Citation Nr: 21027816 Decision Date: 05/06/21 Archive Date: 05/06/21 DOCKET NO. 10-36 470A DATE: May 6, 2021 REMANDED Service connection for a low back disorder is remanded. Service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD), adjustment disorder, anxiety disorder, depression, and alcohol use disorder is remanded. Service connection for a right-hand disorder, to include carpal tunnel syndrome, is remanded. Service connection for a left arm disorder, to include degenerative joint disease, left shoulder tendonitis, and left C5 radiculopathy is remanded. REASONS FOR REMAND The Veteran, who is the appellant, served on active duty from January 1972 to September 1976. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an October 2009 rating decision from the Regional Office (RO), which, in pertinent part, denied service connection for a low back disorder, a left arm disorder, a right hand disorder, and PTSD. In May 2013, the Veteran testified at a Board videoconference hearing from the RO in Cleveland, Ohio, before the undersigned Veterans Law Judge in Washington, DC. The hearing transcript has been associated with the record. This matter was previously before the Board in July 2013 and June 2018. In the June 2018 Board Decision, the Board denied service connection for an acquired psychiatric disorder, right hand disorder, left arm disorder, and low back disorder. The Veteran appealed the matter to the U.S. Court of Appeals for Veterans Claims (Court). In a September 2019 Memorandum Decision, the Court remanded the matter to provide adequate reasons and bases regarding whether duty to assist was met in obtaining any available records documenting the 1974 motor vehicle accident. In January 2021, the Veteran testified at a Board virtual hearing before the undersigned Veterans Law Judge. The hearing transcript has been associated with the record. As the Board is remanding the issues on appeal for additional development, the Board need not address the duty to assist at this time. 1. Service connection for a low back disorder is remanded. 2. Service connection for an acquired psychiatric disorder is remanded. 3. Service connection for a right-hand disorder is remanded. 4. Service connection for a left arm disorder is remanded. The Veteran seeks service connection for a low back disorder, right hand disorder, left arm disorder, and an acquired psychiatric disorder (claimed as PTSD) all related to a motor vehicle accident (MVA) in Sandhofen, Germany, during service. Specifically, the Veteran asserts that in either April 1973 or May 1974 he and a friend, whom he originally identified as Sergeant Hamilton and more recently identifies as Sergeant Jackson, were on their way to a race track when their car lost control, went off the road, and collided with a tree. The Veteran cannot recall the reported friend's first name but testified that the servicemember was assigned to the 2nd and 13th Infantry Division in Mannheim, Germany, while the Veteran was assigned to the 38th Cavalry, Coleman barracks in Mannheim Germany. The Veteran asserts that a Sergeant Hamilton or Sergeant Jackson did not survive the accident and that the Veteran sustained serious injuries including a concussion, back injury, left arm injury, and right hand injury. The Veteran testified that he was hospitalized for one or two weeks at the Army Hospital in Heidelberg, Germany. He testified that he was rendered unconscious by the accident and, once he returned to his unit, learned that Sergeant Hamilton or Jackson had died. The Veteran contends that his current acquired psychiatric disorder, low back disorder, right hand disorder, and left arm disorder are all related to the in-service MVA. See March 2013, January 2021 Board Hearing Transcripts. Outstanding Service Documentation Service treatment records show that the Veteran was treated at the 735th Medical Detachment aid station in Sandhofen, Germany APO 09028 following a motor vehicle accident in May 1974. The Veteran only reported neck pain following the accident. No record of hospitalization for a severe injury, to include unconsciousness, following the accident is associated with the record. As previous attempts to obtain records documenting the MVA were limited to a search for records pertaining to the Veteran, the Board will expand the search to include for the reported death of Sergeant Hamilton or Sergeant Jackson following the car accident. On remand, the RO should contact the appropriate United States Army military police for records of any motor vehicle accident involving the Veteran and the alleged decedent, Sergeant Hamilton or Sergeant Jackson, in Sandhofen, Germany for the period of May 1974. The RO should also contact the German police authorities in Sandhofen, Mannheim, and Heidelberg, Germany to request copies of all available records pertaining to motor vehicle accident involving the Veteran and any names of Sergeant Hamilton or Sergeant Jackson for the period of May 1974, following the motor vehicle accident. Additionally, the RO should contact the Heidelberg Army Hospital and the 735th Medical Detachment Aid Station in Sandhofen, Germany APO 09028 for any record of treatment of the Veteran and the claimed Sergeant Hamilton or Sergeant Jackson, for a motor vehicle accident for May 1974. The RO should also request all service treatment records for a Sergeant Hamilton or Sergeant Jackson who might have been assigned to the 2nd and 13th Infantry Division in Mannheim, Germany, in May 1974. Outstanding Private and VA treatment records During the January 2021 Board hearing, the Veteran testified that he was disqualified from some jobs because he was unable to pass physical examinations required for the jobs due to problems with his back. Specifically, the Veteran testified that he underwent physical examinations for Southern N&W Railroad and Kahn meat company, which are not currently of record. Additionally, the Veteran testified that he sought treatment for left arm pain in 1986, but it is unclear where this treatment occurred. On remand, the RO should request clarification from the Veteran as to the date and location of treatment for the left arm, right hand, low back disorders and the acquired psychiatric disorder, to include any outstanding treatment records from Southern N&W Railroad and Kahn meat company. Additionally, the RO should associate all VA treatment records with the claim file