Citation Nr: 18140508 Decision Date: 10/03/18 Archive Date: 10/03/18 DOCKET NO. 16-20 702 DATE: October 3, 2018 ORDER Entitlement to service connection for an acquired psychiatric condition is granted. REMANDED Entitlement to service connection for Type II diabetes mellitus is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) due to service-connected disabilities is remanded. FINDINGS OF FACT 1. The Veteran was diagnosed with depressive disorder during the pendency of the appeal. 2. Resolving reasonable doubt in the Veteran’s favor, his diagnosed depressive disorder was caused by his service-connected disabilities. CONCLUSION OF LAW The criteria for entitlement to service connection for an acquired psychiatric condition are met. 38 U.S.C. §§ 1110, 1111, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran served on active duty from January 1974 to July 1989. 1. Entitlement to service connection for an acquired psychiatric condition, to include as secondary to his service-connected disabilities The Veteran contends that he developed an acquired psychiatric condition that is secondary to his service-connected disabilities. The Board concludes that the Veteran was diagnosed with depressive disorder during the course of the appeal period which was more than likely caused by his service-connected disabilities. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.310. The Veteran’s service-connected disabilities include a fracture dislocation of the right hip with posttraumatic arthritis status post hip replacement, bilateral hearing loss, and right ear tinnitus, as well as a scar associated with his right hip disability. In February 2014, a private psychologist diagnosed the Veteran with depressive disorder. In an opinion accompanying the examination report, the psychologist concluded it was more likely than not that the Veteran’s service-connected medical problems caused his depressive disorder. In support of this conclusion, the psychologist stated that medical literature identified the comorbidity of pain, medical conditions and depression, particularly when there is considerable pain. He stated there was also a significant literature on the relationship of hearing difficulties and mental health problems. Since the Veteran’s service-connected injury in 1983, he has experienced increasing pain and discomfort both from his right hip fracture and subsequent hip replacement, as well as the impact from his tinnitus, which has led to significant depressive symptoms and substance abuse as self-medication. In May 2016, a VA examiner noted that the Veteran had a history of experiencing depression due to his hip pain, which was service-connected. However, the examiner stated that at his evaluation, the Veteran did not meet the criteria for a depressive disorder. Instead, the Veteran was diagnosed with severe amphetamine-type substance use disorder in full remission. The requirement that a current disorder be present is satisfied when a claimant has a disorder at the time a claim for VA disability compensation is filed or during the pendency of that claim, even if the disorder resolves prior to the adjudication of the claim. See McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). In this case, the Veteran filed his present claim in February 2012. He submitted evidence showing a diagnosis of depressive disorder in February 2014 during the pendency of the claim. There is no medical opinion to the contrary in the record concerning the etiology of the Veteran’s diagnosed depressive disorder. Based on the foregoing evidence, the Board finds that the preponderance of the evidence is in favor of service connection for an acquired psychiatric condition, and the claim is granted. REASONS FOR REMAND 1. Entitlement to service connection for Type II diabetes mellitus is remanded. 2. Entitlement to a TDIU is remanded. In April 2011, the Veteran underwent a VA examination to determine the etiology of his diabetes. An examiner diagnosed diabetes mellitus but provided no opinion on whether the condition had its onset or was otherwise related to active duty service. As such, a remand is needed for a VA examiner’s opinion. The outcome of service connection claim for Type II diabetes mellitus could impact the Veteran’s combined rating and eligibility for TDIU; these issues are intertwined. Therefore, this issue must be deferred by the Board. Since the claims file is being returned it should be updated to include any outstanding VA treatment records. See 38 C.F.R. § 3.159 (c)(2); see also Bell v. Derwinski, 2 Vet. App. 611 (1992). The matters are REMANDED for the following action: 1. Obtain and associate with the Veteran’s claims file copies of all outstanding VA treatment records dated from June 2017 to the present. 2. Then forward the Veteran’s claims file to the examiner who conducted the April 2011 VA examination (or another appropriate examiner if that examiner is unavailable) for supplemental comment regarding his claim for service connection for Type II diabetes mellitus. The claims file, to include a copy of this Remand, must be made available to the examiner for review prior to the exam. If the opinion provider determines that an opinion cannot be provided without an examination, the Veteran should be scheduled for an appropriate examination. Based on the examination, if deemed necessary, and review of the record, the examiner is requested to provide an opinion addressing the following question: Is it at least as likely as not (50 percent or higher probability) that the Veteran’s Type II diabetes mellitus had its onset in or is otherwise related to active duty service? A full rationale is to be provided for all stated medical opinion. If an opinion cannot be made without resort to speculation, the examiner should provide an explanation as to why this is so and note what, if any, additional evidence would permit such an opinion to be made. M. E. Larkin Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Jack S. Komperda, Counsel