Citation Nr: 20042003 Decision Date: 06/19/20 Archive Date: 06/19/20 DOCKET NO. 17-61 973 DATE: June 19, 2020 ORDER Entitlement to service connection for tinnitus is granted. New and material evidence not having been received, the claim for reopening entitlement to service connection for a bilateral ankle disorder is denied. New and material evidence not having been received, the claim for reopening entitlement to service connection for a bilateral knee disorder is denied. New and material evidence not having been received, the claim to reopen entitlement to service connection for carpal tunnel syndrome is denied. New and material evidence not having been received, the claim to reopen entitlement to service connection for a bilateral shoulder disorder is denied. New and material evidence not having been received, the claim to reopen entitlement to service connection for a bilateral elbow disorder is denied. New and material evidence not having been received, the claim to reopen entitlement to service connection for a left hand disorder is denied. New and material evidence having been received, the claim to reopen entitlement to service connection for a disorder of the right hand and bilateral fingers is granted. New and material evidence having been received, the claim to reopen entitlement to service connection for an acquired psychiatric disorder, to include depression and posttraumatic stress disorder (PTSD) is granted. REMANDED Whether new and material evidence has been received to reopen entitlement to service connection for a right leg disorder is remanded. Whether new and material evidence has been received to reopen entitlement to service connection for a left leg disorder is remanded. Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to service connection for an acquired psychiatric disorder, to include depression and PTSD is remanded. Entitlement to service connection for a low back disorder is remanded. Entitlement to service connection for disorders of the right hand and bilateral fingers is remanded. FINDINGS OF FACT 1. The Veteran’s tinnitus had its onset during service. 2. The August 2013 rating decision that denied reopening entitlement to service connection for an acquired psychiatric disorder, bilateral ankle disorder, bilateral shoulder disorder, bilateral knee disorder, bilateral elbow disorder, carpal tunnel syndrome, and disorders of the bilateral hands and fingers is final. 3. Evidence received since the August 2013 rating decision, when considered by itself or in connection with evidence previously assembled, relates to unestablished facts necessary to substantiate the claims for entitlement to service connection for a psychiatric disorder, and disorders of the right hand and bilateral fingers. 4. Evidence received since the August 2013 rating decision, when considered by itself or in connection with evidence previously assembled, does not relate to unestablished facts necessary to substantiate the claims for entitlement to service connection for a bilateral ankle disorder, bilateral shoulder disorder, a bilateral elbow disorder, left hand disorder, carpal tunnel syndrome, and a bilateral knee disorder. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for tinnitus have been met. 38 U.S.C. §§ 101, 1112, 1113, 1131,5017; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. 2. Evidence received since the August 2013 rating is new and material, and the criteria to reopen the claim for entitlement to service connection for an acquired psychiatric disorder, to include depression and PTSD, have been met. 38 U.S.C. § 5108; 38 C.F.R. § 3.156. 3. Evidence received since the August 2013 rating is not new and material, and the criteria to reopen the claim for entitlement to service connection for a bilateral knee disorder not have been met. 38 U.S.C. § 5108; 38 C.F.R. § 3.156. 4. Evidence received since the August 2013 rating is not new and material, and the criteria to reopen the claim for entitlement to service connection for a bilateral elbow disorder not have been met. 38 U.S.C. § 5108; 38 C.F.R. § 3.156. 5. Evidence received since the August 2013 rating is not new and material, and the criteria to reopen the claims for entitlement to service connection for bilateral shoulder disorder have not been met. 38 U.S.C. § 5108; 38 C.F.R. § 3.156. 6. Evidence received since the August 2013 rating is not new and material, and the criteria to reopen the claim for entitlement to service connection for a bilateral ankle disorder have not been met. 38 U.S.C. § 5108; 38 C.F.R. § 3.156. 7. Evidence received since the August 2013 rating is new and material, and the criteria to reopen the claims for entitlement to service connection for disorders of the right hand and bilateral fingers, have been met. 38 U.S.C. § 5108; 38 C.F.R. § 3.156. 8. Evidence received since the August 2013 rating is not new and material, and the criteria to reopen the claims for entitlement to service connection for carpal tunnel syndrome have not been met. 38 U.S.C. § 5108; 38 C.F.R. § 3.156. 