12-04 472
12-04 472
| Board of Vet. App. | Aug 31, 2017Background
- Veteran served Aug–Nov 1990 and May 1991–Jun 1993; appealed RO denials of PTSD, hypertension (HTN), and TDIU to the Board. Multiple Board remands (2014–2016) for development; AOJ subsequently obtained VA exams and opinions (2016–2017).
- Service-connected degenerative joint disease/spondylosis of the lumbar spine (low back disability) is established; veteran has a current diagnosis of benign essential hypertension since ~2002 and a current diagnosis of PTSD.
- Medical opinions (2010, 2015, 2016) consistently found HTN likely essential but at least as likely as not aggravated by chronic low back pain and analgesic/NSAID use; examiners viewed such aggravation as episodic during pain flare-ups.
- Record shows frequent back pain flare-ups (weekly or daily) and recurrent severe episodes; Board treated recurrent episodic aggravation as effectively permanent for secondary service-connection purposes.
- Veteran reported military sexual trauma (MST) while stationed in Germany (drink allegedly spiked, sexual assault not reported contemporaneously). Personnel records lacked corroborating markers; VA mental-health treatment notes and a 2016 VA examiner documented PTSD and behavioral changes consistent with MST.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Service connection for HTN (secondary to service‑connected low back disability) | HTN was caused or aggravated by chronic low back pain and medications | HTN is likely essential (family history, epidemiology); at most episodically aggravated by pain/NSAIDs, not permanently caused | Granted: HTN service‑connected on secondary (aggravation) basis — Board found frequent flare‑ups made aggravation effectively permanent and resolved doubt for veteran |
| Service connection for PTSD (including MST) | PTSD is the result of in‑service MST in Germany (and later workplace assault); behavioral changes and treatment records support the stressor and diagnosis | AMC/RO noted lack of contemporaneous corroboration/markers in service records; formal finding initially declined to corroborate MST | Granted: PTSD service‑connected as due to in‑service MST — Board credited VA exam and treatment records, found sufficient corroboration and resolved doubt for veteran |
| Entitlement to TDIU | Veteran seeks TDIU based on service‑connected disabilities impairing employability | AOJ has not completed development; recent records conflict regarding employment status | Remanded: TDIU deferred to AOJ for development (send VA Form 21‑8940, readjudicate after implementing Board decision) |
Key Cases Cited
- Stegall v. West, 11 Vet. App. 268 (Board remand confers right to compliance with remand orders)
- Shedden v. Principi, 381 F.3d 1163 (elements required for service connection)
- Gilbert v. Derwinski, 1 Vet. App. 49 (Board must discuss probative evidence and reasons for rejection)
- Allen v. Brown, 7 Vet. App. 439 (standard for secondary service connection/aggravation)
- YR v. West, 11 Vet. App. 393 (benefit‑of‑the‑doubt and personal‑assault stressor corroboration rules)