Citation Nr: 20021179 Decision Date: 03/24/20 Archive Date: 03/24/20 DOCKET NO. 18-45 632 DATE: March 24, 2020 ORDER Entitlement to service connection for an acquired psychiatric disorder is granted. REMANDED Entitlement to service connection for hypertension is remanded. FINDING OF FACT The Veteran’s major depressive disorder was caused by his witnessing traumatic events while service in a combat zone. CONCLUSION OF LAW The criteria for service connection for an acquired psychiatric disorder have been met. 38 U.S.C. §§ 1131, 1154(b), 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.304, 4.125(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Marine Corps from October 2001 to October 2005. 1. Entitlement to service connection for an acquired psychiatric disorder Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. §§ 1110; 38 C.F.R. § 3.303(a). Establishing service connection generally requires competent evidence of three things: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship, i.e., a nexus, between the claimed in-service disease or injury and the current disability. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). Service connection may also be granted for any disease diagnosed after discharge when all of the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). In addition, for veterans who have served 90 days or more of active service after December 31, 1946, there is a presumption of service connection for certain chronic diseases, including psychoses, if the disability is manifest to a compensable degree within one year of discharge from service. 38 U.S.C. §§ 1101, 1110, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309. In this case, because the Veteran has not been diagnosed with a psychosis, this presumption does not apply. The Veteran contends that he has an acquired psychiatric disorder stemming from his period of service. In this case, the evidence of record establishes that the Veteran received hostile fire/imminent danger pay for serving in a combat zone in Iraq. A July 2019 VA examiner diagnosed the Veteran with major depressive disorder and opined that the Veteran’s condition was related to witnessing injuries from a car which did not stop at the assigned check point and exploded. The type of event described by the Veteran is consistent with the known circumstances of Iraq service, and “actual documentation” of the event is not required. 38 U.S.C. § 1154(a). The Board finds the 2019 opinion to be highly credible and highly probative as to the issues of diagnosis and etiology, as the examiner combined the specific facts of the Veteran’s case with sound medical principles to sufficiently support the conclusion. Given the above, and the lack of evidence against the Veteran’s claim, the Board finds that service connection for major depressive disorder is warranted. REASONS FOR REMAND 1. Entitlement to service connection for hypertension is remanded. The Veteran contends that his hypertension was either caused or aggravated by the medications he was prescribed for his now service-connected major depressive disorder. At the January 2017 VA examination, the examiner declined to provide an opinion regarding secondary service connection, as the Veteran’s psychiatric disability was not service connected. Given the outcome of the Veteran’s appeal regarding his service connection claim for an acquired psychiatric disorder, the Board finds that remand is required for an addendum opinion to determine whether there is a possible link between the Veteran’s hypertension and his service-connected psychiatric disorder. The matters are REMANDED for the following action: 1. Forward the Veteran’s claims file to an appropriate clinician for an addendum opinion regarding the nature and etiology of the Veteran’s hypertension. The examiner should opine whether it is at least as likely as not that the Veteran’s hypertension was either caused by his period of service or caused or aggravated by his service-connected acquired psychiatric disorder, to include medications prescribed for his psychiatric disorder which reportedly included Effexor. The need for further examination is left to the discretion of the examiner. A rationale must be provided for the opinions offered. T. MAINELLI Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Orie, 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.