Citation Nr: 21071594 Decision Date: 11/30/21 Archive Date: 11/30/21 DOCKET NO. 17-29 343 DATE: November 30, 2021 REMANDED Service connection for posttraumatic stress disorder (PTSD) is remanded. Service connection for hypertension to include as secondary to diabetes is remanded is remanded. Service connection for peripheral neuropathy of the left upper extremity to include as secondary to diabetes is remanded. Service connection for peripheral neuropathy of the right upper extremity to include as secondary to diabetes is remanded. REASONS FOR REMAND The Veteran served honorably in the United States Air Force from March 1966 to January 1970. These matters come to the Board of Veterans' Appeals (Board) on appeal from a February 2014 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). This appeal is being adjudicated under the legacy appellate framework. The Veteran does not desire a personal hearing before the Board. 1. PTSD is remanded. At issue is whether the Veteran is entitled to PTSD. The Veteran underwent a VA examination in January 2014. The examination opined that the Veteran PTSD was unrelated to a period of service, because the examiner did not find the Veteran's reports of an in-service stressor to be credible. Ultimately, the credibility of the Veteran's statements is a matter for the Board rather than the examiner, and the Board is unable to determine the medical significance of the Veteran's statements if (and the Board emphasizes if) are found to be credible based on the current examination results of record. Once VA undertakes the effort to provide the Veteran with a VA examination, it must provide the Veteran with an adequate one, and an adequate examination nis sufficiently detailed in order to ensure that VA's evaluation of the Veteran's claim is fully formed. Barr v. Nicholson, 21 Vet. App. 303 (2007). Therefore, this matter must be remanded for a new VA examination in order to address these concerns. 2. Service connection for hypertension to include as secondary to diabetes is remanded is remanded. At issue is whether the Veteran is entitled to hypertension to include as secondary to diabetes. The Veteran underwent a VA examination in January 2014, and the examiner opined that the Veteran's hypertension was not secondary to the Veteran's diabetes; because the Veteran was diagnosed with the conditions at the same time. This opinion is inadequate, because it does not explain why the Veteran could not have: first manifested diabetes without detection, second that diabetes caused hypertension without detection, and finally a simultaneous diagnosis of diabetes and hypertension. Therefore, the examination in not sufficiently detailed enough for VA to fully evaluate the claim, and the Veteran must remand this matter for a new examination to address this concern. See Barr. (CONTINUED ON NEXT PAGE) 3. Service connection for peripheral neuropathy of the left upper extremity to include as secondary to diabetes is remanded. 4. Service connection for peripheral neuropathy of the right upper extremity to include as secondary to diabetes is remanded. At issue is whether the Veteran is entitled to service connection for peripheral neuropathy of the bilateral upper extremities. As discussed above, the issue of service connection is being remanded for an examination in order to determine the side effects of the Veteran's diabetes. Therefore, this matter must be remanded as well in order to avoid piecemeal appellate litigation. Stegall v. West, 11 Vet. App. 268 (1998). The matters are REMANDED for the following action: 1. Arrange to provide the Veteran with a VA examination in order to address the following: (a.) Is it at least as likely as not (50 percent or more) that a medical nexus exists between an acquired psychiatric disorder other than PTSD and an in-service incurrence? Why or why not? (b.) Is it at least as likely as not that there is a medical link between PTSD and an in-service stressor? Why or why not? (c.) Are any of the Veteran's claimed stressors related to a fear of hostile military or terrorist activity? Why or why not? (d.) Are any of the Veteran's claimed stressors adequate to support a diagnosis of PTSD? Why or why not? (e.) Are any of the Veteran's PTSD symptom related to any of the Veteran's claimed stressors? (f.) What is the medical significance, if any, of the Veteran's reports of witnessing rocket attacks and any resulting casualty attacks are true? Why? 2. Arrange to provide the Veteran with a VA examination in order to address the following: (a.) Please identify any and all disabilities that the Veteran has that have been caused by the Veteran's diabetes? Why? (b.) Is it at least as likely as not (50 percent or more) that the Veteran's hypertension was proximately due to or aggravated by a previously service-connected disability (to include diabetes)? Why or why not? In offering this opinion, please consider the possibility that either the Veteran's diabetes or the Veteran's hypertension could have manifested without being detected or diagnosed. (c.) Is it at least as likely as not (50 percent or more) that the Veteran's peripheral neuropathy of the bilateral upper extremities was proximately due to or aggravated by a previously service-connected disability (to include diabetes)? Why or why not? In offering this opinion, please consider the possibility that either the Veteran's diabetes or the Veteran's peripheral neuropathy could have manifested without being detected or diagnosed. DAVID L. WIGHT Veterans Law Judge Board of Veterans' Appeals Attorney for the Board David R. Seaton, 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.