Citation Nr: 18142983
Decision Date: 10/17/18	Archive Date: 10/17/18

DOCKET NO. 15-24 271
DATE:	October 17, 2018
REMANDED
Service connection for an acquired psychiatric disorder.
REASONS FOR REMAND
Although the Veteran’s initial claim was limited to posttraumatic stress disorder (PTSD), this appeal has been expanded to include all acquired psychiatric disorders given the evidence of record.  Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009).
A remand is needed to address several psychiatric diagnoses offered during the pendency of this appeal and to provide a nexus opinion.  Further, evidence has been added to the record which tends to corroborate one of the Veteran’s claimed stressors of an in-service aircraft accident, which must be considered by an examiner in assessing the etiology of the claimed disorder.  As the evidence is indicative of a possible nexus in this case and there are no opinions of record, a remand is warranted for a new examination.   
The matter is REMANDED for the following actions:
1. Schedule the Veteran for an examination by a VA psychiatric or psychologist or a psychiatrist or psychologist with whom VA has contracted to assess the Veteran’s psychiatric symptomatology.  The claims file and a copy of this remand must be made available for review.
The examiner is asked to:
	a.  Identify any psychiatric disabilities shown 	during the pendency of this appeal.  A diagnosis of 	PTSD must be offered in accordance with DSM-5 	criteria.
	b.  Indicate whether it is at least as likely as not 	(50 percent probability or more) that the Veteran’s 	disability began in service, was caused by service, 	or is otherwise related to service.
	With respect to a PTSD diagnosis, the examiner 	must also specifically assess whether the disability 	is at least as likely as not related to a fear of hostile 	military activity or combat with the enemy.  
	With respect to any other psychiatric diagnosis, the 	examiner must also specifically assess whether the 	disability is at least as likely as not related to an 	in-service aircraft accident. 
In formulating the opinions, the examiners are advised that the term “at least as likely as not” does not mean “within the realm of possibility.”  Rather, it means that the weight of the medical evidence for and against the claim is so evenly divided that it is as medically sound to find in favor of the claim as it is to find against it.
A complete rationale should be provided for all opinions or conclusions expressed.  It should be noted that the Veteran is competent to attest to observable symptomatology.  If there is a medical basis to support or doubt the history provided by the Veteran, the examiners should provide a fully reasoned explanation.
2. Readjudicate the psychiatric appeal.  If the benefit sought remains denied, issue a supplemental statement of the case to the Veteran and his representative and provide an appropriate period for response.
 
L. HOWELL
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	K. Kovarovic, Associate Counsel