Citation Nr: 0814180 Decision Date: 04/30/08 Archive Date: 05/08/08 DOCKET NO. 05-02 354 ) DATE ) ) On appeal from the Department of Veterans Affairs (VA) Regional Office (RO) in Waco, Texas THE ISSUE Entitlement to service connection for a bipolar disorder. REPRESENTATION Appellant represented by: Texas Veterans Commission WITNESSES AT HEARING ON APPEAL The appellant and his wife ATTORNEY FOR THE BOARD Robert E. O'Brien, Counsel INTRODUCTION The veteran had active service from April 1984 to December 1985. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a September 2004 rating decision of the VARO in Waco, Texas, that denied entitlement to the benefit sought. The matter is being REMANDED to the RO via the Appeals Management Center in Washington, D.C. VA will notify the veteran should further action be required. REMAND A review of the service medical records reveals the veteran was accorded a mental status evaluation prior to separation from service. It was indicated that he was having difficulties in developing and maintaining effective interpersonal relationships. It was stated his expressed lack of motivation and apparent apathy to the military was unlikely to result in his becoming an effective active military member. He was described as psychiatrically cleared for any administrative action. At the time of general medical examination by VA in February 1986, the veteran was described as "quite anxious" at the onset of the examination. He showed diminished anxiety as the exam progressed. No psychiatric diagnosis was made. The post service medical evidence of record includes a May 2004 communication from a VA psychiatrist who stated that the veteran had a bipolar disorder "which began during military service and PTSD which began after his service." It does not appear that the examiner had access to the claims folder. Under McLendon v. Nicholson, 20 Vet. App. 79 (2006), in disability compensation (service connection) claims, VA must provide a medical examination when there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability, and (2) evidence establishing that an event, injury, or disease occurred in service or establishing certain diseases manifesting during an applicable presumptive period for which the claimant qualifies, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the veteran's service or with another service-connected disability, but (4) insufficient competent medical evidence is on file for VA to make a decision on the claim. In view of the foregoing, the Board finds that a VA examination is necessary to determine the nature and etiology of the veteran's clinically diagnosed bipolar disorder. See 38 C.F.R. § 3.159 (c) (4). In view of the foregoing, the case is REMANDED for the following actions: 1. VA should ensure that the notification requirements of the Veterans Claims Assistance Act of 2000 are fully complied with and satisfied. Specifically, the veteran should be given an opportunity to provide information as to any psychiatric treatment or evaluation he might have received from both VA and non-VA providers in the late 1980's and early 1990's. 2. The veteran should be accorded a comprehensive psychiatric examination. The claims file and a copy of this REMAND must be provided to the examiner for review in conjunction with the examination. The examination report should include any indicated studies, to include psychological testing, that are deemed necessary for an accurate assessment of the veteran's psychiatric status. With regard to the bipolar disorder, the examiner should provide an opinion regarding whether it is more likely than not (i.e., probability greater than 50 percent), at least as likely as not (i.e., probability of 50 percent), or less likely than not (i.e., probability less than 50 percent), that the veteran has a bipolar disorder related to his active service. Any opinion expressed by the examiner should be accompanied by a complete rationale. 3. After the above has been completed, VA should review and readjudicate the claim. If the benefit sought remains denied, the veteran and his representative should be provided with a supplemental statement of the case. An appropriate period of time should be allowed for response. Then the case should be returned to the Board for further appellate consideration, if otherwise in order. By this REMAND, the Board intimates no opinion as to any final outcome warranted. No action is required of the veteran unless otherwise notified by VA. However, he is placed on notice that pursuant to the provisions of 38 C.F.R. § 3.655 (2007), failure to cooperate by not attending a requested VA examination may result in an adverse determination. The appellant has the right to submit additional evidence and argument on the matter or matters the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board of Veterans' Appeals or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate action must be handled in an expeditious manner. See The Veterans Benefits Act of 2003, Pub. L. No. 108-183, § 707(a), (b), 117 Stat. 2651 (2003) (to be codified at 38 U.S.C. §§ 5109B, 7112). _________________________________________________ V. L. JORDAN Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Appeals for Veterans Claims. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (2007).