Citation Nr: 18143234
Decision Date: 10/18/18	Archive Date: 10/18/18

DOCKET NO. 17-15 283
DATE:	October 18, 2018
REMANDED
Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD) and depression, to include as secondary to service-connected disabilities, is remanded.
REASONS FOR REMAND
The Veteran served on active duty from March 1954 to January 1956.
Service connection for an acquired psychiatric disorder is remanded.
The Veteran contends that service connection for an acquired psychiatric disorder, to include PTSD and depression, is warranted either as directly incurred in service or as secondary to service-connected disabilities (38 C.F.R. § 3.310). See September 2018 Appellant’s Brief.  The Veteran has reported the following alleged in-service events: extreme cold weather in Korea; experiencing a typhoon while on the USS Phoenix in September 1954; observing Korean protests against Americans in June 1955 and September 1955; and seeing a dead Korean in August 1955 when a vehicle fell on him.
In light of the medical records reflecting diagnoses of a depressive disorder and PTSD, the reported in-service stressors, some of which would be verifiable by deck logs or unit histories, and the event of in-service cold exposure and injury, VA should attempt to verify the claimed stressors. Thereafter, the Veteran should be afforded a VA examination to confirm diagnoses of a psychiatric disorder and provide etiology opinions as to whether the current psychiatric disorder(s) are related to service or are secondary to (caused or aggravated by) the service-connected residuals of cold injury.
The matter is REMANDED for the following action:
1. Contact the appropriate records repositories to attempt to verify the following claimed in-service PTSD stressor events: 
A)	experiencing a typhoon while on the USS Phoenix in September 1954
B)	observing Korean protests against Americans in June 1955 and September 1955
2. Request an appropriate VA examination to assist in determining the diagnosis and etiology of current acquired psychiatric disorder symptoms. The VA examiner should provide a detailed review of the in-service history and events, including in-service cold exposure and cold injury to the extremities, current complaints, and past and current findings of PTSD and depression.
The Veteran served on active duty from March 1954 to January 1956, and is service-connected for cold injury residuals of 1) left foot; 2) left hand; 3) right foot; and 4) right hand; and associated peripheral neuropathy of the respective bilateral upper and lower extremities.
The examiner is asked to answer the following questions: 
a.	If the examiner determines that a diagnosis of an acquired psychiatric disorder(s), to include PTSD and depression, has been present at any time during the appellate period, the examiner should opine whether it is at least as likely as not (50 percent probability or greater) that this acquired psychiatric disorder(s), if present, was caused by or is otherwise related to his active duty service, to include the claimed in-service stressor events.
b.	Is it at least as likely as not that any acquired psychiatric disorder(s), including depression, is caused by the service-connected cold injury residuals? 
c.	Is it at least as likely as not that any acquired psychiatric disorder(s), including depression, is worsened beyond a natural progression by the service-connected cold injury residuals?
If the examiner assesses that the service-connected cold injury residuals of the upper and lower extremities worsens the acquired psychiatric disorder(s), the examiner is asked to state whether there is medical evidence created prior to the aggravation or at any time between the time of aggravation and the current level of disability that shows a baseline for the acquired psychiatric disorder(s) prior to aggravation. If the examiner is unable to establish a baseline for the acquired psychiatric disorder(s) prior to the aggravation, he or she should state such and explain why a baseline cannot be determined.
A rationale should be provided for all medical opinions given. 
 
J. PARKER 
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	D. Cheng, Associate Counsel