9. Evidence received since August 2013 rating is not new and material, and the criteria to reopen the claims for entitlement to service connection for a left hand disorders have not been met. 38 U.S.C. § 5108; 38 C.F.R. § 3.156. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from August 1980 to May 1983. This appeal to the Board of Veterans’ Appeals (Board) is from an April 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a hearing before the undersigned in February 2020. A transcript of the hearing is of record. The RO reopened the claim for entitlement to service connection for bilateral ankle disorders but denied the claim on the merits. However, the Board must consider the question of whether new and material evidence has been received because it goes to the Board’s jurisdiction to reach the underlying claim and adjudicate the claim de novo. Jackson v. Principi, 265 F.3d 1366 (Fed. Cir. 2001); Barnett v. Brown, 83 F.3d 1380 (Fed. Cir. 1996). If the Board finds that no new and material evidence has been offered, that is where the analysis must end. Butler v. Brown, 9 Vet. App. 167 (1996). The Board notes that the April 2014 rating decision on appeal denied reopening entitlement to service connection for a low back disorder and that the claim was originally denied in April 2008. The available service treatment records show that some are completely illegible while others are partially illegible. Some but not all the legible service treatment records were available in April 2008 as the rating decision referred to them regarding other issues; however, the ones concerning the low back were not available at that time as the rating decision found no evidence of complaints or findings associated with the Veteran’s low back. Regulation 38 C.F.R. § 3.156(c)(1) provides that if at any time after a claim is denied VA receives or associates with the claims file service department records that existed but had not been associated with the claims file at the time VA first decided the claim, VA will reconsider the claim de novo. If VA thereafter makes an award based in whole or in part on these newly associated service department records, the assigned effective date will be “the date entitlement arose, or the date VA received the previously decided claim, whichever is later.” 38 C.F.R. § 3.156(c)(3); see Mayhue v. Shinseki, 24 Vet. App. 273, 279 (2011). Since the record now contains service treatment records that document his low back complaints, the claim has been recharacterized to reflect de novo review of the claim. New and Material Evidence In order to reopen a claim which has been denied by a final decision, the claimant must present new and material evidence. 38 U.S.C. § 5108. New evidence means existing evidence not previously submitted to VA. Material evidence means existing evidence that, by itself or when considered with previous evidence of record, relates to an unestablished fact necessary to substantiate the claim. New and material evidence can be neither cumulative nor redundant of the evidence of record at the time of the last prior final denial of the claim and must raise a reasonable possibility of substantiating the claim. 38 C.F.R. § 3.156(a). For purposes of reopening a claim, the credibility of newly submitted evidence is generally presumed. See Justus v. Principi, 3 Vet. App. 510, 513 (1992) (in determining whether evidence is new and material, the “credibility” of newly presented evidence is to be presumed unless the evidence is inherently incredible or beyond the competence of the witness). The language of 38 C.F.R. § 3.156(a) creates a low threshold for finding new and material evidence, and views the phrase “raises a reasonable possibility of substantiating the claim” as “enabling rather than precluding reopening.” Evidence “raises a reasonable possibility of substantiating the claim,” if it would trigger VA’s duty to provide an examination in adjudicating a non-final claim. Shade v. Shinseki, 24 Vet. App. 110 (2010). 1. Whether new and material evidence has been received to reopen the claim for entitlement to service connection for an acquired psychiatric disorder. Service connection for an acquired psychiatric disorder was initially denied in an April 2008 unappealed rating decision; the RO declined to reopen the claim in an August 2013 rating decision. The Veteran did not submit a notice of disagreement with the August 2013 rating decision. No new and material evidence was received by VA within one year of the issuance of the August 2013 rating decision. Although service treatment records and records from the Social Security Administration (SSA) were received in August 2014, they either contained evidence not pertinent to the psychiatric disability or they were duplicative of records already considered. Therefore, the April 2008 and August 2013 rating decisions are final. See 38 U.S.C. § 7105; 38 