Citation Nr: 18146951 Decision Date: 11/05/18 Archive Date: 11/02/18 DOCKET NO. 16-45 155 DATE: November 5, 2018 REMANDED Entitlement to service connection for an acquired psychiatric disability, to include post-traumatic stress disorder (PTSD), other specified trauma and stressor disorder, and antisocial personality disorder, claimed as mood disorder, is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1969 to July 1972. The issue on appeal has been expanded pursuant to the Federal Circuit’s decision in Clemmons v. West, 206 F.3d 1401, 1403 (Fed. Cir. 2000). The issue has been recharacterized accordingly, as noted above. Entitlement to service connection for an acquired psychiatric disability, to include PTSD, other specified trauma and stressor disorder, and antisocial personality disorder, claimed as mood disorder, is remanded. The Board finds that additional development is needed prior to final adjudication of the issue on appeal. Specifically, the Board finds that a new examination is needed in order to clarify the Veteran’s acquired psychiatric disability diagnosis. The Veteran was afforded a VA examination in January 2016, at which time he was diagnosed with other specified trauma and stressor related disorder, as well as antisocial personality disorder. However, VA treatment records indicate that the Veteran has been diagnosed with other psychiatric disabilities, including intermittent explosive disorder, unspecified anxiety disorder, and possible unspecified bipolar and related disorders. See VA treatment record, May 2016. In consideration of the Board’s expansion of the Veteran’s claim under Clemmons, a new examination is needed in order to address all of the Veteran’s diagnosed psychiatric disabilities. Further, the Board points out that a personality disorder is not a disability for which service connection may be granted; rather, it is considered a congenital or developmental abnormality. See 38 C.F.R. § 3.303 (c). As VA regulations specifically prohibit service connection for congenital or developmental defects, the Veteran’s diagnosed antisocial personality disorder is not a disability for which VA compensation benefits may be awarded. See VA examination January 2016. However, a superimposed acquired psychiatric disorder resulting from such personality disorder or representing an aggravation of the disorder may be service connected. See 38 C.F.R. § 4.127; VAOPGCPREC 82-90 (1990) (cited at 55 Fed. Reg. 45,711) (Oct. 30, 1990) (service connection may not be granted for defects of congenital, developmental or familial origin, unless the defect was subject to a superimposed disease or injury); Carpenter v. Brown, 8 Vet. App. 240, 245 (1995). However, the question of whether a separate psychiatric disability was superimposed on the Veteran’s personality disorder, is a complex medical question that has not been addressed previously. Accordingly, upon remand the Board will request an opinion that addresses this question. In addition, since the examination, the Veteran has submitted a number of lay statements from friends and family members from the late 1970s, which address his personality, character, and conduct prior to service. The examiner is asked to address these letters. The examiner is also asked to address military personnel records, which state that the Veteran’s military record was basically excellent until such time as he went to the Republic of Vietnam and it slowly deteriorated from excellent to good to unsatisfactory. The examiner is asked to address this in light of the personality disorder diagnosis. In addition, the Board points out that the January 2016 examiner wrote that the Veteran claimed that he was medivacked to Ft. Bliss Army Hospital in El Paso, Texas, for psychiatric reasons from Vietnam, and that he was in the hospital for several weeks; however, the examiner claimed, there is no record to support or deny this and it does not fit with his legal history statements. This is incorrect. The Veteran served in the Republic of Vietnam from July 1970 to January 1972. The Board directs attention to military personnel records, which list the Veteran as being transferred as a patient in January 1972 to William Beaumont General Hospital in El Paso, Texas, for further medical treatment and/or disposition. Other records indicate that this treatment was drug treatment related. Finally, the Board notes that the electronic record is missing a Board decision, issued in September 2006 on an unrelated matter. Upon remand, the Board asks that this decision be associated with the electronic record. The matters are REMANDED for the following action: 1. After securing any necessary consent forms from the Veteran, obtain any outstanding treatment records, to include any VA and/or private treatment records, pertaining to the issue on appeal. All efforts to obtain these records should be documented in the claim file. If any records could not be obtained, this should be noted in the claim file. 2. Upon completion of the above, schedule the Veteran for a VA examination to clarify the diagnosis of his acquired psychiatric disability(ies) and to address the etiology of any diagnosed disability(ies). For each disability diagnosed, the examiner is asked to address whether it is at least as likely as not (i.e., a 50 percent or greater probability) that it was caused by the Veteran’s active duty service or, if preexisting service, was aggravated therein, to include whether it was superimposed on any diagnosed personality disorder. The examiner is asked to specifically address: Diagnoses of intermittent explosive disorder, unspecified anxiety disorder, and possible unspecified bipolar and related disorders, as found in the VA treatment records. See VA treatment record, May 2016. The examiner is also asked to consider lay statements, to include letters submitted by the Veteran written by friends and family members in the 1970s, which address his personality, character, and conduct prior to service. The examiner is also asked to address military personnel records, which state that the Veteran’s military record was basically excellent until such time as he went to the Republic of Vietnam and it slowly deteriorated from excellent to good to unsatisfactory. The examiner is asked to address this in light of any personality disorder diagnosis. In addition, the examiner is asked to address any mental health treatment the Veteran received in service upon his return from the Republic of Vietnam, to include being transferred as a patient in January 1972 to William Beaumont General Hospital in El Paso, Texas, for further medical treatment and/or disposition. For all examinations, all necessary development should be taken. The VA examiner should be given access to the claim file. The examiner should state that a review of the claim file was completed. The examiner must provide a comprehensive report including complete rationales for all opinions and conclusions reached, citing the objective medical findings leading to the conclusions. A detailed rationale is requested for all opinions provided. 3. If upon completion of the above action the issue is denied, the case should be returned to the Board after compliance with appellate procedures. E. I. VELEZ Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD K. Foster, Associate Counsel