Citation Nr: 18139925 Decision Date: 10/01/18 Archive Date: 10/01/18 DOCKET NO. 16-15 140A DATE: October 1, 2018 REMANDED The issue of entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD), anxiety, and alcohol dependence, is remanded for additional development. REASONS FOR REMAND The Veteran served on active duty from October 1975 to October 1978. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a December 2015 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Board observes that the RO had originally adjudicated the Veteran’s claim as entitlement to service connection for PTSD. However, the medical evidence of record reveals diagnoses of various acquired psychiatric disorders. Accordingly, the issue has been amended. Clemons v. Shinseki, 23 Vet. App. 1, 5-6 (2009). In a June 2016 rating decision, the RO granted an effective date of April 28, 2009 for the grant of service connection for tinnitus. As the Veteran specifically requested that the effective date of service connection for tinnitus be the same as the effective date of service connection for hearing loss, the Board finds that this grant of an earlier effective date constitutes a full award of the benefit sought on appeal with respect to that issue and is no longer before the Board. See Grantham v. Brown, 114 F.3d 1156, 1158-59 (Fed. Cir. 1997); see also 38 C.F.R. § 20.200. In May 2016, the Board received from the Veteran a motion for advancement on the docket because he was homeless. The Board hereby grants the Veteran’s motion. As such, this appeal has been advanced on the Board’s docket pursuant to 38 C.F.R. § 20.900(c). 38 U.S.C. § 7107(a)(2). Finally, the Board notes that the Veteran requested a hearing before a Veterans Law Judge in his substantive appeal. However, in April 2017, he indicated that he wished to cancel that hearing. Thus, his hearing request is considered withdrawn. 38 C.F.R. § 20.704(e). Entitlement to service connection for an acquired psychiatric disorder, to include PTSD, anxiety, and alcohol dependence, is remanded. The Veteran is seeking service connection for an acquired psychiatric condition, to include PTSD and anxiety, which he attributes to an in-service incident while stationed in Germany in November 1977. Establishing service connection for PTSD requires (1) medical evidence diagnosing the condition in accordance with 38 C.F.R. § 4.125(a); (2) a link, established by medical evidence, between current symptoms and an in-service stressor; and (3) credible supporting evidence that the claimed in-service stressor occurred. 38 C.F.R. § 3.304(f). At the outset, the record documents extensive treatment for and diagnoses of PTSD, anxiety disorder, and alcohol dependence. As for an in-service stressor, the Veteran has consistently reported that while doing field maneuver exercises, a battalion track vehicle was sliding/tilting on snow. He said that he saw the driver jump out of the vehicle’s hatch and the vehicle rolled over the driver and crushed him to death. The Veteran further reported that he had many conversations with the Army chaplain about this incident. The Veteran has not yet been afforded a VA examination in connection with his claim. VA must provide an examination when there is competent evidence of a disability (or persistent or recurrent symptoms of a disability) that may be associated with an in-service event, injury, or disease, but there is insufficient information to make a decision on the claim. 38 U.S.C. § 5103A(d); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). Lay testimony as to continuity of symptomatology can satisfy the requirement for evidence that the claimed disability may be related to service, and the threshold for finding that the disability (or symptoms of a disability) may be associated with service is low. Id. at 83. Furthermore, the Veteran is competent to testify to in-service injuries, symptoms, and events. Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). Given the Veteran’s reports attributing his current psychiatric condition to service, the Board finds that the low threshold of the McLendon standard has been met in this instance, and that the Veteran should be afforded a VA examination and opinion prior to adjudication of the claim. The matter is REMANDED for the following action: 1. Ask the Veteran to provide the names and addresses of any medical provider, VA or private, who has treated him for a psychiatric condition. After securing any necessary releases, the AOJ should request any relevant records identified that are not duplicates of those already contained in the claims file. Additionally, obtain VA treatment records dating from December 2015 to the present. If any requested records are unavailable, the claims file should be annotated as such and the Veteran and his representative notified of such. 2. After completing the above actions and associating any additional records with the claims file, schedule the Veteran for a VA mental disorders examination to determine the nature and etiology of his psychiatric conditions. All diagnostic testing deemed to be necessary by the examiner should be accomplished. The examiner should provide the following: (a.) Identify all currently diagnosed mental health disabilities. In doing so, the examiner should note that the term “current” means occurring at any time during the pendency of the Veteran’s claim; i.e., from July 2015 onward. The psychiatric disorder need not be present at the time of the examination; rather it is sufficient if it previously existed during the pendency of the claim and then resolved prior to the examination. (b.) The Board notes that the record shows past diagnoses of anxiety disorder and PTSD. All of these disorders should be considered and discussed, in addition to any other disorders that may be found. If any specific disorder is ruled out, a complete explanation must be provided. That explanation should include a discussion of all the pertinent evidence of record, to include lay evidence. So, for example, if the examiner were to find that PTSD is not a current disability, then the explanation should include a discussion of the medical records, prior VA examinations, as well as the Veteran’s lay statements regarding his condition. If the examiner determines that any prior diagnosis cannot be validated, she or he should explain why. (c.) With respect to each diagnosed psychiatric disability, the examiner should opine as to whether it is at least as likely as not (50 percent probability or greater) that the disability arose during service or is otherwise related to any incident of service. Please explain why or why not. (d.) For each diagnosis, opine as to whether the condition is related to the Veteran’s having witnessed a fellow service member’s death. (e.) A rationale for any opinions expressed should be set forth. If the examiner cannot provide an above opinion without resorting to speculation, he/she should explain why an opinion cannot be provided (e.g. lack of sufficient information/evidence, the limits of medical knowledge, etc.). (Continued on the next page)   3. After completing the requested actions, and any additional action deemed warranted, readjudicate the Veteran’s claim. If the benefit sought on appeal remains denied, the Veteran and his representative should be furnished a supplemental statement of the case and given the opportunity to respond thereto. The case should then be returned to the Board for further appellate consideration, if in order. S. C. KREMBS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Bilstein, Associate Counsel