Citation Nr: 21065611 Decision Date: 10/26/21 Archive Date: 10/26/21 DOCKET NO. 19-35 564 DATE: October 26, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disorder is remanded. Entitlement to service connection for a back disability is remanded. Entitlement to service connection for a hearing loss disability is remanded. Entitlement to service connection for tinnitus is remanded. Entitlement to service connection for left leg injury residuals is remanded. Entitlement to service connection for right leg injury residuals is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1979 to July 1982. 1. Acquired psychiatric disorder There is some evidence of record of an acquired psychiatric disorder, which the Veteran attributes to traumatic events in service. The Veteran initially filed a claim for service connection for Post-Traumatic Stress Disorder (PTSD). The Veteran's claim has been broadened to include any acquired psychiatric disorder, as opposed to PTSD alone. The representative, in an August 2021 Appellant's Brief, argued that for service connection for an acquired psychiatric disorder, the available service records have the appearance of including "markers" that a stressor took place. The representative noted that PRP is a program that assesses a servicemembers ability to work with restricted material, typically nuclear. Beginning approximately 18 months after entering service, he began having multiple disciplinary issues that led to his removal from PRP status, an Article 15 (nonjudicial punishment), and eventually a court martial followed by a period of confinement. The representative noted there was no separation examination in the claims file. A VA treatment dated in September 2020 notes that the Veteran had a DSM-5 diagnosis of adjustment disorder with mixed anxiety and depressed mood and there are additional notations of PTSD symptoms in treatment records. While the Veteran appears to have a current diagnosed DSM-V disorder, no examiner has opined whether the diagnosis is at least as likely as not due to service. In addition, the Veteran's representative has argued that a psychiatric disorder is due or aggravated by chronic pain and functional impairments associated with the service-connected knee disorder. The Veteran has not had a VA examination and one is warranted here to address etiology. 2. Service connection for a back disability. The Veteran was granted service connection for right knee, limitation of extension, and right knee meniscal tear and degenerative arthritis, in May 2021, during the pendency of the claim. The Veteran was incarcerated when VA examinations were initially scheduled and the facility holding the Veteran stated that they did not have the ability to conduct onsite examinations. However, the Veteran has since been released from confinement. The representative contended, in the August 2021 Appellant's Brief, that the Veteran had ongoing back problems since service as well as secondary aggravation or causal relationship to the service-connected knee disabilities, as the mechanical alterations from the knees have caused and/or aggravated the back issues. The Veteran has not had a VA examination and one is warranted here to address etiology. 1. 6. All claims Following the issuance of the July 2020 SSOC, additional evidence was added to the claims folder to include VA examinations and VA medical records dated through April 2021. The Board informed the Veteran in August 2021 that this evidence was not previously considered by the AOJ, and that he has the right to have the evidence reviewed by the AOJ prior to Board review. The Veteran responded in May 2021 stating that he wanted his appeal sent back to the AOJ for review of the additional evidence prior to Board review. Considering the above, these matters should undergo review by the AOJ with consideration of all the evidence of record. Due process requires initial AOJ review. See 38 C.F.R. § 20.1304(c). The matters are REMANDED for the following action: 1. After the Veteran's reported stressors have been developed, schedule the Veteran for a psychiatric examination to determine the nature and etiology of any posttraumatic stress disorder (PTSD) or any other acquired psychiatric disorder. The examiner should be made aware of the Veteran's representative arguments that there are markers in the service records (namely, a marked worsening in performance) consistent with a stressor (see above body of the remand for full explanation). If the Veteran is diagnosed with PTSD, the examiner must explain how the diagnostic criteria are met and opine whether it is at least as likely as not related to a verified in-service stressor. Full rationale for all opinions should be provided The examiner is asked the following: (a) If any acquired psychiatric disorders are diagnosed, the examiner is asked to provide an opinion whether any diagnosed disorder is at least as likely as not due to service. (b) If any acquired psychiatric disorders are diagnosed, the examiner is asked to provide an opinion whether any such disorder is proximately due to or the result of a service-connected disease or injury or was aggravated by a service-connected disease or injury. Aggravation means any increase in severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice-connected disease. 2. Schedule the Veteran for a VA examination for a back disorder. Full rationale for all opinions should be provided. The examiner is asked to provide a response to the following: (a) Whether a back disorder was at least as likely as not due to service? (b) Whether a back disorder is proximately due to or the result of a service-connected disease or injury or was aggravated by a service-connected disease or injury. Aggravation means any increase in severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice-connected disease. 3. Readjudicate the claim, considering all evidence added to the file since the July 2020 SSOC. If that review suggests that additional development is indicated, such development should be accomplished. H. N. SCHWARTZ Veterans Law Judge Board of Veterans' Appeals Attorney for the Board P. Yoffe, 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.