Citation Nr: 18146776 Decision Date: 11/01/18 Archive Date: 11/01/18 DOCKET NO. 16-58 463A DATE: November 1, 2018 REMANDED Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD) and major depressive disorder, is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1968 to June 1969. This matter is on appeal from a June 2015 rating decision. Although a Veteran might only claim service connection for a particular psychiatric disorder, the claim cannot be a claim limited only to that diagnosis, but must rather be considered a claim for any mental disability that may be reasonably encompassed. Clemons v. Shinseki, 23 Vet. App. 1 (2009). The Board will consider entitlement to all psychiatric diagnoses raised by the record. Acquired psychiatric disorder The Veteran contends that he has a psychiatric disorder, to include PTSD and major depressive disorder, that is related to his in-service stressors. On May 2015 VA PTSD Disability Benefits Questionnaire (DBQ) examination, the examiner diagnosed persistent depressive disorder with anxious distress. The examining psychologist opined that he depressive disorder was not related to combat during service, because the Veteran did not participate in combat. However, she did not provide an opinion as to whether depressive disorder was otherwise related to his service. On May 2016 VA DBQ examination, the examiner indicated that the Veteran had a diagnosis of PTSD that conformed to DSM-5 criteria, but diagnosed persistent depressive disorder and other specified trauma and other stressor related disorder. The examining attending physician opined that the Veteran reported some symptoms consistent with PTSD, but it is unclear if full diagnostic criteria for PTSD is met at that time due to overlap in numerous symptoms of PTSD and depression. Regarding other specified trauma and other stressor-related disorder, the examiner opined that symptoms appear as least likely as not caused by or related to claimed military stressor and the Veteran’s fear of hostile military and terrorist activities stemming from his service in Vietnam. However, the opinion is somewhat speculative and is unsupported by any rationale. Accordingly, as it remains unclear whether the Veteran has a psychiatric disorder that is related to his service, on remand an examiner should reconcile the psychiatric diagnoses of record and provide an opinion as to whether any psychiatric disorder is related to the Veteran’s service. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). The matter is REMANDED for the following action: Provide the claims file to an appropriate VA examiner, other than the May 2015 and May 2016 VA examiners, who should determine whether a new VA examination is warranted in order to provide a medical opinion regarding the nature and etiology of the Veteran’s psychiatric disorder(s). The claims file, including a copy of this remand, must be made available to the examiner for review who should indicate that the claims file was reviewed. The examiner must provide the following: (a.) Diagnose and identify all psychiatric disorders diagnosed during the current appeal, including whether the Veteran currently suffers from PTSD and major depressive disorder. (b.) Is it at least as likely as not (50 percent or more probability) that any psychiatric disorder, including PTSD and major depressive disorder, diagnosed at any time during the course of the appeal, had its onset in or is etiologically-related to the Veteran’s active duty service. If a psychosis is diagnosed, the examiner should indicate whether it was manifested within one year after the Veteran’s period of active duty. (c.) If the Veteran has a diagnosis of PTSD, the examiner should address the Veteran’s in-service stressor(s), to include whether PTSD is related to fear of hostile military or terrorist activity. The examiner is asked to reconcile the psychiatric disorder diagnoses of record, to specifically include those diagnosed on May 2015 and May 2016 VA examination. The report of examination should include the complete rationale for all opinions expressed. If an opinion cannot be rendered without resorting to speculation, the physician should explain why it would be speculative to respond. The term “at least as likely as not” does not mean within the realm of medical possibility, but rather the weight of medical evidence both for and against a conclusion is so evenly divided that it is as medically sound to find in favor of that conclusion as it is to find against it. K. A. KENNERLY Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD T. Adams, Counsel