Citation Nr: 18143963 Decision Date: 10/22/18 Archive Date: 10/22/18 DOCKET NO. 08-18 143 DATE: October 22, 2018 REMANDED Entitlement to service connection for a liver disability, to include as secondary to a psychiatric disability is remanded. Entitlement to service connection for an acquired psychiatric disability, to include Post-Traumatic Stress disorder (PTSD) and Major Depressive Disorder is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1964 to January 1968. This case came before the Board of Veterans' Appeals (Board) on appeal from a September 2007 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). The issues were last remanded by the Board in October 2015 for further development. In November 2014 correspondence, the Veteran's representative raised the issue of the timeliness of an appeal of a February 2013 rating decision with regard to the claim of an initial compensable rating for residual scarring from melanoma of the upper back. In October 2015 the Board referred the issue to the RO; however, this issue still has not been addressed by the RO in the first instance. Therefore, the Board does not have jurisdiction over it, and it is again referred to the originating agency for appropriate action. 38 C.F.R. § 19.9 (b). Entitlement to service connection for an acquired psychiatric disability, to include Post-Traumatic Stress disorder (PTSD) and Major Depressive Disorder is remanded. In October 2015 the Board remanded the issue of service connection for a psychiatric disability. Specifically, the Board instructed the RO to obtain a VA medical examination to determine the etiology of all acquired psychiatric disorders present during the period of the claim. In a March 2017 VA medical report, the examiner concluded that the Veteran did not meet the diagnostic criteria for PTSD. The examiner went on to opine that the Veteran’s Depressive Disorder is less likely as not related to his military service. The examiner described the Veteran’s reported stressors as “anecdotal” and failed to be confirmed as in-service stressors. In a September 2018 Appellant’s Brief, the Veteran’s representative asserts that the Veteran’s alleged stressor, specifically the witnessing and participating in rescue and recovery efforts of causalities from the crash of an "R and R" plane in Hong Kong Harbor during his third tour in Vietnam aboard the USS VEGA, have been corroborated by the Joint Services Records Research Center (JSRRC). Notably, the June 2016 JSRRC inquiry response reflects that on August 24, 1965, an aircraft did crash while departing Hong Kong resulting in 59 deaths. JSRRC further noted that the USS VEGA was moored in Hong Kong from August 22-28, 1965. Additionally, the September 2018 Appellant’s Brief notes the May 2018 VA Psychiatric Assessment, which noted the Veteran with Major Depressive Disorder and PTSD. The Board find’s the March 2017 VA medical opinion to be inadequate. The examiner concluded that the Veteran’s reported stressors are anecdotal. However, the examiner failed to consider the JRSSC response regarding the August 1965 aircraft crash. Additionally, the examiner concluded that the Veteran failed to meet the diagnostic criteria for PTSD. However, as noted above, VA treatment records reflect the Veteran has been treated for and diagnosed with PTSD. Further, the examiner failed to provide an adequate rationale regarding the Veteran’s diagnosed depressive disorder. A remand by the Board confers on claimants, as a matter of law, the right to compliance with the remand orders. Stegall v. West, 11 Vet. App. 268, 271 (1998). It imposes upon VA a concomitant duty to ensure compliance with the terms of the remand. Based on the above, the Board finds that a medical examination and opinion based on facts and medical principles is required. Entitlement to service connection for a liver disability, to include as secondary to a psychiatric disability is remanded. Finally, the Veteran has alleged that the claimed liver disorder is secondary to his psychiatric disability. The Board finds the liver disorder claim cannot be finally decided until the psychiatric disorder issue is decided. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991) (holding that issues are inextricably intertwined and must be considered together when a decision concerning one could have a significant impact on the other). Thus, the liver disorder claim must also be remanded. The matters are REMANDED for the following action: 1. Obtain all available, outstanding VA and private medical evidence pertinent to the claims on appeal. 2. Thereafter, the Veteran must be afforded a VA examination by an appropriate clinician to determine the nature and etiology of all acquired psychiatric disorders present during the period of the claim. All pertinent evidence of record must be made available to and reviewed by the examiner. Any indicated studies should be performed. Based on the review of the Veteran's pertinent history and the examination results, the examiner should identify all acquired psychiatric disorders that have been present during the period of the claim. The examiner is requested to furnish the following opinions: a.) Whether it is at least as likely as not (50 percent or greater) that PTSD has been present at any time during the period of the claim due to a confirmed in-service stressor, or due to a stressor which relates to "fear of hostile military or terrorist activity." The examiner should address in detail whether a confirmed in-service stressor supports a diagnosis of PTSD at any time during the period of the claim, whether the Veteran's symptoms relate to that in-service stressor, and whether the criteria for a diagnosis of PTSD are met. If a diagnosis of PTSD is not made, the examiner should explain why the Veteran does not meet the criteria for the diagnosis. b.) Whether it is at least as likely as not (50 percent or greater) that the Veteran has an acquired psychiatric disability, to include Major Depressive Disorder related to, or aggravated by, his military service. The examiner must consider and reconcile any conflicting medical evidence or opinions of record. The rationale for all opinions expressed must also be provided. If the examiner is unable to provide any required opinion, he or she should explain why. M. H. HAWLEY Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Brandon A. Williams, Counsel