Citation Nr: 18141346
Decision Date: 10/10/18	Archive Date: 10/10/18

DOCKET NO. 16-55 482
DATE:	October 10, 2018
REMANDED
Entitlement to an initial rating in excess of 50 percent for posttraumatic stress disorder (PTSD) with major depressive disorder and alcohol use disorder is remanded.
REASONS FOR REMAND
The Veteran served on active duty from July 1989 to January 1991.  
This matter is before the Board of Veterans’ Appeals (Board) on appeal of a January 2016 rating decision of the Wichita, Kansas, Regional Office (RO) of the Department of Veterans Affairs (VA). 
By his October 2016 Substantive Appeal, the Veteran indicated that he accepts the earlier effective date granted by the RO of June 12, 2013, therefore, that issue is not on appeal.
1. Entitlement to an initial rating in excess of 50 percent for posttraumatic stress disorder (PTSD) with major depressive disorder and alcohol use disorder is remanded.
In this case, the Veteran last appeared for a VA examination as to his service-connected psychiatric disorder in December 2015.  By his June 2018 Appellate Brief, the Veteran indicated that his disability has worsened.
The Court has held that a veteran is entitled to a new VA examination where there is evidence that the disability has worsened since the last VA examination.  See Snuffer v. Gober, 10 Vet. App. 400 (1997); Caffrey v. Brown, 6 Vet. App. 377 (1994).  As well, VA’s duty to assist includes providing a new medical examination when the available evidence is too old for an adequate evaluation of the current condition. Caffrey v. Brown, 6 Vet. App. 377, 381 (1994) (finding that VA should have ordered a contemporaneous examination of the veteran because a 23-month old exam was too remote in time to adequately support the decision in an appeal for an increased rating).  
The matters are REMANDED for the following action:
1. Obtain all outstanding VA clinical records and give the Veteran the opportunity to identify any private treatment records for association with the claims file.  All records/responses received must be associated with the claims file.  
2. Schedule the Veteran for an examination of the current severity of his service-connected posttraumatic stress disorder (PTSD) with major depressive disorder and alcohol use disorder.  The examiner must also attempt to elicit information regarding the severity, frequency, and duration of any flare-ups, and the degree of functional loss during flare-ups.  To the extent possible, the examiner should identify any symptoms and functional impairments due to the service-connected psychiatric disability alone and discuss the effect of the Veteran’s psychiatric disability on any occupational functioning and activities of daily living.  If it is not possible to provide an opinion regarding flare-ups, symptoms, or functional impairment without speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training).
3. After the above is complete, readjudicate the Veteran’s claims.  If a complete grant of the benefits requested is not granted, issue a supplemental statement of the case (SSOC) to the Veteran and his representative to afford them the opportunity to respond before the case is returned to the Board.
 
KRISTI L. GUNN
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	K. M. Georgiev