Citation Nr: 21065636 Decision Date: 10/26/21 Archive Date: 10/26/21 DOCKET NO. 18-36 971 DATE: October 26, 2021 REMANDED Entitlement to a compensable rating for service-connected bilateral hearing loss is remanded. Entitlement to service connection for a psychiatric disorder, to include posttraumatic stress disorder (PTSD) is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1981 to December 1989. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). In August 2021, the Veteran testified before the undersigned Veterans Law Judge (VLJ). A hearing transcript is associated with the record. In remanding these matters, the Board makes no finding, implicit or otherwise, as to the credibility of the Veteran's assertions. Neither the Veteran's credibility nor any lack thereof should be presumed in this remand. 1. Entitlement to a compensable rating for service-connected bilateral hearing loss is remanded. The Veteran asserts that his hearing loss is worse than when last tested for compensation purposes in 2015. See Hearing Transcript (August 2021). The Board finds that remand is warranted for a current VA examination. Although the mere passage of time is not grounds for a new examination, a new examination is appropriate when there is an assertion of an increase in severity since the last examination. 38 C.F.R. § 3.159; Snuffer v. Gober, 10 Vet. App. 400, 403 (1997). VA must provide a new examination where a veteran claims the disability is worse than when originally rated and the available evidence is too old to adequately evaluate the current severity. Caffrey v. Brown, 6 Vet. App. 377, 381 (1995). As noted above, the Veteran has stated his hearing is worse than when last tested by VA. See Hearing Transcript (August 2021). The most recent C&P examination was in 2015, over 6 years prior. See C&P Exam (January 2015). Accordingly, remand for a current VA examination is required. 2. Entitlement to service connection for a psychiatric disorder, to include PTSD is remanded. The Veteran contends that he has PTSD due to in-service stressors. The stressors he has reported are as follows: 1) witnessing the beginning of the bombing of Beirut while stationed off the coast of Lebanon while on the USS Monongahela; 2) learning that he may have known someone killed in the bombing of Beirut; 3) seeing body bags brought onto the USS Monongahela while off the coast of Virginia after the bombing of the Marine barracks in Lebanon in October 1983, and transporting those bodies to the Norfolk Naval station; 4) being shot at while on the USS Monongahela after crossing Qaddafi's Death Line in January or February 1986; 5) the stressful environment of serving on the USS Taurus while it was engaged in drug enforcement, to include firing upon/disabling drug vessels in October 1989 while at sea in the Florida straits; 6) the stressful environment on the USS Taurus due to multiple mechanical problems, such as flooding and a hull repair near Panama; 6) an incident while serving on the USS Taurus when a helicopter went down and they were unable to save one person aboard; and 7) an incident while serving on the USS Taurus in October or November 1989, where hydraulic spray was sprayed all over him. See Hearing Transcript (August 2021); VA 21-0781, Statement in Support of Claim for PTSD (June 2018); VA 21-4138, Statement in Support of Claim (October 2015); VA 21-0781, Statement in Support of Claim for PTSD (December 2014); Military Personnel Record (May 2015). He also asserts that his undiagnosed PTSD began manifesting during service, after he departed the USS Monongahela. See VA 21-4138 Statement in support of Claim (February 2016). He stated he began to get into fights, used alcohol to mask his symptoms, and went AWOL. See VA 21-4138 Statement in Support of Claim (February 2016). The Board finds that remand is warranted to conduct additional development. Although the RO attempted to verify the Veteran's stressors, the only information received was that the USS Monongahela was either in port at Norfolk, Virginia or cruising the VACAPES operating area from October to December 1983. See Correspondence (May 2018). But the Veteran has not asserted that the USS Monongahela was in Lebanon waters when the Marine barracks were bombed, but that they received body bags from the Marines who were killed in that incident. See Hearing Transcript (August 2021). Additionally, other evidence of record appears to support some of the Veteran's assertions. The Veteran's service personnel records (SPRs) indicate that the Veteran served on the USS Monongahela from October 1981 to April 1986 and on the USS Taurus from August 1988 to December 1989. See Military Personnel Record (May 2015). The SPRs indicate that sometime between April 1989 and December 1989, the Veteran "participated in night SAR mission of downed helo during law enforcement operations" and was "key player during an underway flooding casualty." See Military Personnel Record (May 2015). Other service department records indicate that during the week of October 11, 1989, on the USS Taurus, "[m]aintenance efforts concentrated in repairs to number one SSPU since during a shut down, white smoke was observed from the exhaust stack. Subsequent investigation revealed a rotor rear oil seal and lube oil pump failure." See Medical Treatment Record Government Facility (September 2020). These records also appear to show that the Veteran was a member of the helo crash and salvage team and there was a rescue of 5 of 6 crewmen from a downed helicopter in November 1989 and that the USS Taurus incurred hull damage off the coast of Panama. See Military Personnel Record (May 2015); Medical Treatment Record Government Facility (September 2020). A buddy statement was submitted from MV, who verified that while on the USS Monongahela they were told they took on the remains of Marines and then transported them to the carrier. See Hearing Related (July 2021). The Veteran's SPRs show that the USS Monongahela operated in the vicinity of Libya/Gulf of Sidra in March 1986. See Military Personnel Records (May 2015). Finally, the Veteran's SPRs indicate both excellent performance ratings and disciplinary problems such as drug use, overstaying liberty, AWOL status, and drunk driving. See Military Personnel Records (May 2015). Thus, it appears that several of the stressors are verifiable or verified. Accordingly, remand is required for this further development. Additionally, the Board finds that remand is required to obtain a VA examination. VA has a duty to assist claimants to obtain evidence needed to substantiate a claim. 38 U.S.C. § 5103A; 38 C.F.R. § 3.159. VA's duty to assist includes providing a medical examination when is necessary to make a decision on a claim. 