Citation Nr: 21076144 Decision Date: 12/22/21 Archive Date: 12/22/21 DOCKET NO. 17-26 635 DATE: December 22, 2021 REMANDED Entitlement to service connection for headaches is remanded. Entitlement to service connection for a sinus disability is remanded. Entitlement to service connection for degenerative joint disease is remanded. Entitlement to service connection for a low back disability is remanded. Entitlement to service connection for a right leg disability is remanded. Entitlement to service connection for a left leg disability is remanded. Entitlement to service connection for a memory loss disability is remanded. Entitlement to service connection for sleep apnea is remanded. Entitlement to service connection for a hernia is remanded. Entitlement to service connection for bilateral hearing loss is remanded. Entitlement to service connection for an acquired psychiatric disorder, to include depression and PTSD, is remanded. Entitlement to service connection for erectile dysfunction is remanded. REASONS FOR REMAND The Veteran served active duty in the United States Army from March 1979 to March 1982. In a May 2017 VA Form 9, the Veteran requested a Board hearing. In September 2021 correspondence, prior to the adjudication of the case, the Veteran sent written notice withdrawing the request for a Board hearing. Therefore, the Board will proceed accordingly. 1. Service connection for headaches is remanded. 2. Service connection for a sinus disability is remanded. 3. Service connection for degenerative joint disease is remanded. 4. Service connection for a low back disability is remanded. 5. Service connection for a right leg disability is remanded. 6. Service connection for a left leg disability is remanded. 7. Service connection for a memory loss disability is remanded. 8. Service connection for sleep apnea is remanded. 9. Service connection for a hernia is remanded. The Veteran contends that his headaches, sinus condition, degenerative joint disease, low back disability, right leg disability, left leg disability, memory loss, sleep apnea, and hernia are due to his period of service. In the January 2013 application for compensation, the Veteran reported that he received treatment for his various claimed conditions in Sick Call during his period of service. The Board notes that the Veteran's service treatment records appear to be incomplete, containing reports only to 1981, and a separation examination is not of record. These missing records are potentially relevant, as they may contain evidence of the in-service incurrence or aggravation of a disease or injury, and on remand, they must be obtained. The Board acknowledges the August 2021 private medical opinions provided by a diagnostic consultant; however, the factual basis for the examiner concluding that there was an in-service incurrence of these claimed conditions has not been established by the Veteran's records and cannot be established by the opinion itself. Therefore, a remand is necessary prior to adjudicating the claims. 10. Service connection for bilateral hearing loss is remanded. The Veteran contends that he has bilateral hearing loss due to his period of service. In April 2014, the Veteran was afforded a VA examination. Based on the hearing evaluation, the examiner found that the Veteran's hearing did not meet the criteria for a hearing loss disability for VA purposes. See 38 C.F.R. § 3.385. In an August 2021 private medical opinion, the examiner found that the Veteran suffered progressive bilateral hearing loss. The Board notes that, though a hearing examination was performed, the audiometric findings were not provided. Therefore, the examination is inadequate to determine a diagnosis of a hearing loss disability for VA purposes, and a remand is necessary to determine the Veteran's current level of hearing loss. 11. Service connection for an acquired psychiatric disorder, to include depression and PTSD The Veteran contends that he has an acquired psychiatric disorder, to include PTSD and unspecified depressive disorder, due to his period of active duty service. The Veteran's current medical records indicate treatment for depression. The limited service treatment records indicate treatment at the community mental health section of the Army hospital. The records include a March 1979 unit request for evaluation due to a bedwetting incident. The examiner noted a history of bedwetting in the Veteran's childhood. The examiner referred the Veteran for further consult and evaluation, noting evidence of some adjustment reaction problems. While an August 2021 private medical opinion provides a positive nexus opinion for the Veteran's psychiatric disorder, the Board notes that the service treatment records indicate that the Veteran's condition may have pre-existed his active duty service. Therefore, a remand for an opinion is necessary. 12. Service connection for erectile dysfunction is remanded. The Veteran contends that his erectile dysfunction is due to his period of service. Specifically, the Veteran asserts that his erectile dysfunction is secondary to his acquired psychiatric disorder. As the outcome of the Veteran's claim for service connection for an acquired psychiatric disorder would affect the claim for service connection for erectile dysfunction, the matters are inextricably intertwined. Thus, the issue is also remanded pending adjudication of the claim for service connection for an acquired psychiatric disorder. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991) (noting that two or more issues are inextricably intertwined if one claim could have significant impact on the other). The matters are REMANDED for the following action: 1. Undertake appropriate action to conduct additional search(es) for any outstanding service treatment records of the Veteran not currently of record, to include his separation examination. Follow the procedures set forth in 38 C.F.R. § 3.159 (c) as regards requesting records from Federal facilities. All attempts to obtain these records should be documented in the claims file. If the search for these records is negative, such should be documented in the claims file, and the Veteran must be informed of this in writing in accordance with 38 C.F.R. § 3.159 (e). 2. After completing Step 1, schedule the Veteran with the appropriate examiner to determine the nature and etiology of his claimed acquired psychiatric disorder, to include PTSD and unspecified depressive disorder. The claims file must be provided to and be reviewed by the examiner. Any tests or studies deemed necessary should be conducted, and the results should be reported in detail. The examiner should provide an opinion as to the following: (a) Is it clear and unmistakable that the Veteran entered active military service with a pre-existing psychiatric disorder? (b) If YES, is it clear and unmistakable that the Veteran's pre-existing psychiatric disorder WAS NOT aggravated beyond the natural progress of the disorder by her active military service? In other words, please determine whether it is clear and unmistakable that there was no increase in disability during service or that it is clear and unmistakable that any increase in disability was due to the natural progress of the pre-existing condition. (c) If the Veteran DID NOT clearly and unmistakably (i.e., highest degree of medical certainty) enter active military service with a pre-existing psychiatric disorder, is it at least as likely as not (i.e., 50 percent or greater probability) that the Veteran's current psychiatric disorder is etiologically related to any symptomatology noted during such service? In rendering these determinations, the examiner is asked to consider and discuss the March 1979 service treatment record and the August 2021 private medical opinion and any additional evidence regarding the onset and etiology of the Veteran's psychiatric disorder. The examiner should provide reasons for all opinions. However, if the examiner cannot respond to the inquiry without resort to speculation, he or she should state, whether the inability is due to the limits of the examiner's medical knowledge, the limits of medical knowledge in general, or there is additional evidence, which if obtained, would permit the opinion to be provided. 3. After completing Step 1, schedule the Veteran with the appropriate examiner to determine the nature and etiology of his claimed hearing loss. After examination and review of the record, the examiner should address whether it is at least as likely as not (a 50 percent probability or greater) that the Veteran has a bilateral hearing loss disability that was manifested in, caused by, or is otherwise etiologically related to the Veteran's period of active military service. JENNIFER HWA Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Ford 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.