Citation Nr: 20004347 Decision Date: 01/17/20 Archive Date: 01/17/20 DOCKET NO. 18-04 127 DATE: January 17, 2020 REMANDED Entitlement to service connection for a psychiatric disorder is remanded. Entitlement to service connection for Fuch’s corneal dystrophy with steroid responder (claimed as vision disorder) is remanded. Entitlement to service connection for hypertension is remanded. Entitlement to service connection for hypothyroidism is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1975 to August 1986 and from February 1991 to April 1991. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2015 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). 1. Entitlement to service connection for a psychiatric disorder is remanded. The Veteran seeks service connection for a psychiatric disorder, claimed as anxiety with depression. He essentially asserts that he developed a psychiatric disorder due to stressful events witnessed during his first period of active duty because of his occupational duties. He also avers that he essentially self-treated during service by abusing alcohol. In his February 2019 VA Form 21-4138 and stressor statement, VA Form 21-0781, the Veteran described various events related to his military occupational duties such as moving bodies to the morgue, aiding injured children, seeing burn victims and other injured patients. The Veteran’s DD Form 214 shows his military occupational specialty as HM 8432 – preventive medical technician. In his February 2019 statements, the Veteran indicated that because of the patient trauma he witnessed (and because he was harassed by an individual) he began to drink heavily and was ordered to a Navy alcohol treatment center at NEPMU-2 in Norfolk, Virginia sometime between 1983 and 1984, and that he was also required to complete a Drug and Alcohol Program (DAP). He stated that he stopped drinking excessively in 1989, and around that time, sought outpatient treatment at St. John’s Hospital where he discussed his depression. Personnel records do not appear to reflect referral for any treatment through a DAP or a Navy alcohol treatment center in Norfolk, Virginia. On remand, the RO should seek any additional related records. The file also does not include private medical records from St. John’s Hospital; these should be obtained on remand. Finally, although the current VA medical records do not reflect a currently diagnosed psychiatric disorder, substance dependency disorder, or complaints of anxiety or depression, the Veteran is competent to report that he has experiences anxiety/depression symptoms. Moreover, in a January 2016 written statement, he indicated that he does not talk about his symptoms. Remand is needed for a VA examination and opinion to determine the nature and etiology of his claimed psychiatric disorder. 2. Entitlement to service connection Fuch’s corneal dystrophy with steroid responder (claimed as vision disorder) The Veteran seeks service connection for a vision disorder, to include Fuch’s dystrophy. He believes this condition is related to his in-service left eye corneal abrasion. The Veteran also asserts that his vision problems are related to his excessive use of alcohol that he consumed in service (to essentially self-treat symptoms of anxiety and depression), or to his claimed hypertension and/or hypothyroidism. A December 2017 VA examination report shows that the Veteran has a current diagnosis of bilateral Fuch’s corneal dystrophy and steroid responder. The examiner opined that the Fuch’s corneal dystrophy is unrelated to his in-service left eye corneal abrasion and provided an adequate opinion and rationale. She further noted that the Veteran does not have any current impairment of his visual fields. To the extent that the Veteran asserts, on his VA Form 9, that he developed his eye condition due to his excessive alcohol consumption in service, the Board notes that compensation shall not be paid if a disability is the result of the Veteran’s own willful misconduct as a result of abuse of alcohol or drugs. That is, primary diagnosed disabilities of drug or alcohol abuse are not disabilities for which service connection can be granted. 38 U.S.C. §§ 105, 1131; 38 C.F.R. § 3.301. However, service connection may be awarded for an alcohol or drug abuse disability acquired as secondary to, or as a symptom of, his or her service-connected disability. Allen v. Principi, 237 F.3d 1368 (Fed. Cir. 2001). In order to qualify for service connection in this regard, the Veteran must establish that his alcohol or drug abuse disability is secondary to or is caused by a service-connected disorder. Id. As the appeal is being remanded for a psychiatric examination, and because the intertwined issues of service connection for hypertension and hypothyroidism are also remanded for further development, the Board will defer adjudication of this issue at this time. 3. Entitlement to service connection for hypertension is remanded. The Veteran asserts his hypertension disorder initially onset during his first period of active duty. He further avers that it developed secondary to his excessive use of alcohol in service to essentially self-treat symptoms of anxiety and depression. At separation in July 1986, the Veteran’s blood pressure was recorded as 146/92; hypertension was not diagnosed. During a Reserves enlistment examination in August 1989, his blood pressure was reported as 142/92; ‘mild hypertension’ was diagnosed. The Veteran asserts that he continued to have high blood pressure after discharge from active duty and was under his wife’s medical plan (Tri-Care, Champus) from 1986 to 1990 such that additional medical records are available. A remand is necessary to obtain the identified records and to afford the Veteran a VA examination to determine the nature and etiology for his hypertension. 4. Entitlement to service connection for hypothyroidism is remanded. The Veteran contends that his hypothyroidism developed as a result of his excessive alcohol consumption in service. As noted, compensation shall not be paid if a disability is the result of the Veteran’s own willful misconduct as a result of abuse of alcohol or drugs. 38 C.F.R. § 3.301. As the appeal is being remanded to obtain the outstanding medical treatment records, the Board will defer adjudication at this time. The matters are REMANDED for the following action: 1. Take appropriate action to obtain any relevant records from the Navy Environmental and Preventive Medicine Unit (NEPMU-2) in Norfolk, Virginia from 1983 to 1984. 2. Verify the Veteran’s service dates as a member of the Navy Reserves and determine, to the extent feasible, his specific periods of any ACDUTRA or INACDUTRA service. 3. Ask the Veteran to complete a VA Form 21-4142 for physician(s)/facility(ies) including those from the St. John’s Hospital in Richmond, VA, or from Tri-Care, that have treated his claimed psychiatric disorder, hypertension, and hypothyroidism. Make two requests for the authorized records, unless it is clear after the first request that a second request would be futile. 4. Obtain the Veteran’s VA treatment records for the period from August 2019 to the present. 5. Schedule the Veteran for a VA psychiatric examination to determine the nature and etiology of his psychiatric disorder. The claims file should be reviewed by the examiner. The examiner should identify all current psychiatric disorders and opine as to whether any such disorder(s) is at least as likely as not that any current psychiatric disorder had its onset in service or is otherwise related to service. The examiner must provide a fully-explained rationale and consider the Veteran’s lay report of seeing patients with traumatic injuries/deceased patients as part of his military occupational duties and his use of excessive alcohol consumption to self-treat depression and anxiety in service. 4. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of his current hypertension. a) The examiner must opine whether it is at least as likely as not related to an in-service injury, event, or disease; or manifested within one year of service discharge from active duty in August 1986, or was noted during a period of active service with continuity of the same symptomatology since service. b) If and only if, the Veteran is found to have a psychiatric disorder related to service, then the examiner should provide an opinion regarding whether his hypertension is at least as likely as not proximately due to such service-connected psychiatric disorder OR aggravated beyond its natural progression by service-connected psychiatric disorder. A fully-explained rationale should be provided for all opinions. 5. If appropriate, following the abovementioned development, obtain an addendum opinion from a clinician regarding the Veteran’s Fuch’s corneal dystrophy with steroid responder. Specifically, if the Veteran is found to have a psychiatric disorder and/or hypertension disorder related to service, the examiner should provide an opinion regarding whether the Veteran’s Fuch’s corneal dystrophy with steroid responder is at least as likely as not proximately due to such service-connected disabilities OR aggravated beyond its natural progression by such service-connected disabilities. A fully-explained rationale should be provided for all opinions. D. JOHNSON Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Telamour, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.