Citation Nr: 21004177 Decision Date: 01/26/21 Archive Date: 01/26/21 DOCKET NO. 17-58 415 DATE: January 26, 2021 REMANDED Entitlement to service connection for a bipolar disorder is remanded. Entitlement to service connection for an acquired psychiatric disorder to include, posttraumatic stress disorder (PTSD), is remanded. Entitlement to service connection to a left knee condition is remanded. Entitlement to service connection to a right knee condition, to include as secondary to claimed left knee condition, is remanded. Entitlement to service connection for coronary occlusion resulting in acute angina with respiratory problems (heart disability) is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from June 1957 to June 1961 with additional reserve service. This matter is before the Board of Veterans’ Appeal (Board) on appeal from an October 2015 rating decision issued by the Department of Veteran Affairs (VA) Regional Office (RO). The Veteran appeared at a hearing before the undersigned Veterans Law Judge in October 2020. A transcript of the hearing is in the Veteran’s file. Here, although small portions of the Veteran’s service treatment records (STRs) are of record, they are largely unavailable (i.e., induction, separation, and any treatment records). The RO deemed the Veteran’s STRs unavailable after exhaustive efforts to secure them were unsuccessful. In cases where the STRs are unavailable, the Board has a heightened duty to assist the Veteran in the development of his claim. Cuevas v. Principi, 3 Vet. App. 542 (1992). 1. Entitlement to service connection for a bipolar disorder is remanded. 2. Entitlement to service connection for an acquired psychiatric disorder to include, posttraumatic stress disorder (PTSD), is remanded. The Veteran is seeking service connection for a bipolar disorder and an acquired psychiatric disorder. The Veteran contends that his claimed disorders are products of his service during the Congo Independence Crisis. See December 2014 VA 21-0781. Review of the Veteran’s available medical treatment records indicate that the Veteran has been receiving treatment for a psychiatric disorder since at least 1998. The Veteran, to this point, has not been afforded a VA examination to determine the etiology and nature of his claimed psychiatric disabilities. As such, the Veteran shall be afforded a VA examination to determine the etiology of his claimed psychiatric disorders. Turning to the Veteran’s claimed PTSD, upon remand the RO must take steps to confirm the Veteran’s stressor statement, as confirmation of the Veteran’s alleged stressor is essential to a claim of service connection for PTSD. The Veteran has also presented testimony indicating outstanding private medical records related to his claimed psychiatric disabilities. See October 2020 Board Hearing Transcript. As such, further development is needed to obtain any outstanding medical records. 3. Entitlement to service connection to a left knee condition is remanded. 4. Entitlement to service connection to a right knee condition, to include as secondary to claimed left knee condition, is remanded. The Veteran is seeking service connection for a bilateral knee condition. The Veteran contends that his bilateral knee condition is the result of his active service, specifically while serving in the flight line during his active service. Review of the available medical evidence indicates that the Veteran has complained of right knee pain and has been diagnosed with right knee osteoarthritis. To this point, the Veteran has not been afforded a VA examination to determine the etiology of his claimed bilateral knee condition. Considering the Veteran’s contentions and complaints of knee pain, a VA examination addressing the nature and etiology of the Veteran’s claimed bilateral knee condition is needed. 5. Entitlement to service connection for coronary occlusion resulting in acute angina with respiratory problems (heart disability) is remanded The contends that service connection for a heart disability is warranted. The Veteran asserts that he was exposed to herbicide agents during his reserve service. The Veteran identified an unauthorized trip to Saigon in 1968 or 1969 and potential exposure to transport aircrafts that transported Agent Orange from Philippines and Guam, as potential sources of exposure to herbicide agents. Development is needed to corroborate whether the Veteran was able to take an unauthorized trip to Saigon during reserve duty. Additionally, development is needed to determine the Veteran’s periods of Reserve service, to include whether he worked aboard any C-123 aircraft. To this point, the Veteran has not been afforded a VA examination to determine the etiology of his claimed heart condition. Considering the Veteran’s contentions, a VA examination addressing the nature and etiology of the Veteran’s claimed heart condition is needed. The Veteran indicated that he is a recipient of SSI disability benefits during his October 2020 Board hearing. The Board notes, however, that a February 2018 memorandum from the SSA National Records Center found no medical records for the Veteran. The Board finds that another attempt should be made to determine if there any medical records available with Social Security Administration since February 2018. The matters are REMANDED for the following actions: 1. Obtain the Veteran’s complete service personnel records. 