38 U.S.C. § 5103A(d); 38 C.F.R. § 3.159(c)(4). The RO did not provide the Veteran with an examination. Such development is necessary if the information and evidence of record does not contain sufficient competent medical evidence to decide the claim, but (1) contains competent evidence of diagnosed disability or recurrent symptoms of disability, (2) establishes that the Veteran suffered an event, injury or disease in service, or has a presumptive disease during the pertinent presumptive period, and (3) indicates that the claimed disability may be associated with the in-service event, injury, or disease, or with another service-connected disability. 38 C.F.R. § 3.159(c)(4); McLendon v. Nicholson, 20 Vet. App. 79, 83-86 (2006) (noting that the third element establishes a low threshold and requires only that the evidence "indicates" that there "may" be a nexus between the current disability or symptoms and active service, including equivocal or non-specific medical evidence or credible lay evidence of continuity of symptomatology). Here, VA treatment records contain diagnoses of PTSD and depression. See CAPRI (August 2018); CAPRI (May 2018). Additionally, there appears to be at least one stressor verified the downed helicopter incident in 1989 while on the USS Taurus. The Veteran has reported he sought treatment from a private physician in 1990 or 1991 for depression symptoms. See Hearing Transcript (August 2021). Accordingly, there is evidence of currently diagnosed disabilities, an in-service event, and an indication that the current disabilities may be associated with the in-service event, remand for a VA examination is required. While on remand, the RO should again attempt to obtain relevant private medication records. See 38 C.F.R. § 3.159(c)(1). The matters are REMANDED for the following action: 1. Obtain the Veteran's VA treatment records for the period from April 2018 to the Present. 2. Ask the Veteran to complete a VA Form 21-4142 for all non-VA treatment records pertaining to the claimed conditions to include Dr. JF. Make two requests for the authorized records from Dr. JF, unless it is clear after the first request that a second request would be futile. 3. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected bilateral hearing loss. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran's disability under the rating criteria, to include functional effects caused by the Veteran's hearing loss. 4. Attempt to obtain verification of the Veteran's stressors as listed below. Document all requests for information as well as all responses in the claims file. The Veteran's alleged stressors are as follows: 1) witnessing the beginning of the bombing of Beirut by the US Navy, while stationed off the coast of Lebanon on the USS Monongahela; 2) seeing body bags brought onto the USS Monongahela while off the coast of Virginia after the bombing of the Marine barracks in Lebanon in October 1983, and transporting those bodies to the Norfolk Naval station; 3) being shot at while on the USS Monongahela after crossing Qaddafi's Death Line in January or February 1986; 5) the stressful environment of serving on the USS Taurus while it was engaged in drug enforcement, to include firing upon/disabling drug vessels in October 1989 while at sea in the Florida straits; 6) the stressful environment on the USS Taurus due to mechanical problems, such as flooding and a hull repair near Panama; 6) an incident while serving on the USS Taurus when a helicopter went down and they were unable to save one person aboard; and 7) an incident while serving on the USS Taurus in October or November 1989, where hydraulic spray was sprayed all over him. 5. Schedule the Veteran for a VA examination for all psychiatric disorders. Indicate clearly and expressly for the examiner whether VA concedes the alleged stressors. The entire claims file, to include a copy of this REMAND, should be made available to and reviewed by the clinician. Based on review of the record, detail the Veteran's reported symptoms, including the nature, onset, progression and severity of any symptoms consistent with the diagnosed psychiatric disorders. The opinion should, among other things, include a discussion of the Veteran's documented history and assertions. The opinion should also identify and explain the relevance or significance, as appropriate, of any history, clinical findings, medical knowledge or literature, etc., relied upon in reaching the conclusion(s). The clinician should provide the following opinions, with supporting rationale: (a) If the Veteran is diagnosed with PTSD, the examiner must explain how the diagnostic criteria are met, or not met, and opine whether it is at least as likely as not related to a verified in-service stressor or based on a fear of hostile military or terrorist activity during service. (b) If PTSD is not diagnosed, the examiner must address the prior diagnoses of record. (c) If any other psychiatric disorders are diagnosed, including depression, the examiner must opine whether each diagnosed disorder is at least as likely as not related to an in-service injury, event, or disease, specifically, a verified in-service stressor or fear of hostile military or terrorist activity during service. (d) Consider all relevant evidence of record to include: 1) the service personnel records demonstrating excellent performance ratings and disciplinary problems; 2) the service department records listed above appearing to corroborate some of the Veteran's stressors; 3) MV's buddy statement; 4) the Veteran's statements in support of claim detailing his stressors; 5) the Veteran's Board hearing testimony; and 6) VA treatment records diagnosing depression and PTSD. NOTE (1): An adequate medical opinion may not be predicated solely on the absence of an in-service diagnosis or documented complaints. NOTE (2): If any medical history is rejected, a complete explanation is required. 6. Ensure that the medical opinion obtained includes a complete rationale for the conclusions reached. The medical opinion must support the conclusions reached with an analysis that is adequate for the Board to consider and weigh against other evidence of record; medical opinions must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. If an opinion cannot be expressed without resort to speculation, ensure that the clinician so indicates and discusses why an opinion is not possible, to include whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. 7. Readjudicate. C.A. SKOW Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K.M., 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.