpenter DD-825 and USS Radford DD 446. A June 2009 DPRIS report indicated that deck logs were reviewed with regard to the Radford. The July 2006 3101 print out documented that the Carpenter sailed in the official waters of Vietnam but did not indicate that he ever set foot in Vietnam. What constitutes “inland waterways” was not defined in Haas and is not defined in VA regulations. Thus, the Board has historically referred to the VA Adjudication Procedure Manual M-21 (Manual) for interpretive guidance. While the Adjudication Manual is not binding on the Board, DAV v. Sec’y of Veterans Affairs, 859 F.3d 1072, 1077 (Fed. Cir. 2017) (“The M21-1 Manual is binding on neither the agency nor tribunals”), it provides guidance to VA adjudicators. The Manual maintains that inland waterways include rivers, canals, estuaries, and delta areas, such as those on which the Vietnam “brown water” Navy operated. VA Adjudication Procedure Manual M21-1MR, pt. IV, sub. Pt. ii, ch. 2, § C.10.k. The Manual clearly states that service aboard a ship that merely anchored in an open deep-water harbor, such as Da Nang, Vung Tau, or Cam Ranh Bay, along the Vietnam coast does not constitute inland waterway service to establish presumptive exposure to herbicides. Id. Any such anchorage is considered to be in “blue water” that does not provide for a presumption of herbicide exposure. Id. After review of an Institute of Medicine (IOM) report, ‘‘Blue Water Navy Vietnam Veterans and Agent Orange Exposure,” the Secretary of VA determined that the evidence available at that time did not support establishing a presumption of exposure to herbicides for Blue Water Navy Vietnam Veterans. See 77 Fed. Reg. 76170 (Dec. 26, 2012). In order for the presumption of exposure to Agent Orange to extend to a Blue Water Navy veteran, development must provide evidence that the veteran’s ship operated temporarily on the inland waterways of Vietnam or that the Veteran’s ship docked to the shore or a pier. In claims based on docking, a lay statement that the Veteran personally went ashore must be provided. Although evidence that a veteran’s ship docked, along with a statement of going ashore, is sufficient for the presumption of herbicide exposure, service aboard a ship that anchored temporarily in an open deep-water harbor or port is generally not considered sufficient. M21-1 IV.ii.2.C.3.e Recently, VA amended its process for determining whether a waterway was deemed offshore or inland in response to Gray v. McDonald, 27 Vet. App. 313 (2015), in which the Court found that VA’s interpretation of 38 C.F.R. § 3.307 (a)(6)(iii), designating Da Nang Harbor as an offshore, rather than an inland, waterway was inconsistent with the purpose of the regulation and did not reflect the VA’s fair and considered judgment. In particular, the Court could not discern any reason as to why, in VA’s determination, certain bodies of water such as Quy Nhon Bay and Ganh Rai Bay, were brown water, but Vung Tau Harbor, Da Nang Harbor, and Cam Ranh Bay, were blue water. The Court stated that VA’s old policy of where to draw the line between inland waterways and offshore waters was arbitrary and, thus, not entitled to deference because some harbors and bays were considered to be offshore waters (e.g. Da Nang Harbor) while others were considered inland waterways (e.g., Ganh Rai Bay). The Gray Court did not state that Da Nang Harbor was part of the inland waterways, merely that the line VA drew was flawed. Subsequent to the Court’s decision in Gray, VA updated its policy to state that service aboard a ship that anchored in a deep-water costal harbor, such as Da Nang, Vung Tau, Qui Nhon, Ganh Rai Bay, or Cam Ranh Bay, along the Republic of Vietnam coast, does not constitute inland waterway service or qualify as docking to the shore and is not sufficient to establish presumptive exposure to herbicides, unless the evidence of record confirms the Veteran went ashore during anchorage. VA Adjudication Manual M21-1 IV.ii.2.C.3.m. All harbors and bays are considered offshore, while all rivers and deltas are considered inland. Da Nang Harbor, along with Nha Trang Harbor, Qui Nhon Bay Harbor, Cam Ranh Bay Harbor, Vung Tau Harbor, and Ganh Rai Bay, are specifically considered offshore waters of the Republic of Vietnam. VA Adjudication Manual M21-1 IV.ii.1.H.2.c. Although the Radford operated on the Saigon River during December 1967 (in addition to Ganh Rai Bay), and the USS Carpenter sent a medical team ashore at Song Tra Village on December 20, 1968, the Veteran does not claim, and the evidence does not reflect, that he was part of such service. See Navy and Coast Guard Ships Associated with Service in Vietnam and Exposure to Herbicide Agents (September 4, 2018). In view of the foregoing, the Board finds that there is no probative evidence that the Veteran qualifies for the presumption of Agent Orange exposure or that he was otherwise exposed to Agent Orange. Thus, the presumptive provisions do not avail the