Citation Nr: 21025182 Decision Date: 04/27/21 Archive Date: 04/27/21 DOCKET NO. 16-12 507 DATE: April 27, 2021 ORDER Service connection for posttraumatic stress disorder (PTSD) is granted. FINDING OF FACT The Veteran’s currently diagnosed PTSD is, at least in part, aggravated by his service-connected orthopedic disabilities. CONCLUSION OF LAW The criteria to establish entitlement to service connection for PTSD as secondary to the service-connected orthopedic disabilities are met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310 (2020). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran honorably served on active duty from September 1978 to October 1982. In a March 2015 rating decision, the Regional Office (RO) denied service connection for PTSD. The Veteran appealed, requesting a Board’s hearing, but later withdrew his request. In March 2019, the Board remanded the claim for additional development, to include associating any outstanding VA medical treatment records with the claims file, verifying the claimed in-service stressors, and obtaining a medical opinion as to the nature and etiology of the Veteran’s psychiatric disorders, which was completed and the appeal was returned to the Board. Secondary Service Connection for PTSD—Laws and Analysis Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military, naval, or air service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303 (a). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d). Only chronic diseases listed under 38 C.F.R. § 3.309 (a) are entitled to the presumptive service connection provisions of 38 C.F.R. § 3.303 (b). Walker v. Shinseki, 708 F.3d 1331 Fed. Cir. 2013). Establishing service connection generally requires (1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the current disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may also be granted for a disability that is proximately due to or the result of a service-connected disability. See 38 C.F.R. § 3.310 (a). When service connection is thus established for a secondary condition, the secondary condition shall be considered a part of the original condition. See 38 C.F.R. § 3.310 (a); Harder v. Brown, 5 Vet. App. 183, 187 (1993). The controlling regulation has been interpreted to permit a grant of service connection not only for disability caused by a service-connected disability, but for the degree of disability resulting from aggravation of a non-service-connected disability by a service-connected disability. Allen v. Brown, 7 Vet. App. 439, 448 (1995). In rendering a decision on appeal the Board must analyze the credibility and probative value of the evidence, account for the evidence which it finds to be persuasive or unpersuasive, and provide the reasons for its rejection of any material evidence favorable to the claimant. Gabrielson v. Brown, 7 Vet. App. 36, 39-40 (1994); Gilbert v. Derwinski, 1 Vet. App. 49, 57 (1990). When all the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the veteran prevailing in either event, or whether a preponderance of the evidence is against a claim, in which case, the claim is denied. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. Initially, the Board finds that the Veteran has a current psychiatric disability, diagnosed as PTSD. See January 2020 VA examination report. Next, the Veteran has been awarded service connection for various orthopedic disabilities affecting his hips, feet, spine, and knees; he is currently in receipt of a 100 percent combined disability rating. The Board further finds that the evidence is at least in equipoise as to whether the Veteran’s PTSD is secondary, at least in part, to his service-connected orthopedic disabilities. The evidence includes a February 2016 PTSD Disability Benefits Questionnaire, completed by a clinical psychologist. At that time, it was specifically noted that the Veteran’s PTSD and some “physical pain problems” were “intertwined and exacerbate each other.” A January 2020 VA PTSD examination noted that the Veteran was unable to “sustain focus because of pain.” VA treatment records also show that the Veteran reported that he was not able to function like he used to, thus contributing to his depression. VA treatment notes indicate that the Veteran worried about his health continuing to decline. The Board notes that in Ward v. Wilkie, the United States Court of Appeals for Veterans Claims held that, for secondary service connection, “aggravation” need not be permanent in nature. 31 Vet. App. 233, 241-42 (2019). For these reasons, and resolving reasonable doubt in the Veteran’s favor, the Board finds the criteria to establish service connection for PTSD as secondary to the service-connected orthopedic disabilities are met. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. The appeal is granted. Romina A. Casadei Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Alex Bardin, 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.