C.F.R. §§ 3.104, 3.156, 20.1103; see also Bond v. Shinseki, 659 F.3d 1362, 1367-68 (Fed. Cir. 2011). The RO denied the claim because the evidence considered up to the August 2013 rating decision did not contain any evidence of in-service mental health problems or contain a diagnosed disorder. See April 2008 and August 2013 Rating Decision – Narratives. The Veteran filed his claim to reopen in March 2014. Evidence added to the claims file since the August 2013 rating decision contains diagnoses of depression and PTSD dated in January 2017, and a January 2019 private opinion that links his PTSD to service. See October 2016 CAPRI records and February 2019 Medical Treatment Record – Government Facility. This evidence is new and material because it contains a diagnosis and nexus evidence linking the claimed disability to service. Accordingly, the claim is reopened. 2. Whether new and material evidence has been received to reopen the claim for entitlement to service connection for a bilateral ankle disorder. Service connection for a bilateral ankle disorder was initially denied in an unappealed rating decision in April 2008. Service connection was initially denied on the basis that there was no evidence of gout during service and no evidence that the current diagnosis of gout was related to service. The evidence at that time noted right ankle complaints during service, but a February 2008 VA examiner opined that the Veteran’s joint complaints were less likely than not related to service and more likely than not related to his 23 years of working in construction. An attempt to reopen the claims was denied in an April 2010 rating decision and although the Veteran initiated an appeal of the April 2010 rating decision, he did not submit a substantive appeal after a statement of the case was issued in February 2011. The claims were most recently denied in August 2013 on the basis that the additional evidence leading up to the decision continued to show treatment for the claimed disabilities and did not contain any nexus evidence linking them to service. The evidence considered included February 2008 X-rays that showed mild spurring bilaterally and left ankle gout in November 2009. See November 2009 and May 2010 Medical Treatment Records – Government Facility. The Veteran did not submit a notice of disagreement with the August 2013 rating decision. No new and material evidence was received by VA within one year of the issuance of the August 2013 rating decision. The August 2013 rating decision as well as the April 2008 and April 2010 decisions are final. See 38 U.S.C. § 7105; 38 C.F.R. §§ 3.104, 3.156, 20.1103; see also Bond v. Shinseki, 659 F.3d 1362, 136768 (Fed. Cir. 2011). The Veteran filed a claim to reopen entitlement to service connection for a bilateral ankle disorder in March 2014. Evidence added to the claims file since August 2013 rating decision is cumulative or duplicative of evidence already considered; therefore, it is not new and material. VA treatment records show complaints of ankle pain in October 2007, a left ankle gout attack in November 2009, and left ankle pain in October 2015. See October 2016 CAPRI records. March 2015 X-rays of both ankles show no significant arthritis in the right ankle and some subchondral cyst formation and probably an early osteophyte at the anterior margin of the distal tibial articular surface. See October 2015 CAPRI records. A March 2015 VA examination of the ankles notes the Veteran’s history and the examiner opined that it is less likely as not that the Veteran’s current bilateral ankle conditions were caused by or related to active service. The opinion is based on the current examination, an interview with the Veteran, and review of service treatment records. The Veteran has complaints of right ankle pain during service, but the condition was not progressive or chronic. A left ankle condition was not found on review of documents. The clinician also pointed out that current condition of very early or mild degenerative joint disease of both ankles is approximately 33 years after his initial complaint in service in 1982. Furthermore, the Veteran was in construction for 27 years after his separation from service, and possibility of ankle injuries during such work condition is highly possible. See March 2015 C&P Exam. During the February 2020 hearing, the Veteran stated that he fell on rocks during service and that he currently had arthritis, but no physician told him that it was related to service. See February 2020 Hearing Transcript. His contention is the same as his September 2009 claim and no evidence added to the record supports a finding that a current bilateral ankle disorder is related to service or that arthritis manifested within a presumptive period after service. Thus, the Board finds new and material evidence has not been received and the evidence added to the records does not raise a reasonable possibility of substantiating the claim. 