Citation Nr: 21055605 Decision Date: 09/08/21 Archive Date: 09/08/21 DOCKET NO. 16-09 059 DATE: September 8, 2021 ORDER Entitlement to service connection for residuals of a cervical spine fracture, as secondary to service-connected psychiatric disorder is granted. Entitlement to service connection for residuals of a left wrist fracture, as secondary to service-connected psychiatric disorder is granted. Entitlement to service connection for residuals of a third proximal phalanx fracture of his left hand, as secondary to service-connected psychiatric disorder is granted. Entitlement to service connection for residuals of a lumbar transverse fracture, as secondary to service-connected psychiatric disorder is granted. Entitlement to service connection for residuals of traumatic brain injury (TBI), as secondary to service-connected psychiatric disorder is granted. FINDINGS OF FACT 1. The Veteran's residuals of a cervical spine fracture are proximately due to his service-connected psychiatric disorder. 2. The Veteran's residuals of a left wrist fracture is proximately due to his service-connected psychiatric disorder. 3. Affording the Veteran the benefit of the doubt, residuals of a third proximal phalanx fracture of his left hand are proximately due to his service-connected psychiatric disorder. 4. Affording the Veteran the benefit of the doubt, residuals of a lumbar transverse fracture are proximately due to his service-connected psychiatric disorder. 5. Affording the Veteran the benefit of the doubt, his residuals of TBI is proximately due to his service-connected psychiatric disorder. CONCLUSIONS OF LAW 1. The criteria for service connection for residuals of a cervical spine fracture as secondary to psychiatric disorder are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310. 2. The criteria for service connection for residuals of a left wrist fracture as secondary to psychiatric disorder are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310. 3. The criteria for service connection for residuals of third proximal phalanx fracture of his left hand as secondary to psychiatric disorder are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310. 4. The criteria for service connection for residuals of a lumbar transverse fracture as secondary to psychiatric disorder are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310. 5. The criteria for service connection for residuals of a TBI as secondary to psychiatric disorder are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from July 1984 to July 2004. In March 2019, the Veteran testified at a videoconference hearing before the undersigned Veterans Law Judge. A transcript of the hearing is of record. The Board remanded the claim in July 2019. There has been substantial compliance with the remand directives and the Board will proceed to adjudication. Stegall v. West, 11 Vet. App. 268 (1998). SERVICE CONNECTION The Veteran claims that he suffered additional cervical and thoracic spine disabilities, fractures of the left wrist and left hand, and a TBI in a May 2014 motorcycle accident and that accident itself was the result of the side effects of the medication used to treat his service-connected psychiatric disorder. The claimed disabilities were incurred after service and there is no evidence or argument that they are directly related to service. Service connection on a direct basis will not be discussed. Service connection may also be established on a secondary basis for a disability which is proximately due to or the result of service-connected disease or injury. 38 C.F.R. § 3.310 (a). Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists, and (2) that the current disability was either (a) proximately caused or (b) proximately aggravated by a service-connected disability. Allen v. Brown, 7 Vet. App. 439 (1995). Entitlement to service connection for a cervical spine disability, as secondary to service-connected psychiatric disorder Entitlement to service connection for residuals of a left wrist fracture, as secondary to service-connected psychiatric disorder The Veteran is already service-connected for degenerative disc disease of cervical spine. However, the November 2014 VA examination shows the Veteran had diagnoses of a cervical vertebral fracture and a left wrist fracture. The June 2021 VA examiner opined that the Veteran's both the Veteran's cervical spine fracture and left wrist fracture were at least as likely as not proximately due to his service-connected psychiatric disorder. The examiner explained that the Veteran had episode of a black out due to the medication used to treat his mental condition prior to his 2014 motorcycle accident, medical literature reflects that side effects of his medication included similar effects to somnolence and fatigue, and his disabilities were the result of this accident. Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran's current cervical spine disability and residuals of a left wrist fracture are proximately due to his service-connected psychiatric disorder. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for residuals of a cervical spine fracture and service connection for residuals of a left wrist fracture is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. Entitlement to service connection for residuals of a left-hand fracture, as secondary to service-connected psychiatric disorder Entitlement to service connection for a thoracic spine disability, as secondary to service-connected psychiatric disorder The Veteran is already service-connected for degenerative disc disease of lumbar spine. However, the November 2014 VA examination shows the Veteran had a diagnosis of lumbar transverse fracture. While the June 2021 VA examiner found that the Veteran did not have a thoracic spine fracture after his motorcycle accident and that his third proximal phalanx fracture of his left hand had resolved, the requirement of a current disability is satisfied when the Veteran has a disability at the time he files his service connection claim or during the pendency of that claim, even if the disability resolves prior to adjudication of the claim. McClain v. Nicholson, 21 Vet. App. 319 (2007). The November 2014 VA examination shows diagnoses of a lumbar transverse fracture and a third proximal phalanx fracture of his left hand, both the result of his May 2014 motorcycle accident. Accordingly, the Veteran had diagnoses of a thoracic spine disability and left hand disability during the period on appeal and the requirement of a current disability is satisfied. Additionally, the June 2021 VA examiner opined that the Veteran's May 2014 motorcycle accident was at least as likely as not proximately due to the medications used to treat his service-connected psychiatric condition. Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran's current thoracic spine disability and residuals of a left hand fracture are proximately due to his service-connected psychiatric disorder. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for residuals of a lumbar transvers fracture and service connection for residuals of a third proximal phalanx fracture of the left hand is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. Entitlement to service connection for residuals of TBI, as secondary to service-connected psychiatric disorder The November 2014 VA examination shows a diagnosis of a TBI as a result of the Veteran's May 2014 motorcycle accident. While the June 2021 VA examiner did not provide a nexus opinion as to the Veteran' residuals of a TBI, they did opine that the Veteran's May 2014 motorcycle accident was at least as likely as not proximately due to the medications used to treat his service-connected psychiatric condition. The May 2021 VA examiner provided a negative nexus opinion as to secondary service-connection; however, the Board affords that opinion no probative value as the examiner said it would be speculation for them to attribute the accident to the side effects of medications to treat the Veteran's psychiatric disorder, and the examiner did not discuss the interactions between the medications, his medical records or his history of blackouts. Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran's current residuals of TBI are proximately due to his service-connected psychiatric disorder. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for residuals of TBI is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. M.E. Larkin Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Eric Struening 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.