Citation Nr: 21026647 Decision Date: 05/03/21 Archive Date: 05/03/21 DOCKET NO. 16-55 950 DATE: May 3, 2021 ORDER Entitlement to service connection for posttraumatic stress disorder (PTSD) is granted. Entitlement to service connection for schizoaffective disorder, depressive type, is granted. Entitlement to service connection for prostate cancer is granted. Entitlement to service connection for GERD is granted. Entitlement to service connection for a back disability is granted. FINDINGS OF FACT 1. The Veteran's PTSD was aggravated by active service. 2. The Veteran's schizoaffective disorder began during active service. 3. The Veteran's prostate cancer is related to exposure to herbicide during service. 4. The Veteran's GERD began during active service and is related to exposure to herbicide during service; the Veteran's hiatal hernia was most likely aggravated by military service. 5. The Veteran's back disability is related to an in-service injury. CONCLUSIONS OF LAW 1. The criteria for service connection for PTSD are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for schizoaffective disorder are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 3. The criteria for service connection for prostate cancer are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 4. The criteria for service connection for GERD are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 5. The criteria for service connection for a back disability are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active duty from October 1977 to August 1981. This case comes before the Board of Veterans' Appeals (Board) on appeal from rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO). In September 2020, the Veteran testified at a virtual hearing before the undersigned. A transcript of the proceeding is of record. Service Connection 1. Entitlement to service connection for posttraumatic stress disorder (PTSD) The Veteran contends that his PTSD is due to service. In the alternative, he contends that his PTSD was aggravated by stressor events during service. The Board concludes that the Veteran has a current disability of PTSD that was aggravated by service. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). The October 2015 examiner found that the Veteran did not meet the criteria for PTSD. Both the May 2016 and September 2020 examiners and an April 2015 VA psychologist found that the Veteran had a PTSD diagnosis. The Board finds that the evidence is in favor that the Veteran has a current diagnosis of PTSD. Generally, for service connection to be granted for PTSD, the stressor must be verified by the RO. Here, the Veteran's trauma that caused his PTSD happened prior to service. The evidence shows that the Veteran's PTSD diagnosis instead was aggravated by service. The Veteran's Report of Medical History at the time of entry into the military notes that he had nervous trouble. After examining the Veteran and reviewing the service records and treatment records following service, Dr. A.S. opined that the Veteran's PTSD was aggravated beyond normal course due to active service. The Veteran explained that during service he saw a man take his own life. The evidence shows that this incident aggravated the Veteran's PTSD diagnosis. Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran's current PTSD diagnosis that was aggravated by the trauma he experienced during service. 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. 2. Entitlement to service connection for schizoaffective disorder, depressive type The Veteran contends that his PTSD began during service. In Clemons v. Shinseki, 23 Vet. App. 1 (2009), the Court of Appeals for Veterans Claims (CAVC) held that the scope of a mental health disability claim includes any mental disability that may reasonably be encompassed by the claimant's description of the claim, reported symptoms, and the other information of record. Therefore, the Board finds that the Veteran's claim for schizoaffective disorder was included in his claim for PTSD. The Board concludes that the Veteran has a current disability that began during active service. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). The September 2020 and the October 2015 examiners both found that the Veteran had a current diagnosis of schizoaffective disorder. Thus, the question becomes whether the current disability is related to service. The examiner who conducted the October 2015 examination opined that it is possible that the referenced trauma worsened his schizoaffective disorder but without resort to mere speculation, it is not possible to know this now. He noted that schizoaffective disorder is a progressive illness. The September 2020 examiner opined that the Veteran's schizoaffective disorder began during his military service. The record shows that the Veteran had a change of behavior while stationed in Korea. His personnel records noted that he simply walked away from commanding officers giving him orders without clear reason. The September 2020 examiner opined that his stark behavior change, combined with bizarre and nonsensical nature of behavior suggests early symptoms of schizoaffective disorder, especially when combined with his account of symptoms development. The examiner opined that it was at least as likely as not that the Veteran's schizoaffective disorder began during military service. Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran's current schizoaffective disorder began during service. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for schizoaffective disorder is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. 