3. Whether new and material evidence has been received to reopen the claim for entitlement to service connection for a bilateral knee disorder. Service connection for a bilateral knee disorder was initially denied in an unappealed rating decision in April 2008 on the basis that there was no evidence of gout during service and no evidence that the current diagnosis of gout was related to service. The evidence considered at that time includes a service treatment record that indicates the Veteran had a hyperextended right knee in April 1980, post-service evidence of gout in June 2001 and osteoarthritis September 2007, and a February 2008 VA examiner’s opinion that the Veteran’s joint complaints were less likely than not related to service and more likely than not related to his 23 years of working in construction. See August 2014 STR – Medical, August 2007 Medical Treatment Record – Non-Government Facility, and February 2008 VA Examination. An attempt to reopen the claim was denied in an April 2010 rating decision and although the Veteran initiated an appeal of the April 2010 rating decision, he did not submit a substantive appeal after a statement of the case was issued in February 2011. The claim was most recently denied in August 2013 on the basis that the additional evidence leading up to the decision continued to show treatment for the claimed disability and did not contain any nexus evidence linking it to service. The Veteran did not submit a notice of disagreement with the August 2013 rating decision. No new and material evidence was received by VA within one year of the issuance of the August 2013 rating decision. The August 2013 rating decision as well as the April 2008 and April 2010 decisions are final. See 38 U.S.C. § 7105; 38 C.F.R. §§ 3.104, 3.156, 20.1103. The Veteran filed a claim to reopen entitlement to service connection for a bilateral knee disorder in March 2014. Evidence added to the claims file since August 2013 rating decision is cumulative or duplicative of evidence already considered; thus, it is not new and material. VA treatment records include October 2013 X-rays of the right knee that showed a progression of what was found on the September 2009 X-rays and continued treatment for arthritis and gout. See March 2015 and October 2016 CAPRI records. During the February 2020 hearing, the Veteran stated that he fell on rocks during service and that he currently had arthritis, but no physician told him that it was related to service. See February 2020 Hearing Transcript. His contention is the same as his September 2009 claim and no evidence added to the record supports a finding that a current bilateral knee disorder is related to service or that arthritis, to include gout, manifested within a presumptive period after service. There is still no evidence linking a knee disability to service. Therefore, the Board finds new and material evidence has not been received and the evidence added to the records does not raise a reasonable possibility of substantiating the claim. 4. Whether new and material evidence has been received to reopen the claim for entitlement to service connection for a bilateral shoulder disorder. Service connection for a bilateral shoulder disorder was denied in an unappealed rating decision in April 2008 on the basis that there was no evidence of gout during service and no evidence that the current diagnosis of gout was related to service. The evidence considered included service treatment records that noted left shoulder pain in January 1982, post-service treatment records noting right shoulder pain beginning in August 1983, and a February 2008 VA examination that contained no diagnosis of a bilateral shoulder disorder and an opinion that the Veteran’s joint pain was less likely than not related to service and more likely than not related to his 23 years of working in construction. See August 2014 STR – Medical, August 2007 Medical Treatment Record – Non-Government Facility, and February 2008 VA Examination. An attempt to reopen the claim was denied in an April 2010 rating decision and although the Veteran initiated an appeal of the April 2010 rating decision, he did not submit a substantive appeal after a statement of the case was issued in February 2011. The claim was most recently denied in August 2013 on the basis that the additional evidence leading up to the decision continued to show treatment for the claimed disability and did not contain any nexus evidence linking it to service. The Veteran did not submit a notice of disagreement with the August 2013 rating decision. No new and material evidence was received by VA within one year of the issuance of the August 2013 rating decision. The August 2013 rating decision as well as the April 2008 and April 2010 decisions are final. See 38 U.S.C. § 7105; 38 C.F.R. §§ 3.104, 3.156, 20.1103; see also Bond v. Shinseki, 659 F.3d 1362, 136768 (Fed. Cir. 2011). The Veteran filed a claim to reopen entitlement to service connection for