HEARING LOSS

Summary

The veteran, who served in the U.S. Marine Corps from August 2001 to March 2004, appeals the denial of service connection for bilateral hearing loss and seeks service connection for tinnitus and a left ankle disability. The Board denied service connection for bilateral hearing loss, finding that the veteran's audiometric test results did not meet the criteria for a recognized disability under 38 C.F.R. § 3.385, despite the veteran's competent and credible reports of hearing loss and noise exposure. The Board found the evidence weighed against the claim, making the benefit of the doubt doctrine inapplicable. Service connection for tinnitus was granted for treatment purposes, with the Board finding the veteran's reports of in-service noise exposure and resultant tinnitus credible and the evidence in equipoise, resolving reasonable doubt in his favor. Similarly, service connection for a left ankle disability was granted for treatment purposes, as the AOJ conceded current diagnosis and in-service incurrence, and the evidence was found to be in equipoise, warranting the benefit of the doubt. The Board remanded the issue of the character of discharge, noting the veteran received non-judicial punishment for malingering and entering a female shower, leading to an other than honorable discharge for a pattern of misconduct. The remand also includes obtaining complete service personnel and treatment records, verifying PTSD stressors, and obtaining updated medical opinions for hypertension and PTSD, as the existing opinions were found inadequate.

Rationale

Audiometric thresholds did not meet VA criteria for disability; Evidence persuasively weighs against the claim; Benefit of the doubt doctrine not applicable

Full Decision Text

Citation Nr: A26036422
Decision Date: 04/20/26	Archive Date: 04/20/26

DOCKET NO. 210329-149502
DATE: April 20, 2026

ORDER

Entitlement to service connection for bilateral hearing loss is denied. 

Entitlement to service connection for tinnitus, for treatment purposes only under 38 U.S.C. Chapter 17, is granted. 

Entitlement to service connection for a left ankle lateral collateral ligament sprain (ankle disability), for treatment purposes only under 38 U.S.C. Chapter 17, is granted. 

REMANDED

The issue of whether the Appellant's military service is a bar to the receipt of Department of Veterans Affairs (VA) monetary benefits is remanded. 

Entitlement to service connection for high blood pressure (hypertension), to include for treatment purposes only under 38 U.S.C. Chapter 17, is remanded.

Entitlement to service connection for posttraumatic stress disorder, to include for treatment purposes only under 38 U.S.C. Chapter 17, is remanded.

Entitlement to service connection for a left ankle lateral collateral ligament sprain (ankle disability), for compensation purposes, is remanded. 

Entitlement to service connection for tinnitus, for compensation purposes, is remanded. 

FINDINGS OF FACT

1. The evidence persuasively weighs against finding that the Appellant has experienced hearing loss to an extent recognized as a disability for VA purposes at any time during or approximate to the pendency of his claim.

2. The evidence is in approximate balance as to whether the Appellant's tinnitus is the result of his in-service noise exposure.

3. The evidence is in approximate balance as to whether the Appellant's left ankle disability is related to service.

CONCLUSIONS OF LAW

1. The criteria for service connection for bilateral hearing loss are not met.  38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.385.

2. The criteria for service connection for tinnitus are met.  38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

3. The criteria for service connection for a left ankle disability are met.  38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Appellant served on active duty with the U.S. Marine Corps from August 6, 2001 to March 12, 2004; the character of his discharge is a subject of this appeal. 

These matters come before the Board of Veterans' Appeals (Board) from a December 2020 administrative decision and February 2021 rating decision by a VA Regional Office.

In March 2021, the Appellant submitted a VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement) and elected the Hearing docket. A Board hearing was held on March 11, 2025.

Therefore, the Board may only consider the evidence of record at the time of the respective agency of original jurisdiction (AOJ) decisions on appeal, as well as any evidence submitted by the Appellant or representative at the hearing or within 90 days following the hearing.  38 C.F.R. § 20.302(a).  If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision.  38 C.F.R. §§ 20.300, 20.302(a), 20.801. 

As a preliminary matter, the Board notes that in December 2020, VA issued an administrative decision and determined that the Appellant's character of discharge is a bar to the receipt of VA monetary benefits.  In January 2021, the Appellant submitted a request for an eligibility determination for character of discharge and in the February 2021 rating decision on appeal, the AOJ indicated that the Appellant's character of discharge is a bar to the receipt of VA monetary benefits.  In the March 2025 Board hearing, the Appellant, through his representative clarified his intent to appeal the character of discharge determination in the February 2021 rating decision as part of his Board appeal.  Given the foregoing, the Board has liberally construed the March 2021 VA Form 10182 to include a claim for entitlement to VA monetary benefits.

