Citation Nr: 18143170
Decision Date: 10/18/18	Archive Date: 10/18/18

DOCKET NO. 16-27 705
DATE:	October 18, 2018
REMANDED
Service connection for an acquired psychiatric disability, to include posttraumatic stress disorder (PTSD), is remanded.
REASONS FOR REMAND
The Veteran served on active duty from June 1967 to June 1969 in the United States Army, with service in the Republic of Vietnam from November 1967 to November 1968.
This matter comes before the Board of Veterans' Appeals (Board) on appeal from a February 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). 
In February 2018, the Veteran indicated that he receives treatment through the Alexandria VA Health Care System, in Pineville, Louisiana.  In September 2018, he stated he also receives treatment at the Overton Brooks VA Medical Center in Shreveport, Louisiana.  At present, the file does not contain any post-service medical records.  These records must be obtained.
A further medical opinion is also needed to resolve the claim.  On VA examination in October 2013, the examiner found that the Veteran’s stressors involving being under enemy attack in Vietnam was related to a fear of hostile military or terrorist activity and would be adequate to support a diagnosis of PTSD.  However, the examiner determined the Veteran did not meet the full criteria for PTSD.  The Veteran has argued that the examiner did not consider any other psychiatric diagnoses or their relationship to his stressor.  He reports experiencing various psychiatric symptoms that were not addressed by the examiner, and has indicated a possible worsening of symptoms.  The Board finds that an updated opinion should be obtained.
The matter is REMANDED for the following action:
1. Obtain and associate with the record all VA treatment records from the Alexandria VA Health Care System, as well as from the Overton Brooks VA Medical Center.
2. Afford the Veteran a VA examination with a psychologist or psychiatrist to obtain evidence as to the etiology of his acquired psychiatric disabilities.  A rationale must be provided for all conclusions reached.  
In addressing the below inquiries, the examiner must consider the October 2013 statement of the Veteran’s spouse, as well as the October 2013 VA examination report.
(a.) All current psychiatric disabilities must be identified.  
(b.)  For all psychiatric disabilities other than PTSD, the examiner must provide an opinion on whether it is at least as likely as not related to an in-service injury, event, or disease, including the Veteran’s service in Vietnam.   
(c.)  With respect to PTSD, the RO/AMC must provide the examiner with a summary of any other verified in-service stressors, and the examiner must be instructed that only these events, and his stressors related to the fear of hostile military or terrorist activity in Vietnam, may be considered when determining whether exposure to an in-service stressor has resulted in PTSD.  The examiner must then comment upon the link between the current symptomatology and any verified in-service stressor, including the fear of hostile military or terrorist activity.
 
JOHN Z JONES
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	J. Smith, Counsel