a bilateral shoulder disorder in March 2014. Evidence added to the claims file since August 2013 rating decision is cumulative or duplicative of evidence already considered; thus, it is not new and material. The VA treatment records added to the file did not contain any ongoing treatment or complaints associated with the shoulders nor did the evidence contain a diagnosis or nexus evidence. See March 2015, October 2016, January 2017 CAPRI records. The Veteran testimony that he had in-service shoulder injuries from weightlifting is not significantly different than what he previously reported in September 2009 or from what is shown in his service treatment records, so it is not new and material. See September 2009 Statement in Support of Claim and February 2020 Hearing Testimony. There is still no evidence linking a shoulder disability to service. Thus, the Board finds new and material evidence has not been received and the evidence added to the records does not raise a reasonable possibility of substantiating the claim. 5. Whether new and material evidence has been received to reopen the claim for entitlement to service connection for a bilateral elbow disorder. Service connection for a bilateral elbow disorder was denied in an unappealed rating decision in April 2008 on the basis that there was no evidence of gout during service and no evidence that the current diagnosis of gout was related to service. An attempt to reopen the claim was denied in an April 2010 rating decision and although the Veteran initiated an appeal of the April 2010 rating decision, he did not submit a substantive appeal after a statement of the case was issued in February 2011. The claims were most recently denied in August 2013 on the basis that the additional evidence leading up to the decision continued to show treatment for the claimed disability and did not contain any nexus evidence linking it to service. The Veteran did not submit a notice of disagreement with the August 2013 rating decision. The evidence leading up to the August 2013 rating decision considered service treatment records that that are silent for any elbow problems and post-service treatment records show positive Tinel finding in the elbow in July 2009, nodules in both elbows and bursitis in the left elbow in November 2009, an acute arthritic flare in December 2009, a noted history of gout in the elbows in May 2011. See August 2014 STR – Medical, December 2007 Medical Treatment Records – Furnished by SSA, November 2009 Medical Treatment Record – Government Facility, December 2011 Medical treatment Record – Non-Government Facility, and July 2012 Medical treatment Records – Non-Government Facility. No new and material evidence was received by VA within one year of the issuance of the August 2013 rating decision. The August 2013 rating decision as well as the April 2008 and April 2010 decisions are final. See 38 U.S.C. § 7105; 38 C.F.R. §§ 3.104, 3.156, 20.1103; see also Bond v. Shinseki, 659 F.3d 1362, 136768 (Fed. Cir. 2011). The Veteran filed a claim to reopen entitlement to service connection for a bilateral elbow disorder in March 2014. Medical evidence added to the claims file since August 2013 rating decision is not new and material because it is cumulative and does not contain any evidence relevant to the claim that was not already considered. See March 2015, October 2016, and January 2017 CAPRI records. In February 2020, the Veteran testified that he had in-service elbow injuries from weightlifting. This evidence is new, but it is not material because he had previously indicated in September 2009 that his bilateral elbow disorder was due to an injury in service. See September 2009 Statement in Support of Claim and February 2020 Hearing Testimony. Thus, the evidence does not relate to an unestablished fact necessary to substantiate the claim or raise a reasonable possibility of substantiating the claim. There is still no evidence linking an elbow disability to service. For this reason, the claim is not reopened. 6. Whether new and material evidence has been received to reopen the claim for entitlement to service connection for carpal tunnel syndrome. Service connection for carpal tunnel syndrome was denied in an unappealed rating decision in April 2008 on the basis that there was no evidence of carpal tunnel syndrome during service and no evidence of the disorder until January 2008 or evidence linking it to service. Records considered include service treatment records that were silent for relevant complaints and findings and post-service records in February 2007 and February 2008 that note significant carpal abnormalities and degenerative changes. See August 2014 STR – Medical, August 2007 Medical Treatment Record – Non-Government Facility and February 2008 VA Examination. The claims were most recently denied in August 2013 on the basis that the new and material evidence had not been received. The Veteran filed a claim to reopen entitlement to service