Citation Nr: 21075286 Decision Date: 12/20/21 Archive Date: 12/20/21 DOCKET NO. 17-41 296 DATE: December 20, 2021 ORDER The appeal of the issue of entitlement to service connection for a left eye disorder is dismissed. The appeal of the issue of entitlement to service connection for a respiratory disorder, to include chest nodules, is dismissed. The appeal of the issue of entitlement to service connection for a left leg disorder, to include fibrous dysplasia, is dismissed. REMANDED Entitlement to service connection for a stomach disability is remanded. Entitlement to service connection for a lumbar spine disability is remanded. Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD), anxiety, and major depressive disorder, is remanded. Entitlement to service connection for hypertension is remanded. FINDINGS OF FACT 1. In April 2021 written correspondence, the Veteran, through his authorized representative, withdrew the pending appeal of the claim of entitlement to service connection for a left eye disorder. 2. In April 2021 written correspondence, the Veteran, through his authorized representative, withdrew the pending appeal of the claim of entitlement to service connection for a respiratory disorder, to include chest nodules. 3. In April 2021 written correspondence, the Veteran, through his authorized representative, withdrew the pending appeal of the claim of entitlement to service connection for a left leg disorder, to include fibrous dysplasia. CONCLUSIONS OF LAW 1. The criteria for withdrawal of the pending appeal of entitlement to service connection for a left eye disorder have been met. 38 U.S.C. § 7105; 38 C.F.R. § 19.55. 2. The criteria for withdrawal of the pending appeal of entitlement to service connection for a respiratory disorder, to include chest nodules, have been met. 38 U.S.C. § 7105; 38 C.F.R. § 19.55. 3. The criteria for withdrawal of the pending appeal of entitlement to service connection for a left leg disorder, to include fibrous dysplasia, have been met. 38 U.S.C. § 7105; 38 C.F.R. § 19.55. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the U.S. Army from December 1983 to November 1990. This matter comes to the Board of Veterans Appeals (Board) from an appeal of an August 2015 rating decision from the Department of Veterans Affairs (VA) Regional Office (RO) in Huntington, West Virginia, which, in pertinent part, denied entitlement to service connection for PTSD, anxiety disorder, major depressive disorder, fibrous dysplasia, left leg, lower back disability, hypertension, chest nodules, stomach problems, and left eye vision problems. The Veteran filed a timely Notice of Disagreement (NOD), received in May 2016. A Statement of the Case (SOC) was issued in June 2017. A timely substantive appeal was received in July 2017. According to the Veteran's July 2017 VA Form 9, Appeal to Board of Veterans' Appeals, he requested a Board hearing at a local VA office. However, the Veteran, through his prior representative, withdrew his hearing request in an April 2021 communication. There are no additional hearing requests in the record; therefore, the Board deems his request for a hearing withdrawn. See 38 C.F.R. § 20.704(e). The Board has recharacterized the issues of entitlement to service connection for PTSD, anxiety disorder, and major depressive disorder as entitlement to service connection for an acquired psychiatric disorder. See Clemons v. Shinseki, 23 Vet. App. 1, 5-6, 8 (2009) (holding that the scope of a mental health disability claim includes any mental disability that may reasonably be encompassed by a claimant's description of the claim, reported symptoms, and the other information of record). WITHDRAWAL OF CLAIMS 1. Entitlement to service connection for a left eye disorder. 2. Entitlement to service connection for a respiratory disorder, to include chest nodules. 3. Entitlement to service connection for a left leg disorder, to include fibrous dysplasia. The Board may dismiss any appeal which fails to allege specific error of fact or law in the determination being appealed. 38 U.S.C. § 7105. An appeal may be withdrawn as to any or all issues involved in the appeal at any time before the Board promulgates a decision. 38 C.F.R. § 19.55. Withdrawal may be made by the appellant or by his or her authorized representative. 38 C.F.R. § 19.55(a). In the present case, in an April 2021 VA Form 21-4138, the Veteran, through his authorized representative, requested to withdraw the claims of entitlement to service connection for a left eye disorder, a respiratory disorder with chest nodules, and a left leg disorder, to include fibrous dysplasia. The withdrawal was in writing, included the name of the Veteran, the file number, and a clear statement that the claims withdrawn. See Hembree v. Wilkie, 33 Vet. App. 1 (2020). Thus, the criteria for a withdrawal of the claims of entitlement to service connection for left eye disorder, a respiratory disorder with chest nodules, and a left leg disorder, to include fibrous dysplasia, have been met and there remain no allegations of errors of fact or law for appellate consideration. Accordingly, the Board does not have jurisdiction to review the claims and they are dismissed. REASONS FOR REMAND 1. Entitlement to service connection for a stomach disability. 2. Entitlement to service connection for a lumbar spine disability. Private treatment records reveal that the Veteran has been treated for gastroesophageal reflux disease (GERD). Further, in the Veteran's May 2019 statement, he indicated that he had ulcers due to the stress of his job while he was in service. In that statement, the Veteran also contended that he developed a lumbar spine disability as the result of loading and unloading food supplies while on active duty. VA medical records reveal complaints of back pain and a diagnosis of osteoarthritis, although the affected joint or joints is not specified. In any event, the Board finds that there is an indication that the Veteran may have stomach and back disabilities which were incurred in or are otherwise causally related to his active service. As such, he should be afforded appropriate examinations. 38 U.S.C. § 5103A(d); 38 C.F.R. § 3.159(c)(4); see also McLendon v. Nicholson, 20 Vet. App. 79 (2006). However, the Board makes no credibility findings at this juncture. 