Veteran. Although service connection for diabetes mellitus cannot be established on a presumptive basis pursuant to the laws and regulations relating to Agent Orange exposure, the Board has considered other theories of entitlement. See 38 U.S.C. § 1113(b); 38 C.F.R. § 3.303(d) (the availability of service connection on a presumptive basis does not preclude consideration of service connection on a direct basis). After doing so, however, the Board finds that the preponderance of the evidence is against the claims. The Veteran’s in-service treatment records are negative of complaints or findings of diabetes mellitus. At the Veteran’s May 1971 separation examination, his endocrine system was noted as normal. The post-service record on appeal is similarly negative for complaints or findings of diabetes mellitus within the first post-service year or, indeed, for many years thereafter. For example, the first clinical notation of diabetes mellitus is in 2013, approximately forty-six years after service separation. This is one factor that the Board may consider. See Maxson v. West, 12 Vet. App. 453, 459 (1999), aff’d sub nom. Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000); see also Forshey v. Principi, 284 F.3d 1335, 1358 (Fed. Cir. 2002) (en banc) (the Board may consider in its assessment of a service connection claim the passage of a lengthy period of time wherein the veteran has not complained of the malady at issue). Thus, the evidence establishes that diabetes mellitus type II was not present during the Veteran’s active duty or manifest to a compensable degree within the first post-service year, and the Veteran has not contended otherwise or indicated that he had symptoms of diabetes in service, within the one-year presumptive period, or for many years thereafter. In addition, the record contains no indication that the Veteran’s current diabetes mellitus is otherwise causally related to his active service or any incident therein. The Board has considered the Veteran’s contention that service connection is warranted as such condition is due to his active service. However, the record contains no indication of a link between the Veteran’s diabetes mellitus and his active service or any established incident therein. In this regard, the Veteran has not been afforded a VA examination as to the etiology of his diabetes. Under the VCAA, VA must provide an examination when there is (A) competent evidence of a current disability (or persistent or recurrent symptoms thereof) that (B) may be associated with service, but (C) there is insufficient medical evidence to make a decision on the claim. 38 U.S.C. § 5103A(d). The Federal Circuit has addressed the appropriate standard to be applied in determining whether an examination is warranted under this statute. In Waters v. Shinseki, 601 F.3d 1274 (Fed. Cir. 2010) and Colantonio v. Shinseki, 606 F.3d 1378 (Fed. Cir. 2010), the Federal Circuit held that while there must be competent evidence of a current disability, competent evidence is not required to indicate that the current disability may be associated with service. Colantonio, 606 F.3d at 1382; Waters, 601 F.3d at 1277. On the other hand, a conclusory generalized lay statement suggesting a nexus between a current disability and service would not suffice to meet the standard of subsection (B), as this would, contrary to the intent of Congress, result in medical examinations being “routinely and virtually automatically” provided to all veterans claiming service connection. Waters, 601 F.3d at 1278-1279. The above discussion reflects that the evidence of an association between the Veteran’s diabetes and his service consists of generalized conclusory lay statements of being close enough to shore to drink the water or breathe the air sprayed with Agent Orange. For the reasons set forth above, the Board finds that the preponderance of the evidence is against the claim of service connection for diabetes mellitus type 2. The benefit of the doubt doctrine is not for application where the clear weight of the evidence is against the claim. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. Although the Veteran reported during an April 2014 mental status examination that he is in receipt of disability benefits from the Social Security Administration (SSA), there is no indication that these records are potentially relevant to this claim. Golz v. Shinseki, 590 F.3d 1317, 1323 (Fed. Cir. 2010) (“When a SSA decision pertains to a completely unrelated medical condition and the veteran makes no specific allegations that would give rise to a reasonable belief that the medical records may nonetheless pertain to the injury for which the veteran seeks benefits, relevance is not established”). 