connection for carpal tunnel syndrome in March 2014. Medical evidence added to the claims file since August 2013 rating decision is not new and material because it does not contain any evidence relevant to the claim that was not already considered. See March 2015, October 2016, and January 2017 CAPRI records. The Veteran’s February 2020 hearing testimony noted that the Veteran had carpal tunnel release surgery and stated that no one had put anything in writing that linked his disorders to service. See February 2020 Hearing Transcript. The evidence added to the record does not contain nexus evidence linking his current carpal tunnel syndrome to service or show that it was present in service. Therefore, the evidence added to the record is not new and material and does not raise a reasonable possibility of substantiating the claim. For the reasons stated, the claim is not reopened. 7. Whether new and material evidence has been received to reopen the claim for entitlement to service connection for a disorder of the right hand and bilateral fingers. Service connection for a disorder of the right hand and bilateral fingers was initially denied in an unappealed rating decision in April 2008 on the basis that there was no evidence of gout during service and no evidence that the current diagnosis of gout was related to service. The evidence considered included service treatment records that show he had a jammed 5th finger on the right hand in April 1983; post-service records that indicate gout in the right hands in June 2001, May 2006, May 2007; right hand swelling with a history of an old injury and right hand deformity in January 2008; and a February 2008 VA examination that revealed scars on the left thumb due to surgery as a result of a work related accident in 1984 and included and opinion that the Veteran’s joint pains were less likely than not related to service and more likely related to 23 years of working in construction. See August 2014 STR – Medical, May 2007 Medical Treatment Records – Non-Government Facility, July 2007 Medical Treatment Records – Furnished by SSA, August 2007 Medical Treatment Record – Government Facility, and February 20008 VA Examination. An attempt to reopen the claim was denied in an April 2010 rating decision and although the Veteran initiated an appeal of the April 2010 rating decision, he did not submit a substantive appeal after a statement of the case was issued in February 2011. The claim was most recently denied in August 2013 on the basis that the additional evidence leading up to the decision continued to show treatment for the claimed disability and did not contain any nexus evidence linking it to service. The Veteran did not submit a notice of disagreement with the August 2013 rating decision. No new and material evidence was received by VA within one year of the issuance of the August 2013 rating decision. The August 2013 rating decision as well as the April 2008 and April 2010 decisions are final. See 38 U.S.C. § 7105; 38 C.F.R. §§ 3.104, 3.156, 20.1103; see also Bond v. Shinseki, 659 F.3d 1362, 136768 (Fed. Cir. 2011). The Veteran filed a claim to reopen entitlement to service connection for bilateral hand disorders in March 2014. Medical evidence added to the claims file since the August 2013 rating decision includes April 2014 X-rays that show arthritis in the fingers of both hands and an April 2016 record that indicates he has arthritis in the right hand. See October 2016 CAPRI records. This evidence is material and not cumulative since evidence previously considered did not show he had osteoarthritis in his right hand and bilateral fingers. The remaining records contain earlier records that note gout and hand complaints. See January 2017 CAPRI records. In February 2020, the Veteran testified that he hurt his right hand during service when he fell on slippery rocks. Evidence of osteoarthritis in the right hand and bilateral fingers is new and material evidence and when it is considered with other evidence that he reported hurting his right hand and fingers in service when he fell, it raises a reasonable possibility of substantiating the claim. Thus, the claim is reopened. 8. Whether new and material evidence has been received to reopen the claim for entitlement to service connection for a disorder of the left hand. Service connection for disorders of the left hand was initially denied in an unappealed rating decision in April 2008 on the basis that there was no evidence of gout during service and no evidence that the current diagnosis of gout was related to service. The evidence considered at that time include service treatment records that were silent for complaints or findings associated with the left hand, post-service treatment records that show left hand gout in May 2006, and a February 2008 VA examiner’s opinion that the Veteran’s joint complaints were less likely than not related to service and more likely than not related to his 23 years of working