Service Connection

A veteran is
 character of discharge is a bar to the receipt of VA monetary benefits.  In January 2021, the Appellant submitted a request for an eligibility determination for character of discharge and in the February 2021 rating decision on appeal, the AOJ indicated that the Appellant's character of discharge is a bar to the receipt of VA monetary benefits.  In the March 2025 Board hearing, the Appellant, through his representative clarified his intent to appeal the character of discharge determination in the February 2021 rating decision as part of his Board appeal.  Given the foregoing, the Board has liberally construed the March 2021 VA Form 10182 to include a claim for entitlement to VA monetary benefits.

Service Connection

A veteran is entitled to VA disability compensation if there is a current disability resulting from a personal injury suffered or disease contracted in the line of duty in active service, or for aggravation of a preexisting injury suffered or disease contracted in the line of duty in active service.  38 U.S.C. § 1131.

Generally, to establish a right to compensation for a present disability, a veteran must show: (1) a present disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service, the so-called "nexus" requirement.  Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

Although the Board has an obligation to provide reasons and bases supporting its decision, there is no need to discuss, in detail, every piece of evidence of record.  Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) (noting that VA must review the entire record but does not have to discuss each piece of evidence).  Thus, while the Board considered all evidence of record, in its decision below, the Board will summarize the relevant evidence as appropriate, and the analysis will focus specifically on what the evidence shows, or fails to show, as to the claim.

For veterans who have served 90 days or more of active service during a war period or after December 31, 1946, certain chronic disabilities are presumed to have been incurred in service if manifest to a compensable degree within one year of discharge from service.  38 U.S.C. §§ 1101, 1112, 1137; 38 C.F.R. §§ 3.307, 3.309.  Bilateral sensorineural hearing loss (an "organic disease of the nervous system") is considered by VA to be a "chronic disease" listed under 38 C.F.R. § 3.309(a).  The United States Court of Appeals for Veterans Claims (Court) also issued a decision adding tinnitus (as an organic disease of the nervous system) to the list of disabilities explicitly recognized as "chronic" in 38 C.F.R. § 3.309(a).  See Fountain v. McDonald, 27 Vet. App. 258 (2015).

A Veteran need only demonstrate that there is an approximate balance of positive and negative evidence to prevail.  If the positive and negative evidence is in approximate balance, which includes but is not limited to equipoise, reasonable doubt is resolved in favor of the claimant.  Lynch v. McDonough, 21 F. 4th 776 (Fed. Cir. 2021); 38 U.S.C. § 5107(b).

1. Entitlement to service connection for bilateral hearing loss is denied. 

Hearing loss is considered to be a disability for VA purposes when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz is 40 decibels or greater; or when the auditory thresholds for at least three of these frequencies are 26 decibels or greater; or when speech recognition thresholds using the Maryland CNC Test are less than 94 percent.  38 C.F.R. § 3.385.

In this case, the Board finds, for the following reasons, that the Appellant has not experienced hearing loss to an extent recognized as a disability for VA purposes at any time since his service connection claim was received or prior thereto.  Cf. Romanowsky v. Shinseki, 26 Vet. App. 289, 293 (2013) (Board erred in failing to address pre-claim evidence in assessing whether a current disability existed, for purposes of service connection, at the time the claim was filed or during its pendency); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007).

The
 percent.  38 C.F.R. § 3.385.

In this case, the Board finds, for the following reasons, that the Appellant has not experienced hearing loss to an extent recognized as a disability for VA purposes at any time since his service connection claim was received or prior thereto.  Cf. Romanowsky v. Shinseki, 26 Vet. App. 289, 293 (2013) (Board erred in failing to address pre-claim evidence in assessing whether a current disability existed, for purposes of service connection, at the time the claim was filed or during its pendency); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007).

The Appellant was afforded a VA audiological examination in January 2021.  During that examination, his pure tone thresholds, in decibels, were as follows:

 	 	 	HERTZ 	 	 

 	1000 	2000 	3000 	4000 

RIGHT 	15	15	20 	20

LEFT 	15	10	20	20

Speech audiometry revealed speech recognition ability of 98 percent in the right ear and 100 percent in the left ear.