2. Sleep apnea The Veteran contends that sleep apnea is related to his active service, to include as secondary to his service-connected anxiety disorder. For the following reasons, the Board finds that service connection for sleep apnea, secondary to anxiety disorder is warranted. The record on appeal reflects treatment and diagnosis for a sleep apnea disability. For example, an April 2012 VA clinical record shows that the Veteran was prescribed a CPAP machine and a sleeping pillow for his sleep apnea. A November 2016 VA clinical record indicates that the Veteran uses a CPAP machine every night. Additionally, in a May 2017 letter, doctor R.G., reported that the Veteran had been a patient for more than 10 years, and that his last sleep study was done in May 2004. The Veteran exhibited 100 percent adherence, average use of 10.7 hours/night, minimal leak, and excellent protection with AHI 1.4. Doctor R.G. stated that the Veteran requires ongoing use of CPAP. In a December 2017 private Disability Benefits Questionnaire (DBQ), doctor H.S. reported that the Veteran had a diagnosis of obstructive sleep apna (OSA). Doctor H.S. opined that the Veteran’s service-connected anxiety more likely than not aided in the development of and permanently aggravates the Veteran’s obstructive sleep apnea. The doctor explained that research had shown that psychiatric disorders are commonly associated with OSA. A recent study found that subjects with anxiety compared with individuals that do not have anxiety have a higher prevalence of sleep apnea diagnosis. Doctor H.S. further explained that the study found that with CPAP treatment, both OSA and psychiatric symptoms decreased providing further evidence of the co-morbidity of these conditions. The Board finds that the private nexus opinion indicating that the Veteran’s sleep apnea is caused by his service-connected anxiety disorder, provide a sufficient basis to grant service connection for sleep apnea. Thus, the Board finds that service connection for sleep apnea, secondary to anxiety disorder is warranted. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102, 3.310. 3. Restless leg syndrome The Veteran contends that restless leg syndrome of the lower left and right extremities are related to his active service. For the following reasons, the Board finds that the preponderance of the evidence is against the claim. The Veteran’s service treatment records are negative of complaints or findings of restless leg syndrome. At his May 1971 separation examination, his lower extremities were evaluated and noted as normal. Post-service treatment records show a 2012 diagnosis of restless leg syndrome, but is similarly negative for findings that restless leg syndrome is associated with the Veteran’s active service. In this regard, the Veteran has not been afforded a VA examination in connection with this disability. 38 U.S.C. § 5103A (d); 38 C.F.R. § 3.159 (c)(4); McLendon v. Nicholson, 20 Vet. App. 79 (2006). However, because the service treatment records contain no indication of a pertinent in-service injury, event or illness and the post-service evidence does not indicate any current complaints or treatment referable to these conditions until many years following separation or otherwise indicate that there may be an association between the current disability and active service, a VA examination is not required in this case, even under the low threshold of McLendon. The only evidence of such an association are conclusory generalized lay statements and that is enough to warrant a VA examination, pursuant to Waters. Based on the foregoing, the Board finds that the most probative evidence shows that the Veteran does not have restless leg syndrome of the lower left and right extremities which were incurred in or otherwise related to his active service. As the preponderance of the evidence is against the claim, the benefit of the doubt doctrine is not for application. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. Although the Veteran reported during an April 2014 mental status examination that he is in receipt of disability benefits from SSA, there is no indication that these records are potentially relevant to this claim. Golz, 590 F.3d at 1323 (“When a SSA decision pertains to a completely unrelated medical condition and the veteran makes no specific allegations that would give rise to a reasonable belief that the medical records may nonetheless pertain to the injury for which the veteran seeks benefits, relevance is not established”). 