Citation Nr: 1004495 Decision Date: 01/29/10 Archive Date: 02/16/10 DOCKET NO. 08-19 835A ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Oakland, California THE ISSUE Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD). REPRESENTATION Appellant represented by: California Department of Veterans Affairs ATTORNEY FOR THE BOARD M.G. Mazzucchelli, Counsel INTRODUCTION The Veteran served on active duty from July 1965 to June 1967. This matter is before the Board of Veterans' Appeals (Board) on appeal from a May 2007 rating decision of the Oakland, California, Department of Veterans Affairs (VA) Regional Office (RO) that denied the Veteran's claim for service connection for PTSD. The Board notes that the record includes diagnoses of adjustment disorder, anxiety/depression, mood disorder, and intermittent explosive disorder, as well as PTSD. Thus, the Board has recharacterized the issue more broadly. See Clemons v. Shinseki, 23 Vet. App. 1 (2009). The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the Veteran if further action is required. REMAND The Veteran contends that he has PTSD as a result of an in- service stressor. The RO has conceded that he was exposed to a stressor during his service in the U.S. Navy during the Vietnam conflict when his ship collided with another ship. The record contains diagnoses of PTSD dated in June 2006 and June 2008 from a private marriage and family therapist (MFT) who has treated the Veteran and reported that the Veteran experienced intrusive thoughts of his Vietnam service as well as nightmares, hypervigilance, and trouble sleeping. A VA psychiatric examination in October 2008 conducted by a staff psychologist resulted in diagnoses of intermittent explosive disorder, mood disorder, not otherwise specified, and rule-out bipolar disorder. The examiner stated that the Veteran did not meet the criteria for PTSD, but did not discuss the MFT's reports or the symptoms reported therein. The record also contains other psychiatric diagnoses, including depression, mood disorder, and adjustment disorder. Given the conflicting medical opinions and the absence of a diagnosis of PTSD by a psychologist or psychiatrist, see VA Initial Evaluation for PTSD Examination Worksheet (listing health care providers who can perform initial examination for PTSD), the record as it now stands is not sufficient for the Board to adjudicate the claim. Thus, the Veteran should be afforded a VA examination to identify his current psychiatric diagnosis(es) and to specifically address whether any are related to service. 38 U.S.C.A. § 5103A(d) (West 2002); 38 C.F.R. § 3.159(c)(4) (2009). Accordingly, the case is REMANDED for the following action: 1. Schedule the Veteran for a VA psychiatric examination, to be conducted by a psychologist or psychiatrist, for the purpose of ascertaining the nature and etiology of any psychiatric disorder. The claims folder should be made available to the examiner for review in conjunction with rendering the opinion. Based on the examination and review of the record, including the June 2006 and 2008 opinions of the private MFT and the October 2008 opinion of the VA psychologist discussed above, the examiner should first identify the precise nature of the Veteran's current psychiatric disability or disabilities. If a diagnosis of PTSD is appropriate, the examiner should offer an opinion as to whether it is at least as likely as not (50 percent or greater probability) that there is a link between the Veteran's PTSD and the confirmed in-service stressor. If the examination results in a psychiatric diagnosis other than PTSD, the examiner should offer an opinion as to the etiology of the non-PTSD psychiatric disorder, to include whether it is at least as likely as not (50 percent or greater probability) that any current psychiatric disorder, other than PTSD, is related to the Veteran's service. A rationale for all opinions expressed should be provided. If the examiner cannot reach a conclusion without resorting to speculation, it should be so stated in the examiner's report. 2. After the development requested above has been completed to the extent possible, review the record and adjudicate the Veteran's claim of entitlement to service connection for an acquired psychiatric disorder, to include PTSD. If this claim remains denied, the Veteran and his representative should be furnished a supplemental statement of the case and given the opportunity to respond thereto before this case is returned to the Board. The Veteran 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 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2009). ________________________________________________ J. HAGER Acting 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 the appeal. 38 C.F.R. § 20.1100(b) (2009).