While the Appellant believes he has a current bilateral hearing loss disability that is related to noise exposure in service, and he is competent to report the symptoms of his claimed disability and his exposure to noise in service, VA has determined that for hearing loss to constitute disability, certain audiometric and speech recognition scores must be present.  The Board is bound by the laws and regulations that apply to veterans' claims.  38 U.S.C. § 7104 (c); 38 C.F.R. §§ 19.5, 20.101(a).

The above evidence does not establish hearing loss to the extent recognized as a disability for VA purposes at any time during or approximate to the claim period. Despite the Appellant's competent and credible reports of ear/hearing symptoms, the determination of whether hearing loss constitutes a disability for VA purposes is determined by a mechanical application of the definition found in 38 C.F.R. § 3.385 to audiometric (pure tone threshold and Maryland CNC) testing results. The provisions of 38 C.F.R. § 3.385 do not authorize a finding of hearing loss disability when pure tone thresholds and/or speech recognition scores fail to meet the requirements of the regulation.  Hence, although the Appellant has reported complaints of hearing loss, the Board is bound by the testing results and has no discretion in this regard.

In this regard, Congress has specifically limited entitlement to service connection for disease or injury to cases where such incidents have resulted in disability. See 38 U.S.C. §§ 1110, 1131.  Thus, where, as here, the evidence establishes that the Appellant does not have the hearing loss disability for which service connection is sought, pursuant to the applicable regulation that defines the disability in terms of audiometric and speech recognition scores, there can be no valid claim of service connection.  See Gilpin v. West, 155 F.3d 1353, 1356 (Fed. Cir. 1998). While a diagnosis is not required to meet the current disability requirement and pain alone can constitute disability if it causes impairment in earning capacity, Saunders, 886 F.3d at 1364-65, VA has created an exception to this rule in 38 C.F.R. § 3.385, which specifies the criteria for establishing the current disability in claims of service connection for hearing loss.  Consequently, service connection for bilateral hearing loss disability is not warranted because the first criterion for an award of service connection-evidence of current disability upon which to predicate such an award-has not been met.

For the above reasons, the evidence is neither evenly balanced nor approximately so with regard to whether service connection for bilateral hearing loss disability is warranted.  Rather, the evidence persuasively weighs against the claim.  The benefit of the doubt doctrine, see 38 U.S.C. § 5107(b), is therefore not for application as to this claim and the claim must be denied.  Lynch v. McDonough, 21 F.4th 776, 781-82 (Fed. Cir. 2021) (en banc).

2. Entitlement to service connection for tinnitus, for treatment purposes only under 38 U.S.C. Chapter 17, is granted. 

The Appellant contends that his tinnitus is related to active military service.  See March 2025 Board Hearing Tr.

After a review of the entire evidentiary record and in light of the applicable legal criteria, resolving reasonable doubt in favor of the Appellant, the Board finds that service connection for tinnitus is warranted.

With regard to a present disability, in Charles v.
 to this claim and the claim must be denied.  Lynch v. McDonough, 21 F.4th 776, 781-82 (Fed. Cir. 2021) (en banc).

2. Entitlement to service connection for tinnitus, for treatment purposes only under 38 U.S.C. Chapter 17, is granted. 

The Appellant contends that his tinnitus is related to active military service.  See March 2025 Board Hearing Tr.

After a review of the entire evidentiary record and in light of the applicable legal criteria, resolving reasonable doubt in favor of the Appellant, the Board finds that service connection for tinnitus is warranted.

With regard to a present disability, in Charles v. Principi, 16 Vet. App. 370, 374-375 (2002), the Court held that tinnitus is a condition which is capable of lay observation.  As the Appellant indicated in his March 2025 Board hearing that he has experienced ringing in his ears since service, the Board finds that the Appellant is currently diagnosed with tinnitus and the first element of service connection is met.

Concerning the second element of service connection, an in-service injury, the AOJ has conceded that the Appellant's military occupational specialty (MOS) exposed him to acoustic trauma; thus, the second element of service connection is met.    

As for the third element of service connection, evidence of a nexus between the Appellant's tinnitus and service, the Board notes the evidence of record consists of consistent, competent, and credible statements from the Appellant, and a conflicting VA medical opinion regarding the likely etiology of the Appellant's tinnitus.

In his January 2021 VA examination, the Appellant reported ringing in his ears.  He stated that it occurs 2-3 times a week and lasts for about 2-3 minutes.  The Appellant said that in boot camp, someone threw a grenade into the bunker next to him.  The examiner determined that the Appellant was not diagnosed with recurrent tinnitus.  In his March 2025 Board hearing, the Appellant also reported ringing in his ears since service.  He reported that he experienced tinnitus was "overseas" in "combat."

