Citation Nr: 1306246 Decision Date: 02/22/13 Archive Date: 02/27/13 DOCKET NO. 12-32 500 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Muskogee, Oklahoma THE ISSUE Entitlement to service connection for an acquired psychiatric disability, including depression. ATTORNEY FOR THE BOARD Amanda Christensen, Associate Counsel INTRODUCTION The Veteran had active military service from June 2000 to August 2000. This appeal comes to the Board of Veterans' Appeals (Board) from a May 2011 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Muskogee, Oklahoma. The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the appellant if further action is required. REMAND The Veteran has claimed entitlement to service connection for depression, which he contends originated during service. For the reasons discussed below, the Board finds that further development is necessary for a fair adjudication of the Veteran's claim. Although the Board regrets the additional delay, a remand is necessary to ensure that due process is followed and that there is a complete record upon which to decide the Veteran's claim so that he is afforded every possible consideration. See 38 U.S.C.A. § 5103A (West 2002 & Supp. 2011); 38 C.F.R. § 3.159 (2012). In April 2011, the Veteran was examined by VA. The examiner stated that the Veteran has depressive disorder, not otherwise specified. The examiner stated that the Veteran's depression began in early childhood and continued through his time in service to the present day. Thus, he concluded that the Veteran's depression pre-existed his service, although it was diagnosed in service. However, the opinion did not include any discussion as to whether the Veteran's service may have aggravated the Veteran's depression. In general, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C.A. § 1110; 38 C.F.R. § 3.303(a) (2012). Once VA provides an examination in a service connection claim, the examination must be adequate or VA must notify the Veteran why an adequate examination will not or cannot be provided. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). "Without a medical opinion that clearly addresses the relevant facts and medical science, the Board is left to rely on its own lay opinion, which it is forbidden from doing." Stefl v. Nicholson, 21 Vet. App. 120, 124-25 (2007). It is incumbent upon the adjudicator to return an examination report as inadequate if it does not contain sufficient detail. 38 C.F.R. § 4.2. In this case, no rationaled VA opinion has been offered regarding the relationship between the Veteran's depression and service, to include whether a pre-existing depression was aggravated by the Veteran's. As such, a remand is warranted. The Veteran is hereby notified that it is his responsibility to report for any examination that may be scheduled, and to cooperate in the development of the case, and that the consequences of failure to report for a VA examination without good cause may include denial of the claim. See 38 C.F.R. §§ 3.158 and 3.655 (2012). Accordingly, the case is REMANDED for the following action: 1. Arrange for a review of the Veteran's claims file by the April 2011 examiner, if available, to address the questions of etiology presented in this case. The examiner should determine whether any documented psychiatric disorder, including depression, is etiologically related to the Veteran's service. The examiner should answer the following questions with complete rationale: a) Whether there is clear and unmistable evidence that the Veteran's depression pre-existed service, and b) if so, whether there is clear an unmistakable evidence that the Veteran's pre-existing disability was not aggravated by service or that any increase in disability was due to the natural progression of the disability? Note: "Aggravation" of a pre-existing disability refers to an identifiable, incremental, permanent worsening of the underlying condition, as contrasted with temporary or intermittent flare-ups of symptoms. c) If there is no clear an unmistakable evidence that the Veteran's depression pre-existed his military service, is it at least as likely as not (50 percent or better probability) that the Veteran's depression had its onset in military service? If the April 2011 VA examiner is not available, have the file reviewed by an appropriate specialist for the requested opinion. Additionally, if re-examination is found necessary, a new examination should be scheduled for the Veteran. 2. Upon completion of the above, readjudicate the issue on appeal. If any benefit sought on appeal remains denied, the Veteran and his representative should be furnished an appropriate supplemental statement of the case and be provided an opportunity to respond. Thereafter, the case should be returned to the Board for further appellate consideration, as appropriate. The aVeteran 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. 2012). _________________________________________________ MARK W. GREENSTREET 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) (2012).