Citation Nr: 21067965 Decision Date: 11/08/21 Archive Date: 11/08/21 DOCKET NO. 18-30 420 DATE: November 8, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disability, to include adjustment disorder, depression, and anxiety, is remanded. Entitlement to service connection for gastroenteritis with residual peristalsis and constipation is remanded. Entitlement to service connection for hepatitis B and C is remanded. Entitlement to service connection for hypertension is remanded. Entitlement to service connection for erectile dysfunction secondary to hypertension is remanded. Entitlement to service connection for tinnitus is remanded. Entitlement to service connection for benign paroxysmal positional vertigo is remanded. Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to service connection for a right wrist disability is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1976 to October 1988. This matter comes on appeal before the Board of Veterans' Appeals (Board) from an August 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In May 2021, the Veteran testified before the undersigned Veterans Law Judge via a virtual hearing. A copy of the hearing transcript is of record and has been reviewed. REASONS FOR REMAND 1. Entitlement to service connection for an acquired psychiatric disability, to include adjustment disorder, depression, and anxiety, is remanded. As an initial matter, the Veteran initially submitted a claim for service connection for PTSD. The RO denied the claim in the August 2014 rating decision. In the June 2015 notice of disagreement, the Veteran specifically indicated he wished to appeal the denial of service connection for depression and anxiety, but he did not specifically list PTSD. Thus, the Board will only discuss a service connection claim for adjustment disorder, depression, and anxiety, as phrased above. The Veteran testified that he has been treated at VAMCs in Durham, North Carolina, Raleigh, North Carolina, and Pittsburgh, Pennsylvania. See May 2021 hearing transcript. The Veteran also submitted a May 2014 VA Form 21-4142, listing his medical providers at VA Durham, North Carolina, VA Raleigh, North Carolina, and VA Pittsburgh, Pennsylvania. While the Pittsburgh VAMC records are associated with the claims file, only one May 2013 record from the Durham VAMC is associated with the claims file. Additionally, no VA treatment records from Raleigh VAMC are associated with the claims file. Thus, on remand, all pertinent VA treatment records should be obtained and associated with the claims file, specifically the records from the Raleigh and Durham VAMCs. 2. Entitlement to service connection for gastroenteritis with residual peristalsis and constipation is remanded. As discussed above, VA treatment records from the Durham and Raleigh VAMCs have not yet been obtained. A remand is warranted to obtain outstanding pertinent treatment records and associate them with the claims file. Additionally, the Veteran was afforded a VA examination for the stomach in May 2014. The Veteran was diagnosed with gastroenteritis with residual peristalsis and constipation. The examiner, a physician, noted that the Veteran was treated for gastroenteritis in July 1978, during service. However, no etiology opinion was provided. As the Veteran has a currently diagnosed gastroenteritis disability with residuals of peristalsis and constipation, and he was diagnosed and treated with gastroenteritis in service, a remand is warranted to obtain a medical opinion as to the nature and etiology of this disability. 3. Entitlement to service connection for hepatitis B and hepatitis C is remanded. The Veteran initially submitted his service connection claim for a liver condition. During the appellate period, the Veteran was diagnosed with both hepatitis B and C. Thus, the Board has recharacterized the issue to include both forms of hepatitis. See Clemons, 23 Vet. App. at 5. As discussed above, VA treatment records from the Durham and Raleigh VAMCs have not yet been obtained. A remand is warranted to obtain outstanding pertinent treatment records and associate them with the claims file. The Veteran was afforded a VA examination for a liver condition in June 2014. The examiner, a nurse practitioner, diagnosed the Veteran with hepatitis B and C. The examiner documented the Veteran's risk factors for contracting hepatitis, which included a history of alcohol abuse, a history of polysubstance abuse including heroin and cocaine, engaging in high risk sexual activity, other percutaneous exposures (such as tattoos, body piercing, acupuncture with non-sterile needles, sharing toothbrushes, sharing shaving razors, etc.), and accidental exposure to blood as a health care worker. No etiology opinion was provided. On remand, a VA medical opinion should be obtained as to the nature and etiology of the hepatitis B and C, to include consideration of the Veteran's statements that he was exposed to blood and blood products as a surgical technician in the military. See May 2014 correspondence, June 2014 correspondence, June 2015 notice of disagreement, June 2018 VA Form 9, and May 2021 hearing transcript. The Veteran's contentions should be considered and addressed. 