Reviewing the evidence, the Board finds the Appellant's competent reports of experiencing in-service hazardous noise exposure and resultant auditory pathology in the form of tinnitus credible.  There is thus no evidence in the record to suggest that the Appellant's statements are not credible.  See Washington v. Nicholson, 19 Vet. App. 362 (2005); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Barr v. Nicholson, 21 Vet. App. 303, 307-08 (2007).  

Regarding the VA medical opinion, the Board find it of little probative weight.  Specifically, the VA examiner determined that the Appellant did not experience recurrent tinnitus, and did not provide an adequate rationale for his opinion and did not address the Appellant's competent, consistent, and credible lay assertions as to his continued symptomatology or the Appellant's reports of experiencing combat.   See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008).

Given the above, the evidence of record is, at the very least, in relative equipoise as to whether the Appellant's tinnitus is etiologically related to active duty service.  Resolving reasonable doubt in the Appellant's favor, the Board finds that the Appellant's tinnitus is related to service.  Thus, the third element of service connection has been met.

In light of the above, as the three elements of service connection have been met, the Board finds that the Appellant's tinnitus was incurred in service.  Accordingly, the claim of entitlement to service connection for tinnitus, for treatment purposes only under 28 U.S.C. Chapter 17, is granted.  38 U.S.C. § 5107(b).

3. Entitlement to service connection for a left ankle lateral collateral ligament sprain (ankle disability), for treatment purposes only under 38 U.S.C. Chapter 17, is granted. 

The Appellant contends that his left ankle disability is related to active military service.  See March 2025 Board Hearing Tr.

Here, the AOJ has conceded that the Appellant is currently diagnosed with a left ankle disability and that the disability was incurred during service.  See February 2021 Rating decision.  The Board had determined that these findings are consistent with the record.  

In this regard, service treatment records indicate that the Appellant was treated for reoccurring left ankle pain.   See e.g., December 2003 STR.  In a January 2021
 left ankle lateral collateral ligament sprain (ankle disability), for treatment purposes only under 38 U.S.C. Chapter 17, is granted. 

The Appellant contends that his left ankle disability is related to active military service.  See March 2025 Board Hearing Tr.

Here, the AOJ has conceded that the Appellant is currently diagnosed with a left ankle disability and that the disability was incurred during service.  See February 2021 Rating decision.  The Board had determined that these findings are consistent with the record.  

In this regard, service treatment records indicate that the Appellant was treated for reoccurring left ankle pain.   See e.g., December 2003 STR.  In a January 2021 VA examination, the Appellant was diagnosed with a lateral collateral ligament sprain and the Appellant reported onset of pain in 2003..  

Given the above, the evidence of record is, at the very least, in relative equipoise as to whether the Appellant's left ankle disability is etiologically related to active duty service.  Resolving reasonable doubt in the Appellant's favor, the Board finds that the Appellant's left ankle disability is related to service.  

In light of the above, as the three elements of service connection have been met and the claim of entitlement to service connection for a left ankle disability, for treatment purposes only under 28 U.S.C. Chapter 17, is granted.  38 U.S.C. § 5107(b).

REASONS FOR REMAND

1. . The issue of whether the Appellant's military service is a bar to the receipt of VA monetary benefits is remanded. 

The Appellant essentially seeks "veteran" status.   He asserts that he experienced stress during service and was not provided appropriate treatment during service.  See March 2025 Board Hearing Tr; November 2020 Statement. 

Review of the record reveals that the Appellant enlisted in the U.S. Marine Corps on August 6, 2001, for a four year enlistment.  During service, the Appellant was awarded a non-judicial punishment (NJP) for malingering and falsely altering a medical chit on August 14, 2002.  He was also awarded a NJP for entering a female shower without permission on May 4, 2003.  He was then subject to summary court martial for entering the female head and peeking over a stall on July 1, 2003, having knowledge of a lawful order issued to him not to enter any female heads or shower facilities without proper supervision.  He was also counseled concerning failure to go to a urinalysis (UA) on April 2, 2003; concerning orders violation on May 15, 2003; concerning NJP for orders violation on May 27, 2003; and concerning pattern of misconduct on July 2, 2003. 

The Appellant was administratively discharged under other than honorable conditions on March 12, 2004 by reason of a pattern of misconduct. 

