Citation Nr: A25055152 Decision Date: 06/25/25 Archive Date: 06/25/25 DOCKET NO. 250216-518162 DATE: June 25, 2025 ORDER Entitlement to service connection for bipolar disorder is denied. Entitlement to service connection for hypertension as secondary to post traumatic stress disorder (PTSD), anxiety disorder and hypochondria is denied. Entitlement to service connection for tinnitus is denied. Entitlement to service connection for posttraumatic stress disorder (PTSD) is denied. FINDINGS OF FACT 1. The evidence of record does not show a diagnosis for bipolar disorder. 2. As the claim for service connection of PTSD is being denied, hypertension cannot be secondarily service connected to PTSD. 3. The evidence of record does not show that the Veteran's tinnitus began during active service, during the presumptive period after separation, or is otherwise causally related to active service. 4. The evidence of record does not show a diagnosis of PTSD prior to the December 2024 rating decision on appeal. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for bipolar disorder have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. 2. The criteria for entitlement to service connection for hypertension as secondary to PTSD, anxiety disorder, and hypochondria have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. 3. The criteria for entitlement to service connection for tinnitus have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309. 4. The criteria for entitlement to service connection for PTSD have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 4.125. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran has active service from August 2016 through January 2017, and June 2019 through June 2020, and August 2020 through August 2021 in the Army National Guard. He also has other various periods of service in the Army National Guard. This matter is before the Board of Veterans' Appeals (Board) on appeal from December 2024 (for PTSD) and February 2025 (for hypertension, bipolar, and tinnitus) rating decisions by the Department of Veterans Affairs (VA) Regional Office. In February 2025, the Veteran submitted a Notice of Disagreement: VA Form 10182 in which he appealed both decisions to the Board and selected the direct review docket. Based on that docket selection, the Board is limited in its review of the evidence and may only consider the evidence of record at the time the December 2024 (for PTSD) and February 2025 (for hypertension, bipolar, and tinnitus) rating decisions on appeal were issued. 38 C.F.R. § 20.301. If evidence was submitted after the rating decisions on appeal were issued the Board did not consider it in its decision. 38 C.F.R.? §§ 20.300, 20.801.? If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim: VA Form 20-0995 and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. As an additional preliminary matter, the Board acknowledges that the time frame in which a Veteran may change dockets under the Veterans Appeals Improvement and Modernization Act of 2017 (AMA) appeal system has not elapsed. 38 C.F.R. § 20.202(c)(2). However, in March 2025, the Veteran requested that his appeal be advanced on the docket. This motion was granted in May 2025. As such, the Board finds that the Veteran has indicated a desire for a swift decision and has thereby implicitly waived the remaining time to switch dockets under Williams v. McDonough, 37?Vet. App.?305 (2024) (holding that since a claimant who selected the direct review docket on the Notice of Disagreement may opt to change dockets during the time frame presented in 38 C.F.R. § 20.202(c)(2), the Board may not adjudicate a direct review appeal during that period).?Thus, the Board will move forward on adjudication of the claims. Service Connection VA provides compensation for a disability resulting from disease or injury incurred in or aggravated by service. This is referred to as "service connection." 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Regulations also provide that service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disability was incurred in service. 38 C.F.R. § 3.303(d).??????? 1. Entitlement to service connection for bipolar disorder is denied. Legal Criteria Generally, in order to be entitled to direct service connection there must be competent, credible evidence of (1) a current disability, (2) an in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury. See, e.g., Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Pond v. West, 12?Vet. App.?341 (1999). When these elements are satisfied, service connection may be granted on a direct basis.???? Analysis The Board finds that service connection for bipolar disorder is not warranted. A review of the evidence of record indicates that the Veteran has not been diagnosed with bipolar disorder. As such, the Veteran has not met the first element of direct service connection, a current disability. The Board also considered whether service connection would be warranted based on an expansion of the scope of the claim pursuant to Clemons v. Shinseki, 23?Vet. App.?1 (2009). However, the Board finds that the Veteran has not been diagnosed with another mental health disability which would encompass the symptoms reported by the Veteran or other evidence of record. As such, service connection for bipolar disorder is denied. 2. Entitlement to service connection for hypertension as secondary to post traumatic stress disorder (PTSD), anxiety disorder and hypochondria is denied. Legal Criteria Service connection may be established on a secondary basis for a disability which is due to or the result of, or aggravated by, a service-connected disability. 38 C.F.R. § 3.310(a), (b). Establishing service connection on a secondary basis requires evidence sufficient to show: (1) a current disability exists, (2) the Veteran has a service-connected disability; and (3) the current disability was either (a) caused by; or (b) aggravated by a service-connected disability. 38 C.F.R. § 3.310(b); Allen v. Brown, 7 Vet. App. 439, 448 (1995). Recently, in Spicer v. McDonough, 61 F.4th 1360 (Fed. Cir. 2023), the Federal Circuit Court of Appeals held 38 U.S.C. § 1110 employs only "but-for" causation in direct and secondary service connection claims. Therefore, a service-connected disability need only be a contributing cause (or aggravating factor), not the contributing cause (or aggravating factor), to establish secondary service connection. The Board finds that service connection for hypertension as secondary to PTSD, an anxiety disorder, and hypochondria is not warranted. The Veteran has met the first element of secondary service connection, the existence of a current disability. The Veteran has been diagnosed with hypertension. However, the Board notes that the Veteran has not satisfied the second element of service connection, an already service-connected disability. Currently, the Veteran is service connected for bilateral gout and spinal stenosis. The Veteran is not service connected for the PTSD, anxiety disorder, or hypochondria for which he claims his hypertension is secondary to. Addressing PTSD, as will be discussed in more detail below, the Board has found that service connection is not warranted. As such, hypertension cannot be secondarily service connected to this condition. Addressing the anxiety disorder and hypochondria, the Board finds that the Veteran has not submitted a claim for service-connection of either of these conditions; nor has he been diagnosed with either condition. As such, service connection for hypertension as secondary to PTSD, an anxiety disorder, or hypochondria is denied. 