Citation Nr: 18143833 Decision Date: 10/22/18 Archive Date: 10/22/18 DOCKET NO. 13-23 725 DATE: October 22, 2018 REMANDED Service connection for an acquired psychiatric disorder to include posttraumatic stress disorder (PTSD), to include as due to a service-connected disease or injury, is remanded. Service connection for a back disability, claimed as secondary to a service-connected disease or injury is remanded. Entitlement to a total disability rating based on individual unemployability as due to a service-connected disability (TDIU) is remanded. REASONS FOR REMAND The Board denied these claims in an October 2017 decision, and the Veteran appealed the Board decision to the United States Court of Appeals for Veterans Claims (Court). Pursuant to a June 2018 Order and supporting Joint Motion for Remand (JMR), the Court vacated the Board's October 2017 decision. 1. Service connection for an acquired psychiatric disorder to include PTSD, including as due to a service-connected disease or injury, is remanded.   2. Service connection for a back disability, claimed as secondary to a service-connected disease or injury, is remanded. 3. TDIU is remanded. Consistent with the JMR, this claim must be returned to the Agency of Original Jurisdiction (AOJ) to obtain an addendum medical opinion, as the medical opinion relied upon by the Board was deemed inadequate. The back disability claim must be remanded in turn because it is inextricably intertwined with the psychiatric claim. The April 2017 VA medical opinion reflects that Appellant’s “Unspecified Stressor and Trauma Related Disorder” is “not causally related to his service connected hearing loss nor is there evidence that it was aggravated by his service connected hearing loss.” The JMR noted that the examiner did not provide a rationale for this opinion or discuss the pertinent medical evidence. Importantly, the examiner did not address (1) a December 2009 Social Security Administration (SSA) Psychiatric Review reflecting that the Veteran’s psychiatric symptoms are directly related to his difficulty hearing or (2) a June 2009 Arizona Disability Evaluation reflecting the Veteran’s reported struggling with anxiety and depressive symptoms related to hearing loss and reflecting that an “adjustment disorder” is likely the appropriate diagnosis. As to TDIU, the Court noted that this should be addressed under the provisions of both of 38 C.F.R. §4.16(a) and (b), whereas it has only been addressed under 38 C.F.R. §4.16(a).   In addition, the Veteran submitted additional evidence to the Board in September 2018 and has requested that all the claims be remanded to the AOJ for consideration of that evidence. The matters are REMANDED for the following action: 1. Return the claim to the examiner who authored the April 2017 VA medical opinion, or a suitable substitute, for an addendum medical opinion. An additional examination should only be conducted if determined to be necessary by the examiner. The entire claims file, including the JMR and this remand, must be made available to the examiner. The opinion report should include a discussion of the Veteran's documented mental health history and assertions and all clinical findings should be reported in detail. The examiner should respond to the following: a. Please identify any acquired psychiatric disorder, to include PTSD, present during the pendency of this claim. b. For each diagnosed acquired psychiatric disorder, is it at least as likely as not (a 50 percent probability or greater) that the Veteran's acquired psychiatric disorder is related to or had its onset in active duty? c. Is it at least as likely as not (probability of 50 percent or more) that the Veteran's acquired psychiatric disorder was proximately caused by, or proximately worsened beyond its normal progression (aggravated) as a result of his service-connected hearing loss? Any opinion offered must be accompanied by a complete rationale, which should reflect consideration of all lay and medical evidence of record. The examiner is specifically asked to consider (1) a December 2009 SSA Psychiatric Review reflecting that the Veteran’s psychiatric symptoms are directly related to his difficulty hearing, and (2) a June 2009 Arizona Disability Evaluation reflecting the Veteran’s reported struggle with anxiety and depressive symptoms related to hearing loss and reflecting that an “adjustment disorder” is likely the appropriate diagnosis. 2. Thereafter, undertake any additional development necessary to adjudicate the claims of service connection for acquired psychiatric disorder to include PTSD, service connection for a back disability to include as secondary to a service-connected disability, and TDIU. In this regard, it is noted that the Veteran has urged that he has a back disorder that is proximately due to his psychiatric disorder. 3. Thereafter, readjudicate the issues on appeal, with consideration of all of the evidence, to include that which the Veteran added to the record subsequent to the return of the case to the Board in August 2018. As to TDIU, the AOJ should adequately address the issue of entitlement to TDIU to include under the provisions of 38 C.F.R. §4.16(a) and (b). If the determination remains unfavorable to the Veteran, he and his representative should be furnished a supplemental statement of the case. The Veteran and his representative should be afforded the applicable time period in which to respond, before the record is returned to the Board for further review. H. N. SCHWARTZ Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD N. Rippel, Counsel