Citation Nr: 21075750 Decision Date: 12/21/21 Archive Date: 12/21/21 DOCKET NO. 18-35 881 DATE: December 21, 2021 ORDER Service connection for tinnitus is granted. REMANDED Service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder, sleep deprivation or disturbances and anxiety is remanded. Service connection for glaucoma both eyes is remanded. Service connection for high blood pressure is remanded. Service connection for breathing problems is remanded. Service connection for diabetes is remanded. Service connection for grinding of teeth is remanded. FINDING OF FACT Veteran's tinnitus had its onset in service. CONCLUSION OF LAW The criteria for entitlement to service connection for tinnitus have been met. 38 U.S.C. § 1131; 38 C.F.R. § 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from August 1988 to February 1989, as well as additional service in the Nevada Air National Guard. This appeal stems from a September 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In June 2021, the Veteran testified at a hearing held before the undersigned Veterans Law Judge. At the hearing the undersigned Veterans Law Judge granted the Veteran's motion to hold the record open for a period of 90 days to afford him the opportunity to submit additional evidence in support of this appeal. The Veteran has not done so and the Board will adjudicate this appeal based on the current record. 1. Service connection for tinnitus ringing in the ears. Certain chronic diseases, like tinnitus, will be presumed related to service if they were noted as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if continuity of the same symptomatology has existed since service, with no intervening cause. 38 U.S.C. § § 1101, 1112, 1113, 1131, 1137; Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2012); Fountain v. McDonald, 27 Vet. App. 258 (2015); 38 C.F.R. §§ 3.303(b), 3.307, 3.309(a). The claims file documents a current diagnosis of tinnitus. See July 2017 Private Treatment Record. Next, there is evidence of an in-service injury. The Veteran served as a chemical operations specialist, which has a high probability for hazardous noise exposure. At the June 2021 Board hearing, the Veteran testified that during service, he experienced ringing in his ears following noise exposure from explosive devices during training, and that the ringing has continued since service. The Veterans statements were competent and credible. Accordingly, the Board accepts the Veteran's account of in-service acoustic trauma. Based on the Veteran's competent and credible lay statements that tinnitus had its onset in and has been continuous since military service, as well as the conceded hazardous military noise exposure service, resolving any reasonable doubt in favor of the Veteran, the Board finds that service connection for tinnitus is warranted via competent and credible evidence of continuity of symptomatology. 38 C.F.R. § 3.303(b); see also Fountain, 27 Vet. App. 258. REASONS FOR REMAND 1. Service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder, sleep deprivation or disturbances and anxiety is remanded. 2. Service connection for glaucoma both eyes is remanded. 3. Service connection for high blood pressure is remanded. 4. Service connection for breathing problems is remanded. 5. Service connection for diabetes is remanded. 6. Service connection for grinding of teeth is remanded. The Veteran's claim of entitlement to service connection for posttraumatic stress disorder has been combined with the Veteran's claim of entitlement to service connection for sleep deprivation or disturbances and anxiety as discussed in the Veteran's June 2021 Board prehearing conference, and also expanded to include an acquired psychiatric disorder as retitled above. The Court has held that a scope of a claim is not limited exclusively to what is listed on the claims application but must involve the evaluation of several factors including "the claimant's description of the claim; the symptoms the claimant describes; and the information the claimant submits or that the Secretary obtains in support of the claim." Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009). The Veteran claims direct service connection for an acquired psychiatric disorder, to include sleep apnea deprivation or disturbances and anxiety, glaucoma both eyes, high blood pressure, breathing problems, diabetes, and grinding of teeth. The Veteran maintains that he was treated for glaucoma while in the U.S. National Guard, and that he was diagnosed with asthma after smoke and chemical training during advanced annual training (AIT). The Board notes a January 1989 emergency service treatment record documenting contusion to the Veteran's left eye and eye swelling. The Veteran also explained that his family physician opined that the Veteran's psychiatric symptoms, including a sleep disorder, may be secondary to his tinnitus. Additionally, the Veteran referenced a diagnosis of diabetes in 1993 following AIT, as well as diagnosis for high blood pressure and bruxism around 1988 or 1989. While the claims file show diagnosis of the claimed conditions, the Veteran's complete private and military treatment records have not been associated with the claims file. Therefore, the Board finds that remand for these treatment records is necessary prior to rendering a decision on the appeal. Additionally, to date, the Veteran has not been afforded VA examinations for the above conditions. VA has the duty to assist claimants and must provide a medical examination or obtain a medical opinion when there is competent evidence that the Veteran may have a current disability, and there is evidence that the conditions may be related to service. 38 U.S.C. § 5103A(d)(1); 38 C.F.R. § 3.159(c)(4). The matters are REMANDED for the following action: 1. Obtain and associate with the record all National Guard medical treatment and private treatment records. All attempts to obtain these records should be documented in the claims file. 2. Obtain any outstanding post-service treatment records. 3. Schedule the Veteran for a VA examination (or telehealth interview, review of the record, etc. if an in-person examination is not feasible) to determine the nature, onset and etiology of the Veteran's psychiatric disability, sleep apnea deprivation or disturbances and anxiety, glaucoma both eyes, high blood pressure, breathing problems, diabetes, and grinding of teeth disabilities to determine whether it is at least as likely as not that the disabilities are related to or had onset in service. A diagnosis of asthma and of PTSD must be ruled in or excluded. The examiner must also opine as to whether the Veteran has the Veteran has any sleep problems or mental health issue that were caused or aggravated by his service-connected tinnitus. The examiner must also opine as to whether it is at least as likely as not that the Veteran has symptoms of sleep disorder and or psychiatric disability that is a manifestation of his service-connected tinnitus. The examiner must specifically address the Veteran's lay statements regarding the onset of each claimed disability. (Continued on the next page) The rationale for all opinions rendered must be provided. STEVEN D. REISS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Booker 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.