Citation Nr: 21009527 Decision Date: 02/22/21 Archive Date: 02/22/21 DOCKET NO. 17-52 848 DATE: February 22, 2021 ORDER Service connection for a psychiatric disorder, diagnosed as posttraumatic stress disorder (PTSD), major depressive disorder, and generalized anxiety disorder, is granted. REMANDED The appeals for service connection for costochondritis/Tietze's Syndrome, thrombocytopenia, splenomegaly, hypothyroidism, diabetes mellitus, type 2, vestibular migraines, and polycythemia are remanded. FINDINGS OF FACT The Veteran currently has PTSD, major depressive disorder, and generalized anxiety disorder which are related to service, including the documented Chernobyl nuclear event which started in April 1986. CONCLUSIONS OF LAW The criteria for service connection for a psychiatric disorder, diagnosed as PTSD, major depressive disorder, and generalized anxiety disorder, are met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from December 1983 to December 1987. He claimed service connection for a psychiatric disorder in July 2014, asserting that it is related to the event that started at the Chernobyl nuclear plant in Ukraine on April 26, 1986. His service personnel records show that he was stationed at Bad Aibling, Germany, from January 1986 through August 1987. Evidence which he has submitted shows that this area of southern Germany was exposed to ionizing radiation from the Chernobyl event. Establishing service connection generally requires medical or, in certain circumstances, lay evidence of: (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. See Davidson v. Shinseki, 581 F.3d 1313 (Fed.Cir.2009); Hickson v. West, 12 Vet. App. 247, 253 (1999); Caluza v. Brown, 7 Vet. App. 498, 506 (1995), aff'd per curiam, 78 F.3d 604 (Fed.Cir.1996) (table). Based on the evidence of record, the Board concludes that service connection is warranted for the Veteran's PTSD, major depressive disorder, and generalized anxiety disorder. These disorders were diagnosed by a psychiatrist, Dr. S. Sharpe, in August 2020. The August 2020 private psychiatric examination report recognizes the Chernobyl event as a valid PTSD stressor for the Veteran. Further, Dr. R. Poston, PsyD., concluded that Veteran has “PTSD issues because of the constant worrying about the possibility of disease that may have occurred as a result of Chernobyl.” The private psychiatrist in August 2020 indicated that it is more likely than not that the Veteran’s PTSD is due to the Chernobyl nuclear accident that he experienced in Germany, as well as deadly terrorist attacks against American military personnel and interests while he was stationed in Germany. The Board is satisfied that the Veteran has PTSD, major depressive disorder, and generalized anxiety disorder and that it is due to his experiences in service, including the verified Chernobyl event service stressor which he experienced while stationed at Bad Aibling. REASONS FOR REMAND The claims for service connection for costochondritis/Tietze’s syndrome, thrombocytopenia, splenomegaly, hypothyroidism, diabetes mellitus type 2, vestibular migraines, and polycythemia are being remanded. As noted earlier, the Veteran served on active duty from December 1983 to December 1987. He claimed service connection for the disabilities at issue in May and/or July 2014, asserting that they are due to exposure to ionizing radiation from the event that started at the Chernobyl nuclear plant in Ukraine on April 26, 1986 and caused radioactive fallout into southern Germany. His service personnel records show that he was stationed at Bad Aibling, Germany, from January 1986 through August 1987 approximately 1,730 kilometers from Chernobyl. The Veteran has submitted research articles and materials stating that some ionizing radiation from Chernobyl reached Germany. See Contamination and Radiation Exposure in Germany Following the Accident at the Chernobyl Nuclear Power Plant, received April 2018. He also submitted a 2006 publication by Greenpeace entitled The Chernobyl Catastrophe Consequences of Human Health, which identifies incidences of diabetes, hypothyroidism, diseases of the nervous system (which can include migraines), enlarged and damaged thyroid glands, and thrombocytopenia increasing in “Chernobyl-contaminated areas.” Therefore, the Board finds competent scientific evidence that suggests the claimed disorders are radiogenic diseases such that 38 C.F.R. § 3.311 is for application. 