2. Obtain the Veteran’s records from the Social Security Administration. Document all requests for information as well as all responses in the claims file. 3. With any necessary assistance from the Veteran, obtain private treatment records regarding his claimed disabilities, to include any records related to treatment received in Washington, D.C. and in Europe. 4. Contact the appropriate record depository and request verification of the Veteran’s service dates as a member of the Air Force Reserves and obtain any personnel records related to such service. Determine whether that service included any periods of active duty training (ACDUTRA) or inactive duty training (INACDUTRA) and, to the extent feasible, ascertain the dates for each such period. 5. Attempt to verify the Veteran’s asserted in-service exposure to herbicide agents, to include whether he regularly and repeatedly operated, maintained, or served onboard C-123 aircraft. If more details are needed, contact the Veteran to request the information. If there is still insufficient information to verify exposure to herbicide agents, issue a Formal Finding outlining the steps taken to assist the Veteran and notify the Veteran of VA’s inability to verify the in-service herbicide agent exposure. 6. Schedule the Veteran for an appropriate VA examination to determine the nature and possible relationship to service of his claimed psychiatric disorder and bipolar condition. The evidence of record, to include a copy of this Remand, must be made available to the examiner and the examiner must indicate that the pertinent medical records and lay statements have been reviewed. Following a review of the record, the examiner must address the following: (a) Provide diagnoses for all current psychiatric disabilities, to include those noted during the appeal period. (b) If you find that the Veteran currently suffers from PTSD, please state whether it is at least as likely as not that this disorder is related to any confirmed in-service stressor. (c) If you find that the Veteran suffers from a psychiatric disorder other than PTSD, then state whether it is at least as likely as not that this disorder or disorders had their onset during or are otherwise related to the Veteran’s active service. A complete rationale is required for all opinions offered by the reviewing examiner. 7. Schedule the Veteran for an appropriate VA examination to determine the nature and possible relationship to service of his claimed right and left knee disabilities. The evidence of record, to include a copy of this Remand, must be made available to the examiner and the examiner must indicate that the pertinent medical records and lay statements have been reviewed. Following a review of the record, the examiner must address the following: (a) Provide diagnoses for all current knee disabilities, to include those noted during the appeal period. (b) State whether it is at least as likely as not that any knee disability had its onset during or are otherwise related to the Veteran’s active service. 8. Schedule the Veteran for an appropriate VA examination to determine the nature and possible relationship to service of his claimed heart disability. The evidence of record, to include a copy of this Remand, must be made available to the examiner and the examiner must indicate that the pertinent medical records and lay statements have been reviewed. Following a review of the record, the examiner must address the following: (a) Provide diagnoses for all current heart disabilities, to include those noted during the appeal period. (b) If the Veteran’s herbicide exposure is verified: If you find that the Veteran currently suffers from CAD or IHD, no etiological medical opinion is needed as the Veteran would presumptively service connected. If you find that the Veteran suffers from a heart disability other than CAD or IHD, then state whether it is at least as likely as not that this disorder or disorders had their onset during or are otherwise related to the Veteran’s active service, to include herbicide agent exposure (without consideration of the presumption). (c) If the Veteran’s herbicide exposure is not verified: State whether it is at least as likely as not that any heart disorder or disorders had their onset during or are otherwise related to the Veteran’s active service. Evan M. Deichert Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J.R. Higgins, 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.