Citation Nr: 18142586 Decision Date: 10/16/18 Archive Date: 10/16/18 DOCKET NO. 16-57 311 DATE: October 16, 2018 REMANDED Entitlement to service connection for an acquired psychiatric disorder, to include depressive disorder and anxiety disorder, is remanded. REASONS FOR REMAND The Veteran served in the United States Marine Corps from August 1981 to April 1987. The Veteran has filed separate claims for service connection for depression and anxiety disorder; however, the Board notes that the scope of a mental health disability claim includes any mental disability that reasonably may be encompassed by the claimant’s description of the claim, reported symptoms, and the other information of record. See Clemons v. Shinseki, 23 Vet. App. 1 (2009). Therefore, the Board has amended the issue on appeal to encompass service connection for an acquired psychiatric disorder, to include depressive disorder and anxiety disorder. The Veteran contends that her psychiatric condition(s), to include depression and anxiety disorder, is related to her active duty service, to include as due to exposure to contaminants in Camp Lejeune and as secondary to her service-connected migraine headaches. In September 2017, the Veteran was provided a VA examination. The examiner noted the Veteran was diagnosed with unspecified depressive disorder. The examiner opined that the Veteran’s disorder was less likely than not proximately due to or the result of the Veteran’s service-connected migraines. The examiner rationalized that based on the evidence of record, a temporal relationship between the Veteran’s service-connected migraine headaches and depression could not be established. The examiner further stated that the Veteran described a history of depression that dates back about 25 years in the context of marital discord and other psycho-social stressors. The Board finds the September 2017 VA opinion is inadequate to fairly adjudicate the Veteran’s claim for service connection. Although the VA examiner opined that the Veteran’s depression was less likely than not due to her service-connected migraine headaches, the examiner did not provide an opinion on whether her service-connected migraine headaches aggravates her depression. Further, the examiner marked that the Veteran does not have more than one mental disorder; however, her VA treatment records show a diagnosis and treatment for generalized anxiety disorder and mentions of “borderline personality traits.” Thus, an opinion regarding all mental conditions known should have also been provided. Additionally, although psychiatric disorders are not disabilities to be considered for presumption purposes under 38 C.F.R. §§ 3.307(a)(7), 3.309(f), it does not preclude the Veteran from receiving an opinion on the etiology of her condition, to include whether it is due to exposure to contaminants in Camp Lejeune. Therefore, the Board finds that a remand is required in order to obtain a new medical examination with an opinion addressing the nature and etiologies of the claimed condition. See McLendon v. Nicholson, 20 Vet. App. 79 (2006). The matter is REMANDED for the following action: 1. Obtain and associate with the Veteran’s electronic claims file any outstanding VA treatment records and private medical records relevant to the Veteran’s psychiatric disorder claim. 2. After all outstanding records have been associated with the file, schedule the Veteran for an examination with an appropriate examiner to determine the etiology of any psychiatric disorder. The record and a copy of this Remand must be made available to the examiner. The examiner should state all psychiatric disabilities that are present. For each disability, the examiner should opine as to the following: a) Whether it is at least as likely as not (50 percent probability or more) that the Veteran’s psychiatric condition is aggravated by her service-connected migraine headaches. “Aggravation” is defined as any worsening beyond the natural progression of the disability. b) If the Veteran’s psychiatric disorder is NOT aggravated by her service-connected migraine headaches, is it at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran’s psychiatric disorder had its onset during, or is otherwise related to, her active duty service, to include exposure to contaminants while serving at Camp Lejeune. In offering any opinion, the examiner must consider the full record, to include the lay statements regarding in-service incurrence, and the opinion should reflect such consideration. A clearly stated rationale for any opinion offered should be provided and must not be based solely on the lack of any in-service records. If the examiner is unable to provide an opinion without resort to speculation, he or she should explain whether the inability is due to the limits of the examiner’s medical knowledge, medical knowledge in general or there is evidence that, if obtained, would permit the opinion to be provided. JENNIFER HWA Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. Negron, Associate Counsel