3. Entitlement to service connection for an acquired psychiatric disorder. While the Veteran was provided a VA psychiatric examination in August 2015, in which it was determined that he did not have a current acquired psychiatric disability, a March 2021 Disability Benefits Questionnaire (DBQ) and medical opinion of Dr. A.W. includes a diagnosis of PTSD and a positive nexus opinion. However, Dr. A.W. did not identify which stressor or stressors upon which the diagnosis of PTSD was based, and the opinion was conclusory in nature. Thus, such is insufficient to grant the benefit sought. However, the Board finds that, based upon the March 2021 diagnosis, the Veteran should be afforded a new psychiatric examination. When VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). 4. Entitlement to service connection for hypertension. In August 2015, the Veteran was afforded a VA examination in connection with his claim. At the time of the examination, the examiner opined that the Veteran's claimed hypertension was less likely than proximately related to PTSD because the Veteran did not have PTSD. However, as delineated above, the issue of entitlement to service connection for an acquired psychiatric disorder is being remanded for a new examination. As resolution of the claim of entitlement to service connection for an acquired psychiatric disorder may have an impact on the Veteran's claim of entitlement to service connection for hypertension, the issues are inextricably intertwined. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991) (holding that where a decision on one issue would have a "significant impact" upon another, and that impact in turn could render any appellate review meaningless and a waste of judicial resources, the two claims are inextricably intertwined). The matters are REMANDED for the following action: 1. Afford the Veteran an examination before an appropriate clinician to determine the nature and etiology of any current stomach disability. Access to the claims file should be made available to the examiner for review. After examining the Veteran and reviewing the claims file, for each stomach disability identified, the examiner should opine as to the following: Is it at least as likely as not that a stomach disability had its onset in service or is otherwise related to the appellant's active service? In providing the requested opinions, the clinician should review the relevant evidence of record, to include the Veteran's reports that he had ulcers in service as a result of stress, and the private medical records revealing treatment for GERD. A clear rationale for all opinions would be helpful and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. In providing the requested opinions, the clinician should consider the Veteran's reported symptoms in service and thereafter, including the nature, onset, progression and severity of the Veteran's reported symptoms. If there is any medical reason to accept or reject the proposition that the Veteran's reported in-service and post-service symptoms represented the onset of a stomach disability, this should be noted. Stated another way, do the Veteran's reports about his symptoms align with how the current stomach disability is known to develop or are the Veteran's reports generally inconsistent with medical knowledge or implausible? The Board makes no credibility finding at this juncture. 2. Afford the Veteran an examination before an appropriate clinician to determine the nature and etiology of any current back disability. Access to the claims file should be made available to the examiner for review. After examining the Veteran and reviewing the claims file, for each back disability identified, the examiner should opine as to the following: Is it at least as likely as not that a back disability had its onset in service or is otherwise related to the appellant's active service? In providing the requested opinions, the clinician should review the relevant evidence of record, to include the Veteran's reports of back pain from loading and unloading food supplies in service. A clear rationale for all opinions would be helpful and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. In providing the requested opinions, the clinician should consider the Veteran's reported symptoms in service and thereafter, including the nature, onset, progression and severity of the Veteran's reported symptoms. If there is any medical reason to accept or reject the proposition that the Veteran's reported in-service and post-service symptoms represented the onset of a back disability, this should be noted. Stated another way, do the Veteran's reports about his symptoms align with how the current back disability is known to develop or are the Veteran's reports generally inconsistent with medical knowledge or implausible? The Board makes no credibility finding at this juncture. 3. Afford the Veteran an examination before an appropriate clinician to determine the nature and etiology of any current psychiatric disability. Access to the Veteran's electronic VA claims file should be made available to the examiner for review in connection with the examination. After reviewing the record and examining the Veteran, the examiner should delineate all current mental disorders exhibited by the appellant, if any. Diagnoses should be rendered in accordance with DSM-5. The examiner should provide an opinion as to whether it is at least as likely as not that each diagnosed psychiatric disability is causally related to the appellant's active service or any incident therein. A complete explanation must be provided for any opinion offered. If PTSD is diagnosed, the examiner should specify the stressor(s) upon which the diagnosis is based. The examiner's attention is directed to (a) the March 2021 private DBQ and etiological opinion, and (b) the August 2015 VA examination report and opinion. A clear rationale for all opinions would be helpful and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. In providing the requested opinions, the clinician should consider the Veteran's reported symptoms in service and thereafter, including the nature, onset, progression and severity of the Veteran's reported symptoms. If there is any medical reason to accept or reject the proposition that the Veteran's reported in-service and post-service symptoms represented the onset of a psychiatric disorder, this should be noted. Stated another way, do the Veteran's reports about his symptoms align with how any current disability is known to develop or are the Veteran's reports generally inconsistent with medical knowledge or implausible? The Board makes no credibility finding at this juncture. R. Behlen Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. Scanlan, Associate 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.