Citation Nr: 22013558 Decision Date: 03/09/22 Archive Date: 03/09/22 DOCKET NO. 11-31 189 DATE: March 9, 2022 ORDER The claim for service connection for a gynecological disability manifested by chronic yeast infections is dismissed. Service connection alopecia is granted. REMANDED The claims for service connection for a right shoulder disability is remanded. The claim for service connection for a left shoulder disability is remanded. The claim for service connection for a right hand disability is remanded. The claim for service connection for a low back disability is remanded. The claim for service connection for a left hip disability is remanded. The claim for service connection for a right ankle disability is remanded. The claim for service connection for a right foot disability is remanded. The claim for service connection for a bilateral eye disability (originally claimed as blurry vision) secondary to asbestos exposure is remanded. The claim for service connection for a bilateral hearing loss is remanded. The claim for service connection for anemia is remanded. The claim for right upper extremity numbness is remanded. The claim for service connection for left upper extremity numbness is remanded. The claim for service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD), anxiety and depression is remanded. The claim for nonservice-connected (NSC) pension is remanded. FINDINGS OF FACT 1. In August 2021, prior to the promulgation of a decision in this appeal, the Veteran testified before the undersigned that she wished to withdraw her appeal with respect to the claim for service connection a gynecological disability manifested by chronic yeast infections. 2. The Veteran has a current diagnosis of alopecia. 3. The Veteran had active service in the Southwest Asia theater of operations during the Persian Gulf War. 4. The Veteran's alopecia is a medically unexplained chronic multisymptom illness of an unknown etiology. CONCLUSIONS OF LAW 1. The criteria for withdrawal of the claim for service connection for a gynecological disability manifested by chronic yeast infections by the Veteran have been met. 38 U.S.C. § 7105; 38 C.F.R. § 20.204. 2. The criteria for service connection for alopecia have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.317. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active military service in the United States Marine Corps from January 2000 to January 2005. In August 2021, the Veteran testified before the undersigned. A copy of the proceedings is of record. Withdrawal of Appeal-Service Connection for a gynecological disability manifested by chronic yeast infections The Board may dismiss any appeal which fails to allege specific error of fact or law in the determination being appealed. 38 U.S.C. § 7105. An appeal may be withdrawn as to any or all issues involved in the appeal at any time before the Board promulgates a decision. 38 C.F.R. § 20.205. Withdrawal may be made by the Veteran or by his authorized representative. 38 C.F.R. § 20.205. At her Board hearing in August 2021, the Veteran testified that she wished to withdrawal her appeal with respect to the claim for service connection for a gynecological disability manifested by chronic yeast infections. As the Veteran specifically and affirmatively withdrew the appeals of this issue, there remains no allegations of errors of fact or law for appellate consideration. Accordingly, the Board does not have jurisdiction to review the appeal with respect to this claim and it is dismissed. Service Connection for Alopecia is granted The Veteran seeks service connection for alopecia, contending that her alopecia began during her deployment to Southwest Asia, and that it has persisted since that time. See June 2019 Skin Disability Benefits Questionnaire (DBQ). Service connection may be granted for a Persian Gulf veteran with objective indications of a qualifying chronic disability that manifested either during active service in the Southwest Asia theater of operations or to a degree of 10 percent or more not later than December 31, 2021. 38 U.S.C. § 1117 (a)(1); 38 C.F.R. § 3.317 (a)(1). A qualifying chronic disability is a chronic disability that may result from an undiagnosed illness or a medically unexplained chronic multisymptom illness (MUCMI). 38 C.F.R. § 3.317 (a)(2)(i). The term MUCMI refers to a diagnosed illness without conclusive pathophysiology or etiology, that is characterized by overlapping symptoms and signs and has features such as fatigue, pain, disability out of proportion to physical findings, and inconsistent demonstration of laboratory abnormalities. 38 C.F.R. § 3.317 (a)(2)(ii). A multisymptom illness is a MUCMI where either the etiology or pathophysiology of the illness is inconclusive. Stewart v. Wilkie, 30 Vet. App. 383, 389-90 (2018). A multisymptom illness is not a MUCMI where both the etiology and the pathophysiology of the illness are partially understood. Id. The determination of whether a MUCMI is "medically unexplained," that is, the etiology and pathophysiology of the multisymptom illness, must be particular to the claimant's case. Id. at 391. Here, the Veteran had multiple periods of active service in Iraq, and Afghanistan from March 16, 2004 to July 13, 2004. Therefore, she is considered a Persian Gulf veteran. 