Citation Nr: 21066207 Decision Date: 10/29/21 Archive Date: 10/29/21 DOCKET NO. 20-00 326A DATE: October 29, 2021 ORDER Entitlement to service connection for bilateral hearing loss is granted. Entitlement to service connection for other specified trauma and stressor related disorder is granted. REMANDED Entitlement to service connection for a brain disability due to TCE exposure with headaches, nausea and dizziness is remanded. FINDINGS OF FACT 1. Resolving reasonable doubt in favor of the Veteran, his bilateral hearing loss is etiologically related to military noise exposure. 2. Resolving reasonable doubt in favor of the Veteran, his other specified trauma and stressor related disorder is etiologically related to service. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for bilateral hearing loss have been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.385. 2. The criteria for entitlement to service connection for other specified trauma and stressor related disorder have been met. 38 U.S.C. §§ 1101, 1110, 1112, 1113, 1116, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The appellant is a Veteran who served on active duty from March 1968 to December 1971. This matter is before the Board of Veterans' Appeals (Board) on appeal from rating decisions of a Department of Veterans Affairs (VA) Regional Office (RO). In May 2021, a Video Conference Board hearing was held before the undersigned. A transcript of the hearing is associated with the Veteran's claims file. 1. Entitlement to service connection for bilateral hearing loss. The Veteran contends that his current bilateral hearing loss disability can be attributed to his exposure to loud noise during service. The Veteran's service personnel records document that his specialty was as an Elect. Computer Repairman. The Veteran reported living near the flight line, and working in missile silos with loud machinery and gunfire, without the use of hearing protection. Giving the veteran the benefit of the doubt, in-service noise exposure is conceded. His service treatment records do not reveal hearing loss. In July 2018, the Veteran underwent an examination. He was found to have a bilateral hearing loss disability pursuant to 38 C.F.R. § 3.385. The examiner concluded, based on the evidence, the Veteran's hearing loss is less likely as not caused by or a result of military noise exposure. The examiner reviewed the STRs and explained the Veteran's entrance and separation examination both reveal hearing within normal limits, and there was no in-service threshold shift. In an August 2021 private treatment record, Dr. J. J., stated the Veterans current hearing loss is related to his noise exposure during service, citing the Veteran's proximity to the flight line. At the Board hearing, the Veteran reported being exposed to loud noise during service, and first noticing hearing loss during service. The Veteran has consistently asserted that he has hearing loss as a result of his time in service. Hearing loss may be service connected if the evidence of record shows that a veteran currently has a disorder that was chronic in service, or if not chronic, that was seen in service with continuity of symptomatology demonstrated thereafter. A veteran is also competent to testify regarding facts or circumstances that can be observed and described by a layperson. There is a positive and negative opinion of record, the Veteran has conceded noise exposure, a currently diagnosed bilateral hearing loss disability for VA benefit purposes, limited civilian noise exposure, and competent and credible testimony indicating ongoing hearing problems since service. Additionally, the Veteran has been service connected for tinnitus with the examiner noting tinnitus is related to noise exposure during service. There is competent and credible testimony indicating ongoing hearing problems since service, and a positive medical nexus. As such, all reasonable doubt is resolved in the Veteran's favor, and service connection for bilateral hearing loss is granted. 2. Entitlement to service connection for other specified trauma and stressor related disorder The Veteran has asserted he suffers from a psychiatric disorder that is related to service. He has been diagnosed with adjustment disorder, depression, bipolar disorder, and unspecified trauma or stressor related disorder. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. Service treatment records (STRs) reveal he was seen for nervous trouble due to personal problems. He was seen on numerous occasions for difficulty sleeping, possible emotional instability, nervousness, and insomnia, and was treated with valium. Service personnel records document instances wherein the Veteran was noted as neglecting his responsibilities in December 1970, and difficulty maintaining off duty activities in July 1970. VAMC treatment records document adjustment disorder, depression, and anxiety. Records reveal that prior to service, the Veteran was seen for extreme emotional immaturity and uncontrollable emotional outbursts at school. In a May 2018 statement, the Veteran reported suffering from anxiety since his time in service. In a July 2018 statement from J H., Psy.D., the Veteran was noted as being diagnosed with PTSD, and having had psychiatric distress since service. The Veteran testified at the Board hearing to being subject to harassment on account of his sexuality during service. The Veteran underwent an examination in July 2018. The examiner diagnosed him with other specified trauma and stressor related disorder. The Veteran was also diagnosed with bipolar disorder. The Veteran reported anxiety surrounding working at a nuclear site, and harassment by a superior officer. He reported during service one of his commanders harassed him, and in one instance disturbed his bed and living space, then accusing the Veteran of living in filth. He reported during service monitoring missiles and or software that controlled the missiles. He would have to go to the silos and reside in a small