The Board finds that additional development is required prior to the adjudication of this claim.  The service personnel records associated with the claims file concerning the Appellant's service appear incomplete.  Records, to include any evidence of combat, and performance evaluations, may be central to the to the issue of whether the character of the Appellant's service is a bar to the receipt of VA compensation benefits.  Accordingly, a remand is warranted for the AOJ to ensure that the complete military personnel record has been associated with the claims file prior to adjudicating the claim. 

Moreover, the Board notes that there has been a recent change in law since the most recent AOJ adjudication.  Specifically, 38 C.F.R. § 3.12 has been amended and adds, in certain cases, consideration of an Appellant's mental or cognitive impairment at the time of the in-service misconduct, as well as the Appellant's mental state during service, to include consideration of his age, cultural background, educational level, and judgmental maturity, as mitigating factors to an Appellant's misconduct and characterization of service.  See Update and Clarify Regulatory Bars to Benefits Based on Character of Discharge, 89 Fed. Reg. 32,361 (April 26, 2024) (to be codified at 38 C.F.R. pt. 3), https://www.federalregister.gov/documents/2024/04/26/2024-09012/update-and-clarify-regulatory-bars-to-benefits-based-on-character-of-discharge (last visited April 6, 2026).  Therefore, a remand is also warranted for the AOJ to issue a new administrative decision in the first instance.  

In remanding these issues, the Board makes
ating factors to an Appellant's misconduct and characterization of service.  See Update and Clarify Regulatory Bars to Benefits Based on Character of Discharge, 89 Fed. Reg. 32,361 (April 26, 2024) (to be codified at 38 C.F.R. pt. 3), https://www.federalregister.gov/documents/2024/04/26/2024-09012/update-and-clarify-regulatory-bars-to-benefits-based-on-character-of-discharge (last visited April 6, 2026).  Therefore, a remand is also warranted for the AOJ to issue a new administrative decision in the first instance.  

In remanding these issues, the Board makes no findings as to the credibility of the evidence at this time. 

2. Entitlement to service connection for high blood pressure (hypertension) and PTSD, to include for treatment purposes only under 38 U.S.C. Chapter 17, is remanded.

3. Entitlement to service connection for a left ankle disability and tinnitus, for compensation purposes, is remanded. 

These issues of service connection are inextricably intertwined with the character of discharge issue above, as "Veteran status" is an element of a claim for service connection.  The appropriate remedy where a pending claim is inextricably intertwined with a claim currently on appeal is to defer the claim on appeal pending the adjudication of the inextricably intertwined claim.  See Harris v. Derwinski, 1 Vet. App. 180 (1991).  

Accordingly, entitlement to service connection for high blood pressure and an acquired psychiatric disorder, to include for treatment purposes only under 38 U.S.C. Chapter 17, and entitlement to service connection for a left ankle disability and tinnitus, for compensation purposes, is remanded for readjudication following evidentiary development.

Concerning entitlement to service connection for high blood pressure (hypertension), the Board notes that the Appellant is prescribed medication for blood pressure.  The Appellant also contends that it is related to inservice stress.  See October 2020 Claim.  Review of the record further reveals that the Appellant, while deployed to Kuwait, received imminent danger pay.  

In McLendon v. Nicholson, the United States Court of Appeals for Veterans Claims ("Court") held that an examination is required when there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability, and (2) evidence establishing an "in-service event, injury or disease," or establishing certain diseases manifesting during an applicable presumptive period for which the claimant qualifies, and (3) an indication that the current disability may be related to the in-service event, but (4) insufficient evidence to decide the case.  20 Vet. App. 79, 81-83 (2006).

Given the evidence of record, the Board finds that the Appellant's claim satisfies the requirements of McLendon, and thus remand is warranted as the failure of VA to provide an examination regarding the nature and etiology of any high blood pressure or hypertension was a pre-decisional duty to assist error.  38 U.S.C. § 5103A(d).

Concerning entitlement to service connection for PTSD the Board finds that on remand, the AOJ should obtain a new a VA medical opinion.  Nieves v. Rodriguez v. Peake, 22 Vet. App. 295 (2008).   In this regard the available VA medical opinions, obtained in January 2021 and February 2021 are inadequate.  In the January 2021 opinion, the examiner provided only a notation of the Appellant's current diagnoses.  In the February 2021 opinion, the examiner noted that the Appellant is currently diagnosed with unspecified anxiety disorder and unspecified depressive disorder and that the Appellant sought treatment for mental health issues during service.  He then opined that the Appellant's currently diagnosed disorders are less likely than related to service as the Appellant's diagnoses are based solely on the Appellant's "self-report."