in construction. See August 2014 STR – Medical, May 2007 Medical Treatment Record – Non-Government Facility, and February 2008 VA Examination. An attempt to reopen the claim was denied in an April 2010 rating decision and although the Veteran initiated an appeal of the April 2010 rating decision, he did not submit a substantive appeal after a statement of the case was issued in February 2011. The claim was most recently denied in August 2013 on the basis that the additional evidence leading up to the decision continued to show treatment for the claimed disability and did not contain any nexus evidence linking it to service. The Veteran did not submit a notice of disagreement with the August 2013 rating decision. No new and material evidence was received by VA within one year of the issuance of the August 2013 rating decision. The August 2013 rating decision as well as the April 2008 and April 2010 decisions are final. See 38 U.S.C. § 7105; 38 C.F.R. §§ 3.104, 3.156, 20.1103. The Veteran filed a claim to reopen entitlement to service connection for a left hand disorder in March 2014. Evidence added to the claims file since the August 2013 rating decision is cumulative or duplicative of evidence already considered; thus, it is not new and material. In particular, April 2014 X-rays of the left hand continue to show gout. See October 2016 CAPRI records. The evidence previously considered already indicated the Veteran had gout in his left hand. Thus, the evidence does not relate to an unestablished fact necessary to substantiate the claim or raise a reasonable possibility of substantiating the claim. There is still no evidence linking a left hand disability to service. For this reason, the claim is not reopened. Service Connection Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated during service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. In order to establish entitlement to service connection, there must be (1) evidence of a current disability; (2) medical, or in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) a causal connection between the claimed in-service disease or injury and the current disability. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). Service connection may be presumed for certain chronic diseases, such as hearing loss and tinnitus, which develop to a compensable degree within one year after discharge from service, even though there is no evidence of the disease during the period of service. That presumption is rebuttable by probative evidence to the contrary. 38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309(a). Service connection for a recognized chronic disease can also be established through continuity of symptomatology. Walker v. Shinseki, 708 F.3d 1331 (2013); 38 C.F.R. §§ 3.303(b), 3.309. In determining whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 9. Entitlement to service connection for tinnitus. The Veteran contends that his tinnitus is related to his exposure to loud noises during service. His military occupational specialty was field artillery battery man. See February 2020 Hearing Transcript and April 2007 Certificate of Release or Discharge. His April 2014 claim states it began during service. Many of the Veteran’s service treatment records are of poor quality and illegible; however, a November 1981 treatment record shows that his left ear was impacted with wax and it appears he complained of ringing at the time. His April 1983 separation examination was negative for any ear problems. See August 2014 STR – Medical. On February 2015 VA examination, the Veteran denied having recurrent tinnitus, to the audiologist did not offer an opinion as to its etiology. See February 2015 C&P Exam. However, a November 2016 treatment record indicates he had a history of complaints of ear wax and tinnitus and that this was chronic. Given his MOS, in-service complaints, report of ongoing symptoms since service, and the November 2016 treatment record, reasonable doubt exists as to the etiology of his tinnitus. Since reasonable doubt is resolved in the Veteran’s favor, the claim is granted. REASONS FOR REMAND 1. Entitlement to service connection for a low back disorder is remanded. A partially legible service treatment record in January 1982 shows that the Veteran reported having pain that radiated from his back. In April 1983, he complained of back pain after playing basketball and he was given an assessment of mild muscle strain. See August 2014 STR – Medical. Post-service treatment records in July 2009 show that he had diagnoses of L4-5 mild anterolisthesis, disc bulge, facet arthrosis, L5-S1 Rt paracentral disc protrusion. X-rays mild facet hypertrophy. See December 2007 Medical Treatment Records – Furnished by SSA. Even though the record shows the Veteran had a post-service back injury in 2005, he had back complaints prior to this and as early as January 2002. See August 2007 Medical Treatment Record – Non-Government Facility and December 2007 Medical Treatment Records – Furnished by SSA. For this reason, a VA opinion is needed to determine if any current low back disorder is related to the in-service complaints. 