Citation Nr: 21068681 Decision Date: 11/12/21 Archive Date: 11/12/21 DOCKET NO. 17-14 937 DATE: November 12, 2021 ORDER Entitlement to service connection for posttraumatic stress disorder (PTSD) is granted. Entitlement to service connection for tinnitus is granted. FINDINGS OF FACT 1. The Veteran's reported stressors are related to his fear of hostile military or terrorist activity. 2. A VA psychiatrist found that the Veteran's stressors is adequate to support a diagnosis of PTSD. 3. Tinnitus began during active service. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for PTSD have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.304(f). 2. The criteria for service connection for tinnitus are met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from July 2009 to December 2009 and from January 2011 to January 2012. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a September 2014 decision of the VA Regional Office (RO). In September 2020 correspondence, the Veteran requested an expedited decision due to financial hardship. Upon review of the evidence, the motion is granted, and the Board has advanced the case on the docket. 38 C.F.R. § 20.900 (c). Service Connection 1. Entitlement to service connection for PTSD The Veteran contends that PTSD is related to stressors he experienced during service in Iraq. In a January 2012 statement, the Veteran described stressors that occurred during his first mission in May 2011. The Veteran also described witnessing a truck accident with burned and dismembered bodies. In another statement, the Veteran reported that a group of Iraqis tried to enter the entry control point (ECP), and he had to draw his weapon. Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active service. 38 U.S.C. §§ 1110; 38 C.F.R. § 3.303 (a). Establishing service connection generally requires competent evidence of three things: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship, i.e., a nexus, between the claimed in-service disease or injury and the current disability. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009). In addition to the general requirements for service connection, PTSD claims require: (1) medical evidence diagnosing the condition; (2) a link, established by medical evidence, between current symptoms and an in-service stressor; and (3) credible supporting evidence that the claimed in-service stressor occurred. 38 C.F.R. § 3.304 (f). A diagnosis of PTSD must be established in accordance with 38 C.F.R. § 4.125 (a), which provides that all psychiatric diagnoses must conform to the American Psychiatric Association's Diagnostic and Statistical Manual for Mental Disorders (DSM-V). 38 C.F.R. § 3.304 (f). If a stressor claimed by a veteran is related to the veteran's fear of hostile military or terrorist activity and a VA psychiatrist or psychologist confirms that the claimed stressor is adequate to support a diagnosis of PTSD and that the veteran's symptoms are related to the claimed stressor, in the absence of clear and convincing evidence to the contrary, and provided the claimed stressor is consistent with the places, types, and circumstances of the veteran's service, the veteran's lay testimony alone may establish the occurrence of the claimed in-service stressor. "Fear of hostile military or terrorist activity" means a veteran experienced, witnessed, or was confused with an event or circumstance that involved actual or threatened death or serious injury, or a threat to the physical integrity of the veteran or others, such as rocket or mortar fire, and the veteran's response to the event or circumstance involved a psychological or psycho-physiological state of fear, helplessness, or horror. 38 C.F.R. § 3.304 (f)(3). The Veteran's DD Form 214 reflects that he served in Iraq from February 2011 to December 2011. His occupation was motor transport. The Veteran was afforded a VA examination in September 2014. The examiner was asked to determine whether the Veteran has PTSD, and if so, whether his diagnosis is related to a fear of hostile military activity. The examination reflects that there was no diagnosis rendered. The examiner opined that the symptomatology did not meet the criteria for a separate diagnosis of PTSD or other psychiatric diagnosis. The examiner explained that the trauma and exposure symptomatology reported by Veteran does not meet the criteria for a PTSD diagnosis under DSM-IV or DSM-V. VA treatment records dated in June 2015 reflect that the Veteran reported PTSD and depression. The Veteran reported that the base was bombed when he was driving to Kalfu on his first mission. He reported that he saw a big fire in a 18-wheeler, and there were people in the car. It was noted that he felt like he was going to die. The Veteran also reported that they were shot at and bombed every night when they went out of the base. A psychiatrist diagnosed the Veteran with PTSD, combat-related. In this case, there is conflicting evidence regarding the diagnosis of PTSD. Cohen v. Brown, 10 Vet. App. 128, 139, 140 (1997) (mental health professionals "are presumed to know the DSM requirements applicable to their practice and to have taken them into account in providing a PTSD diagnosis"). The diagnosis of PTSD is related to a fear of hostile military activity. The Board finds that the evidence is at least in equipoise as to whether the criteria for service connection for PTSD are met. Resolving reasonable doubt in the Veteran's favor, the Board finds that service connection for PTSD is warranted. 38 C.F.R. § 3.102. 2. Entitlement to service connection for tinnitus The Veteran contends that he has tinnitus due to his deployment in Iraq. The Veteran has a current diagnosis of tinnitus, moderate, combat related. See June 2015 treatment records. The Veteran was afforded a VA examination in September 2014. The examination reflect that the Veteran reported tinnitus. He reported that he initially noticed bilateral tinnitus in 2009. The examiner did not provide an opinion regarding the etiology of tinnitus because the examiner found threshold testing for both ears to be unreliable. For veterans who have served 90 days or more of active service during a war period or after December 31, 1946, certain chronic disabilities, including tinnitus, are presumed to have been incurred in service if manifest to a compensable degree (10 percent disabling) within one year of discharge from service. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309. The September 2014 VA examination reflects that the Veteran reported a history of tinnitus since 2009. The Veteran's reported history of tinnitus symptoms is probative as to the onset, as he is competent to report experiencing tinnitus. The Board finds him credible. Service connection may be presumed based upon onset within a year of separation. A June 2015 treatment record also provides a positive nexus to his service. Accordingly, the evidence is at least in equipoise, and service connection for tinnitus is warranted. J. NICHOLS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Catherine Cykowski 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.