Citation Nr: 18142460 Decision Date: 10/15/18 Archive Date: 10/15/18 DOCKET NO. 16-23 470 DATE: October 15, 2018 REMANDED Entitlement to service connection for a psychiatric disability to include posttraumatic stress disorder (PTSD) is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from May 1983 to May 1987. This matter is before the Board of Veterans’ Appeal (Board) on appeal from a May 2014 rating decision issued by the Department of Veteran Affairs (VA) Regional Office (RO) in Montgomery, Alabama. Entitlement to service connection for a psychiatric disability to include PTSD is remanded. The Veteran is seeking service connection for PTSD (or other psychiatric disability). Although the Board sincerely regrets the additional delay this may cause, further development is necessary prior to the adjudication of this claim. The Veteran’s medical treatment records indicate a diagnosis of PTSD. The Board notes that a May 2014 VA memorandum found a lack of information to corroborate the Veteran’s claimed stressor associated with his claim for service connection for PTSD due to the Veteran’s failure to provide the necessary information regarding his claimed stressor. The Veteran, however, submitted a VA Form 21-0781a in November 2016 detailing his alleged stressor. The Veteran contends that in June 1984, he was attached to SUBLANT/Subgroup Six stationed on the USS Daniel Boone SSBN 629 and went on a deterrent patrol cruise. The Veteran reported that during the patrol, the Veteran stated that his unit went into DEFCON 3, which required no outside contact with the world for three to four months. The Veteran also reported participating in DEFCON 2 training exercises. The Veteran described one particular drill when his commander “was out of control” and the submarine started a slow descent and, “escalated enough that there was a concern to restart the reactor.” The Veteran stated that he considered running to the control panel and flipping the high-pressure switches to force the submarine back to the surface, but he stayed at his station and did his job. Nobody was harmed and the submarine returned to the surface, but the Veteran reports that he agonizes over the decision not to flip the high-pressure switches because everybody could have been killed. The Board finds that further development is needed to corroborate the Veteran’s claimed stressor. Additionally, review of the record indicates that the Veteran’s personnel record has not been associated with the records, thus steps must be taken to associate his outstanding personnel records with the file. Moreover, the Veteran has not been afforded a VA examination to determine the nature and etiology of his claimed PTSD. The Board highlights that the Veteran’s medical treatment records confirm a diagnosis of PTSD and he has submitted his claimed stressor. Under these circumstances, the Board will not proceed with final adjudication of the claims until a competent medical opinion with supporting rationale is obtained that adequately addresses the etiology of the Veteran’s claimed disability. McLendon v. Nicholson, 20 Vet. App. 79 (2006). Due to the need for a remand in this matter, the Board will also provide the opportunity for the procurement of any outstanding VA or private medical records. The matter is REMANDED for the following actions: 1. The AOJ should secure the Veteran's complete service personnel and treatment records from his active duty service in the United States Navy from May 1983 to May 1987. If it is determined that such records are unavailable, a formal finding of unavailability should be made and associated with the record. Contact the appropriate agencies, to include, if warranted, the Joint Services Records Research Center (JSRRC), to attempt to verify the Veteran’s claimed stressor. All attempts to verify the Veteran’s stressor must be documented in the record. If the AOJ is unable to verify any claimed stressor, a memorandum documenting such must be prepared and associated with the evidence of record. This memorandum must describe in detail all steps taken in furtherance of attempted verification. The Veteran has alleged the following which should be addressed in a November 2016 VA Form 21-0781a. The Veteran contends that in June 1984, he was attached to SUBLANT/Subgroup Six stationed on the USS Daniel Boone SSBN 629 and went on a deterrent patrol cruise. The Veteran reported that during the patrol, the Veteran stated that his unit went into DEFCON 3, which required no outside contact with the world for three to four months. The Veteran also reported participating in DEFCON 2 training exercises. The Veteran described one particular drill when his commander “was out of control” and the submarine started a slow descent and, “escalated enough that there was a concern to restart the reactor.” The Veteran stated that he considered running to the control panel and flipping the high-pressure switches to force the submarine back to the surface, but he stayed at his station and did his job. Nobody was harmed and the submarine returned to the surface, but the Veteran reports that he agonizes over the decision not to flip the high-pressure switches because everybody could have been killed 2. Send the Veteran and his representative a letter requesting that he provide sufficient information and, if necessary, authorization, to obtain any additional evidence from all VA and non-VA health care providers who have treated him for his claimed PTSD and any other acquired psychiatric disorder that is not currently of record, including any private treatment records related to ongoing treatment for the aforementioned disability. If the Veteran responds, assist him in obtaining any additional evidence identified, following current procedures set forth in 38 C.F.R. § 3.159. All records/responses received should be associated with the claims file. If any records are not obtained, notify the Veteran of the records that were not obtained, explain the efforts taken to obtain them, and describe further action to be taken. 3. After all records and/or responses received from each contacted entity have been associated with the claim (to the extent possible), schedule the Veteran for a VA examination by a VA psychiatrist or psychologist to determine the etiology of any psychiatric disorder found, to include PTSD. Prior to conducting the examination, the electronic claims file must be made available to the examiner for review of the case. A notation to the effect that this record review took place should be included in the report of the examiner. In reviewing the Veteran’s electronic claims file, the examiner should identify and examine all records indicating any signs/indicators or change of behavior or performance during service, subsequent to the claimed stressor alleged by the Veteran to have occurred during active service, and offer an opinion as to the clinical significance, if any, of such evidence. After reviewing the record and examining the Veteran, the examiner should determine what psychiatric disorders are present. If a diagnosis of PTSD is made, the examiner should offer an opinion as to whether any claimed in-service stressor is sufficient to have caused PTSD and whether it is at least as likely as not (50 percent probability or more) that any claimed stressor caused the Veteran’s PTSD. The examiner must explain how the diagnostic criteria of the Diagnostic and Statistical Manual for Mental Disorders are met, to include identification of the specific stressor(s) underlying the diagnosis, and comment upon the link between the current symptomatology and one or more of the stressors. If a diagnosis of PTSD is not deemed appropriate, the examiner must specifically explain how the diagnostic criteria for PTSD of the Diagnostic and Statistical Manual for Mental Disorders have not been met. The examiner should acknowledge and discuss the findings in the service treatment and personnel records, lay statements from the Veteran and fellow servicemen, and post-service VA psychiatric treatment reports of record. For each diagnosed psychiatric disorder other than PTSD, the examiner is requested to provide an opinion, based upon review of the service and post-service treatment records, the lay statements of record, and any examination findings, as to whether it is at least as likely as not (50 percent probability or more) that the Veteran’s psychiatric disorder is related to his active military service, to include his claimed stressors in service. Again, the examiner should acknowledge and discuss the findings in the service treatment and personnel records, lay statements from the Veteran and fellow servicemen, and post-service VA psychiatric treatment reports of record. The examiner should consider the lay testimony of record. A detailed rationale supporting the examiner’s opinion must be provided. If the examiner is unable to offer the requested opinion, it is essential that the examiner offer a rationale for the conclusion that an opinion could not be provided without resort to speculation, together with a statement as to whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. See Jones v. Shinseki, 23 Vet. App. 382 (2010). 4. After undertaking any additional development deemed appropriate, and giving the Veteran full opportunity to supplement the record, adjudicate the Veteran’s pending claim in light of any additional evidence added to the record. If any benefit sought on appeal remains denied, the Veteran and his representative should be furnished with a Supplemental Statement of the Case and be afforded the applicable opportunity to respond before the record is returned to the Board for further review. J. CONNOLLY Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. R. Higgins, Associate Counsel