4. Earlier Effective Date for Service Connection for Anxiety Disorder The Veteran contends that he is entitled to an effective date prior to January 15, 2013, for the grant of service connection for anxiety disorder. The Veteran has not, however, provided any explanation as to the reasons for his belief that an earlier effective date is warranted. As a preliminary matter, the Board notes that, effective March 24, 2015, VA amended its regulations to require that all claims governed by VA’s adjudication regulations be filed on a standard form. The amendments also, inter alia, eliminate the constructive receipt of VA reports of hospitalization or examination and other medical records as informal claims to reopen. See 79 Fed. Reg. 57,660 (Sept. 25, 2014), codified as amended at 38 C.F.R. §§ 3.151, 3.155, 3.157. The amended regulations, however, apply only to claims filed on or after March 24, 2015. Because the Veteran’s claims were received by VA prior to that date, the former regulations apply and are cited below. A specific claim in the form prescribed by the Secretary of the VA must be filed in order for benefits to be paid to any individual under the laws administered by VA. 38 U.S.C. § 5101 (a); 38 C.F.R. § 3.151 (a). Any communication or action, indicating an intent to apply for one or more benefits under the laws administered by VA may be considered an informal claim. Such informal claim must identify the benefit sought. Upon receipt of an informal claim, if a formal claim has not been filed, an application form will be forwarded to the claimant for execution. If received within 1 year from the date it was sent to the claimant, it will be considered filed as of the date of receipt of the informal claim. 38 C.F.R. § 3.155 (a). Unless specifically provided otherwise, the effective date of an award based on an original claim, a claim reopened after final adjudication, or a claim for increase, of compensation, dependency and indemnity compensation, or pension, shall be fixed in accordance with the facts found, but shall not be earlier than the date of receipt of application therefor. 38 U.S.C. § 5110 (a); 38 C.F.R. § 3.400. Except as otherwise provided, the effective date of a claim for increase will be the date of receipt of the claim or the date entitlement arose, whichever is later. 38 U.S.C. § 5110; 38 C.F.R. § 3.400. The effective date of an award of increased compensation shall be the earliest date as of which it is ascertainable that an increase in disability had occurred, if application is received within one year from such date. 38 U.S.C. § 5110 (b)(2). Otherwise, it is the date of receipt of the claim. 38 C.F.R. § 3.400 (o)(2); see also Quarles v. Derwinski, 3 Vet. App. 129, 135 (1992) (holding that evidence in a claimant’s file which demonstrates that an increase in disability was “ascertainable” up to one year prior to the claimant’s submission of a claim for VA compensation should be dispositive on the question of an effective date for any award that ensues). In this case, the Veteran’s original claim of service connection for PTSD was received on January 15, 2013. His claim of service connection for anxiety disorder was granted in a December 2013 rating decision, which also assigned an effective date of January 15, 2013, the date of the claim. The record contains no earlier statements or documents that could be construed as an informal claim and the Veteran has pointed to no such statements or documents. The Board acknowledges that the Veteran may have been experiencing symptoms prior to January 15, 2013. However, the effective date of an award of service connection is assigned not based on the date the disability appeared or the date of the earliest medical evidence demonstrating the existence of such disability and a causal connection to service or a service-connected disability. Rather, the effective date is assigned based on consideration of the date that the application upon which service connection was eventually awarded was received by VA. See LaLonde v. West, 12 Vet. App. 377, 382-383 (1999). Based on both the law and the facts set forth above, the Board finds that an effective date prior to January 15, 2013, for the award of service connection for the Veteran’s anxiety disorder is not warranted. Thus, the appeal for an earlier effective date for the grant of service connection for anxiety disorder must be denied. As the preponderance of the evidence is against the claim, the benefit of the doubt doctrine is not for application. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. REASONS FOR REMAND 1. Anxiety disorder, NOS (claimed as PTSD and mood swings) The record appears to be incomplete with regard to this claim. During an April 2014 mental status examination, the Veteran reported that he is in receipt of disability benefits from SSA. Records from SSA are potentially relevant to the Veteran’s VA claim for a higher initial rating for a service-connected psychiatric disability and VA therefore has a duty to undertake the necessary efforts to obtain them. Golz, 590 F.3d at 1320-21. The matter is REMANDED for the following action: (Continued on the next page)   1. Request from SSA a copy of its determination(s) on the Veteran’s claim for disability benefits, as well as copies of all medical records underlying its consideration of the Veteran’s application for benefits. In requesting these records, follow the procedures set forth in 38 C.F.R. § 3.159(c) as regards requesting records from Federal facilities. All records and/or responses received should be associated with the claims file. Jonathan Hager Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD R. Walker, Associate Counsel