Citation Nr: 21016084 Decision Date: 03/19/21 Archive Date: 03/19/21 DOCKET NO. 17-38 518 DATE: March 19, 2021 ORDER Entitlement to an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD), is granted. REMANDED Entitlement to service connection for hypertension is remanded. Entitlement to service connection for bilateral hearing loss is remanded. FINDING OF FACT The Veteran has been diagnosed with PTSD which is attributable to his service. CONCLUSION OF LAW The criteria for entitlement to an acquired psychiatric disorder have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from September 1966 to March 1970. In January 2021, he testified at a Board hearing before the undersigned Veterans Law Judge. A transcript of the proceeding is in the record. Entitlement to an acquired psychiatric disorder The Veteran contends that he has an acquired psychiatric disability related to his service in Vietnam. The Veteran asserts that his PTSD is the result of fear of hostile military or terrorist activity while in Vietnam, specifically coming under mortar fire while his ship was stationed in the waters near Vietnam. Service connection for PTSD specifically requires medical evidence diagnosing the condition in accordance with 38 C.F.R. § 4.125 (a) (i.e., under the criteria of DSM-5); a link, established by medical evidence, between current symptoms and an in-service stressor; and credible supporting evidence that the claimed in-service stressor occurred. 38 C.F.R. § 3.304 (f). The Board concludes that the Veteran has a current diagnosis of PTSD based on a stressor that is consistent with the circumstance of his service. 38 U.S.C. §§ 1110, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303 (a). The Veteran’s service personnel records show he served aboard the USS Mount McKinley. Those records include an August 1968 commendation from the Chief of Naval Operations which documents that from July 1967 to February 1968, the Veteran’s ship served in support of military operations involving conflict with an opposing foreign force in the Republic of Vietnam. The ship participated in 14 amphibious operations in Vietnam. Further, the Veteran has been consistent in recounting stressful events in service. The in-service stressor is conceded. See 38 C.F.R. § 3.304 (f); 38 U.S.C. § 1154 (b). The Veteran’s private treatment records reflect a current diagnosis of PTSD under the DSM-5 criteria. In August 2020, a private psychologist concluded following interview-based examinations with the Veteran and a review of the evidence that the Veteran’s diagnosed PTSD was due to his combat experiences in Vietnam. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for PTSD is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. REASONS FOR REMAND 1. Entitlement to service connection for hypertension is remanded. The Veteran contends that he suffers from hypertension that is secondary to his service-connected ischemic heart disease. In September 2015, he was afforded a VA examination in which he was diagnosed with hypertension. However, the examiner’s negative nexus opinion is inadequate for the Board to adjudicate the claim because it fails to address the aggravation prong of secondary service connection. Remand is needed for a VA addendum opinion. 2. Entitlement to service connection for bilateral hearing loss is remanded. The Veteran contends that he experiences hearing loss as a result of acoustic trauma during service. In October 2015, he underwent a VA examination where he was diagnosed with bilateral hearing loss. However, the examiner’s negative nexus opinion is inadequate for the Board to adjudicate the claim because of an inaccurate factual premise, namely, that the Veteran’s activities in service showed a low probability of noise exposure. In fact, the Veteran’s statements coupled with his military personnel records show a high probability of acoustic trauma given that he served aboard a Naval ship involved in combat activities off the coast of Vietnam. Remand is needed for a VA addendum opinion that concedes the Veteran’s in-service acoustic trauma. The matters are REMANDED for the following action: 1. Obtain an addendum opinion regarding the Veteran’s service connection claim for hypertension. The claims file, to include a copy of this Remand, must be made available to the examiner for review prior to the exam. If the opinion provider determines that an opinion cannot be provided without an examination, the Veteran should be scheduled for an appropriate examination. Based on the examination, if deemed necessary, and review of the record, the examiner is requested to provide an opinion addressing the following question: Is it at least as likely as not (50 percent or higher probability) that the Veteran’s diagnosed hypertension was caused or aggravated (defined as any increase in disability) by his service-connected ischemic heart disease? A full rationale is to be provided for all stated medical opinions. If an opinion cannot be made without resort to speculation, the examiner should provide an explanation as to why this is so and note what, if any, additional evidence would permit such an opinion to be made. 2. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s diagnosed bilateral hearing loss is at least as likely as not related to his conceded in-service acoustic trauma resulting from service aboard a Naval ship involved in combat activities off the coast of Vietnam. A full rationale is to be provided for all stated medical opinions. If an opinion cannot be made without resort to speculation, the examiner should provide an explanation as to why this is so and note what, if any, additional evidence would permit such an opinion to be made. M. E. Larkin Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Jack S. Komperda, 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.