3. Entitlement to service connection for tinnitus is denied. Legal Criteria In order to be entitled to direct service connection there must be competent, credible evidence of (1) a current disability, (2) an in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury. See, e.g., Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Pond v. West, 12?Vet. App.?341 (1999). When these elements are satisfied, service connection may be granted on a direct basis. Additionally, certain disabilities, such as organic diseases of the nervous system, which presumably includes tinnitus, are presumed to be service connected if manifested to a compensable degree within one year following separation from service. 38 C.F.R. §§ 3.303, 3.307, 3.309.? Analysis Direct Service Connection The Veteran has met the first element of direct service connection, a current disability. The Veteran was diagnosed with recurrent tinnitus during a January 2025 VA examination. Likewise, the Veteran has met the second element of direct service connection, an in-service event or injury. The February 2025 rating decision identified a favorable finding for in-service event; i.e. noise exposure. The Board is bound by this favorable finding. 38 C.F.R. § 3.104(c). The remaining question for the Board is whether the Veteran has met the third element of direct service connection, a nexus between the in-service event and the current disability. For the reasons that follow, the Board finds that the Veteran has not met this element. First, while the Veteran was likely exposed to loud noises during his military service in the Army, he did not report having tinnitus, or ringing in the ears. Audiologic testing during service did not reveal any complaints or findings of tinnitus. Moreover, the medical opinion evidence is against the claim. The February 2025 examiner opined that the Veteran's tinnitus was less likely than not caused by military service. The rationale provided notes that the Veteran when the Veteran's hearing was tested during his military service, there were no significant threshold shifts, which, the examiner explained, showed that there was no permanent auditory damage on active duty. Additionally, the examiner noted that the Veteran denied tinnitus symptoms on more than one occasion post-service and thus a nexus could not be made between the in-service noise exposure and the current tinnitus. There is no probative medical opinion in support of the claim. In the absence of a nexus between the in-service event and the current tinnitus, direct service connection must be denied. Presumptive Service Connection The Veteran's claim for service connection of tinnitus also raises an additional theory of entitlement, presumptive service connection pursuant to 38 C.F.R. § 3.307. Under this theory of entitlement, certain chronic disease processes are eligible for service connection even if not shown in service but typically must be shown within the first post-service year. Tinnitus arguably falls within the category of an "other organic disease of the nervous system" within the chronic diseases enumerated. Here, the Veteran's first report of having tinnitus came during his initial claim for service connection in December 2024. Prior to this claim, the Board finds no complaints of tinnitus contained in the evidence of record. Critically, while the Veteran asserts today that that tinnitus symptoms began during service, he denied tinnitus symptoms on several occasions. During an April 2021 Annual Periodic Health Assessment, the Veteran indicated that he did not experience persistent noises in his head and ears (such as ringing, buzzing, or humming). During a July 2021 Post-Deployment Health Assessment, the Veteran indicated that he was "not bothered at all" by noises in his head or ears (such as ringing, buzzing, crickets, humming, or tone, etc.) Additionally, during a February 2024 VA treatment visit the Veteran denied tinnitus symptoms. Based upon the multiple denials of tinnitus symptoms after the Veteran's basic training, the Board does not find the Veteran's current assertions to be credible. Thus, a grant based on presumptive service connection is not warranted. 4. Entitlement to service connection for posttraumatic stress disorder (PTSD) is denied. Legal Criteria Service connection for PTSD is specifically governed by 38 C.F.R. § 3.304(f), which requires: (1) medical evidence diagnosing the condition in accordance with the Diagnostic and Statistical Manual of Mental Disorders 5th Edition (DSM-5), (2) credible supporting evidence that the claimed in-service stressor occurred, and (3) a link, established by the medical evidence, between current symptoms and an in-service stressor. Factual Background During a November 2020 VA treatment visit the Veteran was administered a PTSD screening which produced a negative result for PTSD. During an April 2021 Periodic Health Assessment, the Veteran reported no nightmares, no intrusive thoughts, no avoidance behaviors, no detachment, no hypervigilance, no loss of interest, and no depression. At this time, the examiner found no mental health concerns. During a July 2021 Post-Deployment Health Assessment, the Veteran reported that during his deployment he did not feel in danger of being killed, did not encounter dead bodies or people being killed or wounded, and did not engage in direct combat where he had to discharge his weapon. At this time, the examiner found no mental health concerns. During a November 2024 VA examination for PTSD, the Veteran was found not to have a diagnosis of PTSD which conforms to the DSM-5. Additionally, the examiner noted that the Veteran had no mental health disorder which conforms with the DSM-5. Analysis The Board finds that the Veteran has not met the first element of service connection for PTSD, a current diagnosis which conforms to the DSM-5. Specifically, the Veteran was judged as having no mental health issues as early as November 2020. Additionally, the Veteran was specifically examined for PTSD in November 2024 and was found not to have a diagnosis of PTSD. The Board notes that additional evidence regarding the Veteran's claim for PTSD was received in January 2025. However, the Board cannot use this evidence in the adjudication of this claim as it was received after the December 2024 rating decision on appeal was issued. As is noted above, if the Veteran would like VA to consider this evidence he may file a Supplemental Claim: VA Form 20-0995 and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Accordingly, service connection for PTSD is denied. M. Tenner Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Crain, N. 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.