from Atlanta, Georgia VA Medical Center (VAMC) and Cincinnati, Ohio VAMC through present date. Addendum Medical Opinion The Veteran contends that his acquired psychiatric disorder is related to serious injuries sustained and the death of Sergeant Hamilton or Sergeant Jackson in a motor vehicle accident that occurred in Sandhofen, Germany in 1973 or 1974. Both the VA examiner in October 2013 and the private psychologist in February 2021 opined that the Veteran does not meet the diagnostic criteria for PTSD. However, the private psychologist opined that the Veteran's adjustment disorder with anxiety as likely as not began during service and his alcohol use disorder is likely secondary to the adjustment disorder. Specifically, the private psychologist reasoned that the record shows that the Veteran was stressed related to the health of his wife and other family members and this led him to go AWOL at times. Additionally, the Veteran has reported drinking significantly during downtime in service, which per the private psychologist, "appears to have been at least somewhat in reaction to ongoing anxiety and restless and inability to cope with stressors." See February 2021 private treatment record. A review of the service personnel records shows that the Veteran applied for and was granted a hardship separation in September 1976 due to his spouse's health problems and financial strain associated with his spouse's inability to work due to her health problems. Medical records also show that the Veteran has a history of alcohol abuse for many years. Service treatment records are silent for any reports of psychiatric symptoms during service or for many years after service. In light of recent evidence suggesting a relationship between the Veteran's adjustment disorder and alcohol use disorder and events during service related to the health of the Veteran's family members and finances, an addendum opinion would be helpful to assess whether the Veteran's current acquired psychiatric disorder is related to service. Request for Curriculum Vitae of VA examiners In December 2020 correspondence, the representative requested the Curriculum Vitae of the VA examiners who provided the VA psychological, back, shoulder/arm, and hand examination reports in September 2013 and October 2013. On remand, the RO should provide the representative with the Curriculum Vitae or equivalent professional credentials of the VA examiners who provided the VA examination reports in September and October 2013, as well as the professional credentials of the examiner who provides the addendum psychological opinion requested by this remand. Service connection for an acquired psychiatric disorder, low back disorder, right hand disorder, and left arm disorder are REMANDED for the following action: 1. Private Records: Contact the Veteran to request specific information as to any outstanding private medical treatment concerning treatment of the acquired psychiatric disorder, low back disorder, left arm disorder, and right hand disorder from 1976 to present, to include all records and treatment notes from Southern N&W Railroad and Kahn meat company. The Veteran is advised to submit all treatment records, as failure to do so may result in denial of the claim. See 38 C.F.R. § 3.158. The RO is to request any records identified. 2. VA treatment records: Obtain and associate with the claim file all outstanding VA treatment records from Atlanta, Georgia and Cincinnati, Ohio VAMCs through present date. 3. Service Records: Contact the National Personnel Record Center (NPRC) and/or the appropriate service entity and request that a search be made of the records at 1) Heidelberg, Germany Army Hospital or equivalent medical facility, 2) the 735th Medical Detachment Aid Station in Sandhofen, Germany APO 09028, 3) the Mannheim, Germany and Sandhofen, Germany, United States Army military police units for May 1974 for any entries pertaining to a motor vehicle accident involving the Veteran and a Sergeant Hamilton or a Sergeant Jackson (assigned to the 2nd and 13th Infantry Division in Mannheim, Germany). All material produced by the requested search should be incorporated into the record. If no records are located a written statement to that affect should be incorporated into the record. 4. German Police Records: Contact the appropriate German police authorities and request copies of all records pertaining to the Veteran and a Sergeant Hamilton or Sergeant Jackson for May 1974 as it pertains to the documented May 1974 motor vehicle accident in Sandhofen, Germany. All material produced by the requested search should be incorporated into the record. If no records are located a written statement to that affect should be incorporated into the record. 5. Addendum Opinion: Return the VA medical opinion report to the VA examiner who provided the psychological medical opinion in October 2013. If the original VA examiner is unavailable, a new examiner may be assigned to address the requested opinion. The relevant documents in the record should be reviewed by the examiner and a detailed history of relevant symptoms should be obtained from the record. A rationale for all opinions and a discussion of the facts and medical principles involved should be provided. The examiner should offer an opinion: (Continued on the next page) Is it at least as likely as not (50 percent or greater probability) that the current acquired psychiatric disorder was caused by or etiologically related to financial strain and health of family members during service? In rendering the requested opinion please consider and comment on service personnel records indicating that the Veteran was granted a hardship separation related to financial strain and the health of his spouse, the Veteran's long history of alcohol use disorder, and the February 2021 private psychological opinion. 6. Professional Credentials: provide the Veteran's representative a copy of the curriculum vitae or equivalent professional credentials of the VA medical examiners who provided the VA examination reports in September 2013 and October 2013, as well as the examiner who provides the requested addendum psychological medical opinion. The professional credentials of the examiners should also be incorporated into the record. J. PARKER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Moore, Shanna 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.