Although the examiner discusses the Appellant's reported stressors, he relies in part, on the Appellant failure to seek medical treatment and fails to reconcile his negative nexus opinion with the evidence of record indicating that the Appellant received imminent danger pay for service in Kuwait from February 2002 to June 2003.  Notably, in the March 2025 Board hearing, the Appellant reported experiencing combat.  Given the foregoing, the Board finds the medical opinion inadequate.  Accordingly, a remand is warranted to correct a pre-decisional duty to assist error and for the AOJ to obtain an adequate medical opinion.  

In remanding these claims, the Board makes no credibility findings, explicit or otherwise, at this time. 

The matters are
 discusses the Appellant's reported stressors, he relies in part, on the Appellant failure to seek medical treatment and fails to reconcile his negative nexus opinion with the evidence of record indicating that the Appellant received imminent danger pay for service in Kuwait from February 2002 to June 2003.  Notably, in the March 2025 Board hearing, the Appellant reported experiencing combat.  Given the foregoing, the Board finds the medical opinion inadequate.  Accordingly, a remand is warranted to correct a pre-decisional duty to assist error and for the AOJ to obtain an adequate medical opinion.  

In remanding these claims, the Board makes no credibility findings, explicit or otherwise, at this time. 

The matters are REMANDED for the following action:

1. The AOJ should send the claimant appropriate VCAA letter regarding the Appellant's character of discharge claim.

2. The AOJ should contact the appropriate repositories and make reasonable attempts to obtain any outstanding service personnel records and service treatment records and associate them with the claims file. 

In doing so, the AOJ should attempt to obtain the complete service personnel records, to include any performance evaluations, and all assignment data, embarkation documents, and TDY documents, if any.

The AOJ should also attempt to obtain any mental health treatment records.  See December 2020 Statement ("I enrolled in counseling thru the on base hospital.")

3. Conduct the appropriate development to verify the Veteran's reported PTSD stressors, to include any combat experience. 

In doing so, advise the Appellant that he may submit additional lay statements that may tend to corroborate his claimed stressor, including the dates and locations thereof.  All attempts to verify the Appellant's reported PTSD stressors must be documented in the claims file.

4. Following the receipt of any outstanding records, schedule the Appellant for a VA examination with an appropriate examiner to determine the nature and etiology of the Appellant's high blood pressure.  All indicated tests and studies should be accomplished and the finding reported in detail.  The record must be made available to the examiner for review, including a copy of this Remand, and the examiner should indicate that the record was reviewed in connection with the examination.

Based upon a review of the record, the examiner should address whether it is approximately at least as likely as not that any diagnosed high blood pressure (hypertension) manifested during service, was manifest to a compensable degree within one year of service, or is otherwise causally or etiologically related to military service.

In rendering the opinions, the examiner must consider and discuss the statements of the Appellant regarding the onset and continuity of the symptoms of his disability.

The examiner should provide a complete rationale for all opinions expressed and conclusions reached, including a discussion of the facts and medical principles involved.

5. After completion of the above, obtain a medical opinion from an appropriate psychiatrist or psychologist concerning the Appellant's mental health condition.  The need for an examination is left to the discretion of the clinician. 

After examination of the Appellant, if deemed necessary, review of his claims file, to include a copy of this REMAND the clinician should offer an opinion as to:

a)	Identify any/all diagnosed mental health disorders.  

In doing so, the clinician should address whether the Appellant is currently diagnosed with PTSD.  See March 2025 Board Hearing Tr. 

b)	For any diagnosed mental health disorder (with the exception of unspecified anxiety disorder associated with unspecified depressive disorder), is the disorder approximately at least as likely as not (i.e., the likelihood is at least approximately balanced or nearly equal, if not higher) related to service?

c)	Does the evidence, either lay or medical, indicate the Appellant exhibited mental or cognitive impairment at the time of the in-service misconduct? Why or why not? If so, to what extent?  If no mental or cognitive impairment was exhibited, please explain why.  See 38 C.F.R. § 3.12(e)(2).

d)	Discuss the Appellant's mental state during service, to include consideration of his age, cultural background, educational level, and judgmental maturity at the time of the offenses that resulted in his bad conduct discharge.

In offering the requested opinions, the examiner should address the Appellant's lay statements in the record. 

The examiner should provide a complete rationale for all opinions expressed and conclusions reached, including a discussion of the facts and medical principles involved.

6. Then, issue an administrative decision regarding the issue of character of discharge.

 

 

Jonathan Hager

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	M. Kaufer, 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