3. Entitlement to service connection for prostate cancer The Veteran contends that his prostate cancer is due to his military service. The Board concludes that the Veteran has a current disability that is related to his exposure to herbicide during service. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). A December 2015 VA treatment record notes that the Veteran had a history of prostate cancer with a radical prostatectomy nine years earlier. Due to the surgery, he has urinary incontinence. The evidence shows that the Veteran has residuals of his prostate cancer disability. Thus, the question becomes whether the current disability is related to service. On this question there is a probative opinion in favor of the claim. In January 2021, a physician reviewed the Veteran's claims file which included service personnel records, VA records, service treatment records, the Veteran's personal statements and the Veteran's private medical records. The physician explained that he was a residency trained occupational and environmental physician with 30 years of experience in Military Medicine, Occupational Medicine and Environmental Health. The physician noted that the Veteran was stationed in Camp Hovey, South Korea which was fifteen miles from the demilitarized zone (DMZ). He reported that he was on guard duty for several hours. The examiner noted that although the Veteran served in Korea outside the presumptive period for herbicidal exposure in Korea, the dates assigned for the presumptive period are arbitrary and are not associated with any clean-up of herbicide. The examiner also noted that there is also documentation showing that herbicides were still used after 1971 in Korea. The examiner opined that it is highly probable that the environment was still inundated with the chemicals, because the persistence of phenoxy herbicides in the environment is well established. The examiner provided documentation to support his opinion. Based on this evidence, the examiner concluded that herbicides were used unfettered in and around the Korean DMZ, and the Veteran was exposed. The examiner concluded that the Veteran's prostate cancer was more than likely caused by exposure to herbicides while serving in Korea. He further noted that the Veteran's urinary incontinence and erectile dysfunction were more likely caused by his prostate cancer. Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran's current prostate cancer residuals are related to service. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for prostate cancer is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. 4. Entitlement to service connection for GERD The Veteran contends that his gastroesophageal problems began in service. The Board concludes that the Veteran has a current disability that began during active service. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). The September 2020 examiner found that the Veteran had a current diagnosis of H. pylori infection, reflux esophagitis, and hiatal hernia. Service treatment records note epigastric pain on several occasions. The Veteran testified that he had no stomach problems prior to service. He did not report nor did the examiner find any gastroesophageal disability upon entry into service. Thus, the question becomes whether the current disability is related to service. On this question there is a probative opinion in favor of the claim. The September 2020 physician reviewed the Veteran's medical and personnel records. The physician found that it was more likely than not that the gastroesophageal condition is due to herbicide exposure while he was in the DMZ. The examiner provided a reasoned rationale for his opinion. The examiner also noted that the Veteran's mechanical problems with gastroesophageal junction with hiatal hernia more likely pre-existed service, but was more likely than not aggravated by military service. This condition led to endoscopic and open hiatal hernia repair. Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran's current gastrointestinal disabilities are related to service. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for gastroesophageal disabilities is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. 5. Entitlement to service connection for a back disability The Veteran contends that his back problems began in service. The Board concludes that the Veteran has a current disability that began during active service. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). A January 2016 VA treatment record notes a current diagnosis of degenerative changes with disc space and foraminal narrowing as shown in a lumbar spine x-ray. The September 2020 physician reviewed the Veteran's medical and personnel records. The physician found that it was more likely than not that his back disability was due to the Veteran's military service. The examiner noted the Veteran's treatment for his back during service. The examiner also noted that the Veteran injured his back by carrying heavy rucksack on long marches and carrying a heavy machine gun. (Continued on the next page) Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran's current degenerative joint disease of the Veteran's back is related to service. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for degenerative joint disease is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. KRISTI L. GUNN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Tahirih S. Samadani, 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.