38 C.F.R. § 3.311(b)(4). Further development of the claims is therefore warranted. Namely, a dose estimate must be made as to the size and nature of the radiation dose or doses that the Veteran sustained as a result of being stationed at Bad Aibling during the Chernobyl event, in accordance with 38 C.F.R. § 3.311(a). To help the Under Secretary comply with 38 C.F.R. § 3.311(e), the Veteran should first submit medical records showing the probable date of onset of each of the disabilities at issue. He indicated during his hearing before the undersigned Veterans Law Judge that he had received non-VA treatment prior to 2014, and a March 2014 VA medical record reports that the first of these disabilities (costochondritis/Tietze’s syndrome) started in about 1999 or 2000. The matters are REMANDED for the following action: 1. Make arrangements to obtain all available medical records of treatment which the Veteran has received for costochondritis/Tietze’s syndrome, thrombocytopenia, splenomegaly, hypothyroidism, diabetes mellitus type 2, vestibular migraines, and polycythemia, including the private medical records showing the initial onset and updated VA treatment records. 2. The AOJ shall collect, to the extent not already done, all available records concerning the Veteran's exposure to radiation during service and forward them to the Under Secretary for Health for the preparation of a dose estimate, to the extent feasible, based on available methodologies, given the Veteran was stationed at Bad Aibling during the Chernobyl event. 3. In the event that the process described above results in a positive dose estimate, the claims shall be referred to the Under Secretary for Benefits for further consideration 38 C.F.R. § 3.311(b)(iii), (c). The Under Secretary for Benefits shall then review the claim with reference to the following factors: (i) The probable dose, in terms of dose type, rate and duration as a factor in inducing the disease, taking into account any known limitations in the dosimetry devices employed in its measurement or the methodologies employed in its estimation; (ii) The relative sensitivity of the involved tissue to induction, by ionizing radiation, of the specific pathology; (iii) The Veteran's gender and pertinent family history; (iv) The Veteran's age at the time of exposure; (v) The time lapse between exposure and onset of the disease; and, (vi) The extent to which exposure to radiation, or other carcinogens, outside of service may have contributed to development of the disease. 38 C.F.R. § 3.311(e)(1) - (6). The Under Secretary for Benefits may request an advisory medical opinion from the Under Secretary for Health. If after such consideration the Under Secretary for Benefits is convinced sound and scientific medical evidence supports the conclusion it is at least as likely as not the Veteran's costochondritis/Tietze’s syndrome; thrombocytopenia; splenomegaly; hypothyroidism; diabetes mellitus type 2; vestibular migraines; and/or polycythemia resulted from exposure to radiation in service, the Under Secretary for Benefits shall so inform the AOJ of jurisdiction in writing, setting forth the rationale for this conclusion, including an evaluation of the claim with respect to the factors cited above. 38 C.F.R. § 3.311(c)(1)(i). If the Under Secretary for Benefits determines that there is no reasonable possibility that the Veteran's costochondritis/Tietze’s syndrome; thrombocytopenia; splenomegaly; hypothyroidism; diabetes mellitus type 2; vestibular migraines; and/or polycythemia resulted from radiation in service, the Under Secretary for Benefits shall so inform the AOJ in writing, setting forth the rationale for this conclusion 38 C.F.R. 3.311(c)(1)(ii). If the Under Secretary for Benefits, after considering the opinion of the Under Secretary for Health, is unable to conclude whether it is at least as likely as not, or that there is no reasonable possibility, the Veteran's costochondritis/Tietze’s syndrome; thrombocytopenia; splenomegaly; hypothyroidism; diabetes mellitus type 2; vestibular migraines; and/or polycythemia resulted from radiation exposure in service, the Under Secretary of Benefits shall refer the matter to an outside consultant pursuant to Section 3.311(d) for an opinion on the likelihood the disease is a result of exposure as claimed. 38 C.F.R. § 3.311(c)(2). Thereafter, the claims shall be forwarded to the Under Secretary who shall comply with   38 C.F.R. § 3.311(c), including by considering the claims with reference to the factors specified in 38 C.F.R. § 3.311(e). M. C. GRAHAM Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Lawson 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.