2. Whether new and material evidence has been received to reopen entitlement to service connection for a right leg disorder is remanded. Since the record indicates that the Veteran had right lower extremity radiculopathy associated with the lumbar disorder, the Board finds the two issues are inextricably intertwined. See December 2007 Medical Treatment Records – Furnished by SSA. As such, no determination can be made regarding the right lower extremity until service connection for a low back disorder is decided. 3. Entitlement to service connection for bilateral hearing loss is remanded. During the February 2020 hearing, the Veteran testified that his last hearing test had been two years ago. As the findings of the test are pertinent to the appeal, they should be added to the record. 4. Entitlement to service connection for an acquired psychiatric disorder, to include depression and PTSD is remanded. The Veteran’s service treatment records show he served in Beirut. He has a diagnosis of PTSD based on a stressor stemming from him service in Beirut. Specifically, he reported being in Beirut when a truck with TNT exploded into barracks. Many servicemen were injured or killed. See August 2014 STR – Medical, February 2019 Medical Treatment Record – Government Facility, and February 2020 Hearing Testimony. No attempt yet had been made to corroborate this stressor. This should be done on remand. 5. Whether new and material evidence has been received to reopen a claim for entitlement to service connection for a left leg disorder is remanded. The April 2015 rating decision denied reopening entitlement service connection for a left leg disorder. The Veteran’s November 2015 notice of disagreement included the denial of reopening the claim, but this issue was not addressed in the November 2017 statement of the case. Thus, the Board has limited jurisdiction over the issue for the sole purpose of remanding it so the RO can issue a statement of the case. Manlincon v. West, 12 Vet. App. 238 (1999). 6. Entitlement to service connection for a disorder of the right hand and bilateral fingers is remanded. The Veteran testified that he hurt his right hand and fingers when he fell during service and he currently has osteoarthritis in the right hand and bilateral fingers. Since the Veteran was not afforded a VA examination, an opinion is needed to determine if his osteoarthritis is related to service. The matters are REMANDED for the following action: 1. Issue a statement of the case for the claim to reopen entitlement to service connection for a left leg disorder. 2. Obtain the Veteran’s complete service personnel records, to include any that document the dates when the Veteran served in Beirut, Lebanon and his unit assignment. Then contact appropriate sources to corroborate the Veteran’s stressor statement and determine if he was stationed when and where it occurred. 3. Ask the Veteran where his hearing was tested two years ago and, if necessary, have him complete and return a medical release to obtain the records. 4. Schedule the Veteran for a VA examination (or telehealth interview, review of the record, etc., if an in-person examination is not feasible) to evaluate his claim for service connection for a low back disorder. The examiner should review the claims file. After the examination/interview and review of the record, the clinician should identify the Veteran’s low back disorders and opine whether any are at least as likely as not (50 percent probability or greater) related to service and the complaints noted therein. The clinician is advised that even though the record indicates a post-service back injury in 2005 he or she should consider the treatment records prior to this that also show back complaints. The clinician must explain the rationale that supports the opinion with references to the evidence, as needed. 5. Schedule the Veteran for a VA examination (or telehealth interview, review of the record, etc., if an in-person examination is not feasible) to evaluate his claim for service connection for disorders of the right hand and bilateral fingers. The examiner should review the claims file. After the examination/interview and review of the record, the clinician should opine whether the osteoarthritis in the right hand and bilateral fingers is at least as likely as not (50 percent probability or greater) related to a fall he had in service. The clinician is advised that many of the service treatment records are illegible and that the Veteran is competent to report injuries stemming from a fall. The clinician must explain the rationale that supports the opinion with references to the evidence, as needed. S. HENEKS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Bredehorst 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.