space for 72 hours at a time. He reported going through numerous readiness drills as well, which equally put his anxiety over his tolerance threshold. He had symptoms of depressed mood, anxiety, suspiciousness, near continuous panic, sleep impairment, disturbances of motivation and mood, difficulty establishing and maintaining effective work and social relationships, difficulty adapting to stressful circumstances, and inability to establish and maintain effective relationships. The examiner concluded the diagnosed other specified trauma and stressor related disorder is at least as likely as not incurred in or caused by the claimed in service stressor. Anxiety was identified as other specified trauma and stressor related disorder. His heightened sense of fear and suspiciousness experiences throughout service due to his MOS at least as likely as not effected the Veteran, as evidence by the stressor related on examination indicating his MOS and time of service in which a pervasive fear of an imminent nuclear attack has carried over into his daily life. As for bipolar disorder, the examiner found that the Veteran's bipolar disorder was less likely than not aggravated beyond its natural progression by an in-service injury, event, or illness. The examiner concluded bipolar disorder which clearly and unmistakably existed prior to service, was clearly and unmistakably not aggravated beyond its natural progression by an inservice injury event or illness. There is a documented history that the Veteran had mental issues prior to service, however, the degree of severity increased many folds during service and shortly after discharge leading up to present. The examiner opined it is less likely than not that the in service participation triggered a worsening of a previously existing unspecified bipolar disorder, because the examiner maintains the Veteran was biologically predisposed to developing a more serious psychiatric condition due to the natural progression that chronological age often plays in the triggering of more serious symptoms that previously existed. Though there is evidence of the Veteran experiencing emotional disturbance prior to service, and there is an opinion as to preexisting bipolar disorder, it has not been established or indicated that he suffered from other trauma related disorder prior to service. Accordingly, he was presumed sound at entry as to the other specified trauma disorder. The Veteran has consistently asserted that he has had a psychiatric disorder as a result of his time in service. A Veteran is also competent to testify regarding facts or circumstances that can be observed and described by a layperson. The Board has no reason to question the Veteran's credibility as to his reports of these in-service events of harassment or fear of an attack. Further, the Veteran was treated throughout service for what was called "nervous trouble," and "personal problems," and there are notes in his personnel records of neglecting his responsibilities, which is in line with the Veteran's report of his room being tampered with and then being accused of not maintaining his living space. There is a positive medical opinion linking his other specified trauma and stressor related disorder to service. As such, all reasonable doubt is resolved in the Veteran's favor, and service connection for other specified trauma and stressor related disorder is granted. REASONS FOR REMAND 1. Entitlement to service connection for a brain disability due to TCE exposure with headaches, nausea, and dizziness is remanded. The Veteran has asserted he suffers from a brain disability due to exposure to TCE. He has submitted articles in support of this contention. Records from Emory Healthcare reveal he was diagnosed with insomnia, TBI, and PTSD. Records from MidTown Neurology reveal he has been diagnosed with occipital neuralgia, cervicalgia, polyneuropathy, and imbalance. In May 2018, the Veteran asserted exposure to TCE during service. He reported TCE exposure affected his central nervous system. In a July 2018 statement from J. H., PsyD., it was indicated the Veteran had neurological and chronic pain issues, which may be linked in part to repeated/daily exposure for prolonged periods of time to the industrial solvent trichloroethylene (TCE) while serving. At the July 2018 psychiatric examination, the examiner commented on the purported TCE exposure. The examiner noted the Veteran presented with an unspecified neurological disorder that neither his doctors at Emory nor Midtown Neurology could identify. They all believed its unclear etiology can be traced back to TCE, a substance used decades ago to clean metal. Symptoms from exposure for adults can cause dizziness, headaches, confusion, and nausea. At times death can result. The Veteran reported using it on a daily basis while working in closes spaces. At the Board hearing the Veteran requested an opinion as to any link between TCE exposure and his current symptoms. He reported exposure to TCE in confined environments with no ventilation while he served various Air Force bases. As the Veteran has not been afforded an examination addressing his claim, the Board finds one is needed to determine the etiology of any diagnosed condition. The matters are REMANDED for the following action: 1. Afford the Veteran an examination to determine the nature and etiology of his claimed brain disorder. The examiner is asked to answer the following: a) Is it at least as likely as not that any diagnosed brain disorder is related to his service? b) Is it at least as likely as not that the Veteran was exposed to TCE? c) If so is it at least as likely as not that TCE exposure led to a current brain disorder? The examiner is asked to address the Veteran's contentions, the STRs, and the July 2018 VA examiner's observation. The examiner is asked to provide a rationale for any opinions rendered. H.M. WALKER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E. Skiouris, 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.