38 C.F.R. § 3.317 (e). At a June 2019 examination, the Veteran was diagnosed as having alopecia with an onset of 2001. Thus, it has existed for at least six months and it is considered chronic under the regulatory definition. The Board will grant the claim for service connection for alopecia because the evidence persuasively favors a finding that it is a medically unexplained chronic multisymptom illness of unknown etiology. There is one opinion that is support of the claim. At the close of the June 2019 examination, the examiner opined that the Veteran's alopecia was a category two (2) disability pattern, a diagnosable but medically unexplained chronic multisymptom illness of unknown etiology presumed to be caused by service in the Southwest Asia theater of operations. As there is no affirmative evidence to the contrary (see 38 C.F.R. § 3.317 (a)(7)(i)-(iii)), the Veteran's alopecia is considered a MUCMI and presumptive service connection is warranted. REASONS FOR REMAND An August 2019 Social Security Profile and Data sheet reflects that the Veteran applied for, but was denied, disability benefits from the Social Security Administration (SSA) during the pendency of the appeal. A remand is required to allow VA to request these federal records. Regarding the Veteran's claim for acquired psychiatric disorder, to include PTSD, The Veteran contends that she is entitled to service connection for an acquired psychiatric disorder, to include PTSD, contending that she was exposed to hostile fire, notably mortar rounds, and felt aftershocks of improvised explosive devices (IEDS) and/or or warfare weapons while working on the flight line where she fixed and serviced jets that had engaged in hostile fire while stationed in Iraq and Afghanistan. See August 2021 Transcript (T.) at page (pg.) 33)) and VA Form 21-0781, Statement in Support of Claim for Service connection for PTSD. The Veteran's military personnel records reflect that the Veteran served in Iraq and Afghanistan and that her military occupational specialty (MOS) was a Fixed Wing Aircraft Safety Equipment Mechanic. A claim for service connection for PTSD falls within the scope of a claim for service connection for an acquired psychiatric disorder based on another diagnosis. Clemons v. Shinseki, 23 Vet. App. 1 (2009). This raises VA's duty to assist, because VA normally takes steps to provide confirmation of the Veteran's claimed stressors in a claim for service connection for PTSD. Additionally, the description of surviving an alleged uprising is suggestive of fear of hostile military or terrorist activity. Fear of hostile military or terrorist activity may be a stressor that provides grounds for service connection even without confirmation if a qualified expert confirms that the claimed stressor may support a diagnosis of PTSD. 38 C.F.R. § 3.304. As such, the Veteran must be provided a VA examination in order to determine whether or not her claimed stressors qualify as fear of hostile military or terrorist activity sufficient to support a diagnosis of PTSD. Finally, the claim for a non-service-connected pension is inextricably intertwined with the instant appeal and must be deferred pending the above-requested development. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991) (holding that where a claim is inextricably intertwined with another claim, the claims must be adjudicated together in order to enter a final decision on the matter). The matters are REMANDED for the following action: 1. Obtain the Veteran's federal records from Social Security Administration, to include any decision denying the Veteran disability benefits and the records upon which that decision was made. Document all requests for information as well as all responses in the claims file. 2. Provide the Veteran with a VA psychiatric examination with a psychiatrist or psychologist in order to answer the following questions: a. Does medical evidence establish a link between a current diagnosis of PTSD and an in-service stressor? Why or why not? b. Do any of the Veteran's claimed in-service stressors from her time in Iraq and Afghanistan, as a Fixed Wing Aircraft Safety Equipment Mechanic, constitute fear of hostile military or terrorist activity sufficient to support a diagnosis of PTSD. See August 2021 T. at pg. 33 and VA Form 21-0781, Statement in Support of Claim for Service connection for PTSD. Why or why not? If the examiner concludes that the Veteran does not have PTSD as a result of her military service, then the examiner should indicate whether it is at least as likely as not (50 percent or greater) that the Veteran has an acquired psychiatric disability, other than PTSD, that either began during or was otherwise caused by her military service. Why or why not? MATTHEW W. BLACKWELDER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Carole Kammel, 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.