Citation Nr: 18142955 Decision Date: 10/17/18 Archive Date: 10/17/18 DOCKET NO. 13-15 674 DATE: October 17, 2018 REMANDED Service connection for a psychiatric disorder, to include posttraumatic stress disorder (PTSD), is remanded.   REASONS FOR REMAND The Veteran served on active duty from March 1990 to March 1994. The case is on appeal from an August 2011 rating decision. In June 2017, the Board denied service connection for a chronic kidney disorder and for a psychiatric disorder. The Veteran subsequently appealed the decision in regard to the psychiatric disorder claim to the United States Court of Appeals for Veterans Claims (Court). The parties to the appeal entered into a March 2018 Joint Motion for Remand (Joint Motion) to remand the psychiatric disorder claim to the Board. In an Order dated later in March 2018, the Court granted the Joint Motion. Thereafter, in April 2018, the Veteran’s representative requested a 90 day extension to submit evidence. The extension request was granted in July 2018. The Veteran’s representative then submitted additional evidence in August 2018 and September 2018 and waived initial RO consideration of the additional evidence. See 38 C.F.R. § 20.1304(c). Service connection for a psychiatric disorder, to include PTSD. The Veteran is seeking service connection for a psychiatric disorder based on his service in the Persian Gulf War. The Veteran was afforded a VA examination in regard to this claim in June 2013. The examiner did not find a PTSD diagnosis was appropriate and instead diagnosed the Veteran with an anxiety disorder and psychosis. The examiner also noted the presence of polysubstance dependence and depression. She did not attribute the Veteran’s psychiatric conditions to his military service. In remanding the claim for additional development in November 2016, the Board found that the Veteran’s reported stressor of being near scud missile attacks during service in the Persian Gulf War to be credible. The Board also requested an addendum opinion from the June 2013 VA examiner. Thereafter, the June 2013 VA examiner provided an addendum opinion in February 2017. The examiner reported that the Veteran’s statements regarding scud missile attacks were not fully credible and that the Veteran’s psychiatric conditions are not related to service. The March 2018 Joint Motion found that the February 2017 addendum opinion was improper because it is based in part on a finding that the Veteran’s statements regarding scud missile attacks are less than credible in contradiction of the November 2016 Board remand. The Joint Motion also noted that a psychiatric condition that developed after discharge can be service-connected based on an in-service event. Subsequently, in September 2018, the Veteran’s representative submitted a psychiatric assessment performed by a private psychologist. The psychologist diagnosed the Veteran with PTSD, schizoaffective disorder, and substance use disorders. She found that the Veteran’s PTSD and schizoaffective disorder are due to the scud missile attacks and his substance use disorders are due to his PTSD. Given the differences of opinion in regard to the nature and etiology of the Veteran’s psychiatric disorders, and the concerns of the March 2018 Join Motion, the Board finds that remand is warranted to obtain another VA psychiatric examination and opinion. In addition, updated VA treatment records should be associated with the file. The claim is REMANDED for the following actions: 1. Obtain complete VA treatment records from August 2018. 2. After completing the records development indicated above, schedule the Veteran for an appropriate VA examination to determine the nature and etiology of all currently diagnosed psychiatric disorders. The record, to include a copy of this remand, must be made available to and be reviewed by the examiner. Any indicated evaluations, studies, and tests should be conducted. In offering any opinion, the examiner is to accept as credible the Veteran’s reports of scud missile attacks during his Gulf War service. (a.) Identify all of the Veteran’s psychiatric disorders experienced during the claim period (since September 2010), to include whether he meets the criteria for PTSD. If PTSD is not diagnosed, it should be explained why this is so. (b.) If the examiner finds that the Veteran meets the diagnostic criteria for PTSD, indicate whether it is caused or incurred during service and whether such diagnosis is the result of a verified in-service stressor, to include the Veteran’s reports of scud missile attacks. (c.) For each currently diagnosed psychiatric disorder other than PTSD and any substance use disorders, the examiner should offer an opinion as to whether it is at least as likely as not (probability of 50 percent or greater) that any such disorder had its onset during, or is otherwise related to, the Veteran’s military service, to include the Veteran’s reports of scud missile attacks. (d.) If the Veteran has a substance abuse disorder, indicate the severity of all relevant symptoms experienced by the Veteran due to such diagnosis. Also, state whether the substance abuse disorder is at least as likely as not (probability of 50 percent or greater) caused or aggravated by any psychiatric disorder that is related to his service. The term “aggravation” means an increase in the claimed disability; that is, a worsening of the condition beyond the natural clinical course and character of the condition due to the service-connected disability as contrasted to a temporary worsening of symptoms. A rationale for all opinions expressed should be provided. RYAN T. KESSEL Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD D. Jimerfield, Associate Counsel