4. Entitlement to service connection for hypertension is remanded. As discussed above, VA treatment records from the Durham and Raleigh VAMCs have not been obtained. A remand is warranted to obtain outstanding pertinent treatment records and associate them with the claims file. 5. Entitlement to service connection for erectile dysfunction secondary to hypertension is remanded. As discussed above, VA treatment records from the Durham and Raleigh VAMCs have not yet been obtained. A remand is warranted to obtain outstanding pertinent treatment records and associate them with the claims file. 6. Entitlement to service connection for tinnitus is remanded. The Veteran initially submitted a service connection claim for right and left ear conditions. During the appellate period, the Veteran described his symptoms as ringing his ears that made it difficult to hear and dizziness after a blow to the head during service. The Veteran was afforded a VA examination during the appellate period which diagnosed the Veteran with benign paroxysmal positional vertigo, bilateral hearing loss, and tinnitus. Based on the Veteran's symptoms, the Board broadens the service connection claim for a right and left ear condition to include a service connection claim for tinnitus. See Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009) (holding that the scope of a claim is determined by the claimant's description of the claim, the symptoms described, and the information submitted or developed in support of the claim). As discussed above, VA treatment records from the Durham and Raleigh VAMCs have not yet been obtained. A remand is warranted to obtain outstanding pertinent treatment records and associate them with the claims file. As noted above, the Board expanded the Veteran's service connection claim for right and left ear conditions to include tinnitus. As the AOJ has not yet adjudicated this issue in the first instance, the Board remands the claim for the AOJ to review the evidence and issue an initial decision on the claim. 7. Entitlement to service connection for benign paroxysmal positional vertigo is remanded. As discussed above, VA treatment records from the Durham and Raleigh VAMCs have not yet been obtained. A remand is warranted to obtain outstanding pertinent treatment records and associate them with the claims file. The Veteran was afforded a May 2014 VA examination for the ear disability, claimed as right and left ear problems. The Veteran was diagnosed with benign paroxysmal positional vertigo. The Veteran reported that he was in an "altercation" at an off-limits location during service, and he did not report this incident. Service treatment records and personnel records are silent as to the Veteran being involved in a physical fight during service. The Veteran indicated that since this incident he had ringing in his ears and dizziness. His balance remained intact, and the dizziness was usually brief and positional. The examiner did not provide a medical opinion as to the etiology of the vertigo. Thus, on remand, an addendum opinion should be obtained. 8. Entitlement to service connection for bilateral hearing loss is remanded. As discussed above, VA treatment records from the Durham and Raleigh VAMCs are not yet associated with the claims file. A remand is warranted to obtain outstanding pertinent treatment records and associate them with the claims file. 9. Entitlement to service connection for a right wrist disability is remanded. As discussed above, VA treatment records from the Durham and Raleigh VAMCs are not yet associated with the claims file. A remand is warranted to obtain outstanding pertinent treatment records and associate them with the claims file. If the additional VA treatment records show a current right wrist disability, schedule a VA examination with an appropriate clinician to determine the nature and etiology of the right wrist disability, to include whether it had onset during service or was due to his Karate training and competitions in service. See May 2021 hearing transcript. The matters are REMANDED for the following action: 1. Obtain any outstanding pertinent VA treatment records and associate them with the claims file. Specifically, ensure all VA treatment records from the Durham and Raleigh VAMCs are obtained. 2. Request a release from the Veteran for the pertinent prison treatment records from the 2000-2008 incarceration. 3. Obtain a VA medical opinion from an appropriate clinician as to the nature and etiology of the currently diagnosed gastroenteritis disability with residuals of peristalsis and constipation. Whether an additional physical examination is necessary is left to the examiner's discretion. After a thorough review of the claims file, the examiner should provide an opinion as to whether the currently diagnosed gastroenteritis with residuals of peristalsis and constipation had onset during or are otherwise related to service. 4. Obtain a VA medical opinion from an appropriate clinician as to the nature and etiology of the currently diagnosed hepatitis B and hepatitis C disabilities. Whether an additional physical examination is necessary is left to the discretion of the examiner. A thorough review of the claims file is required, and all the Veteran's contentions should be addressed, to include that he was exposed to blood and blood products as a surgical technician in service and he was told during service that he was no longer able to donate blood due to a "blood disorder." See May 2014 correspondence, June 2014 correspondence, June 2015 notice of disagreement, June 2018 VA Form 9, and May 2021 hearing transcript. 5. If, and only if, the additional VA treatment records show a currently diagnosed right wrist disability, schedule the Veteran for a VA examination to determine the nature and etiology of the right wrist disability, to include as due to Karate training and competitions during service. See May 2021 hearing transcript; see also March 1980 STR. 6. Readjudicate the claims on appeal, to include service connection for tinnitus. S. B. MAYS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Harper, 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.