Citation Nr: 18147700
Decision Date: 11/05/18	Archive Date: 11/05/18

DOCKET NO. 15-36 896
DATE:	November 5, 2018
REMANDED
Entitlement to an acquired psychiatric disorder, to include depression and posttraumatic stress disorder (PTSD), is remanded.
 
REASONS FOR REMAND
The Veteran had active service in the U.S. Army from February 1996 to June 2001.
This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a January 2015 rating decision of the Department of Veterans Affairs (VA) Regional office (RO) in St. Petersburg, Florida.
The Board has recharacterized the claim for PTSD as a more general claim of entitlement to service connection for a psychiatric disorder, to include PTSD, due to the other mental health conditions noted in the record.  Clemons v. Shinseki, 23 Vet. App. 1 (2009).
1. Entitlement to an acquired psychiatric disorder, to include depression and posttraumatic stress disorder (PTSD), is remanded.
This matter is remanded for a new VA examination.
The Veteran has previously undergone VA examinations in December 2014 and January 2015.  These VA examiners gave negative opinions.  The VA examiner in January 2015, for instance, attributed positive complaints of anxiety and depression during service as “associated with and a consequence of substance abuse, and do not represent a separate disorder, independent of her extensive substance abuse issues.”  But, neither examiner addressed evidence indicating preexisting symptomatology.  
Specifically, during VA treatment in October 2004, the Veteran gave a history of “[a]s a teen she went to mental health center, inpatient, because she was getting in trouble i.e.: stealing a car and smoking pot. Diagnosed as having PTSD from parents divorce.”  
This raises a question as to whether a psychiatric diagnosis preexisting service, which, in turn, raises a question as to her substance overuse during service was a consequence of the preexisting condition.  
As no VA examiner has addressed this question, remand for an addendum opinion is needed.  
The matter is REMANDED for the following action:
1. Obtain an addendum opinion from an appropriate clinician regarding the Veteran’s psychiatric condition.  the examiner is asked to address the following:
(a.) Did a psychiatric condition preexist the Veteran’s active service, which began in February 1996?  In answering this question, the examiner should address for instance the May 1995 service entrance examination, which indicates a history of past marijuana and cocaine use, plus an October 2004 VA treatment record indicating a history of “[a]s a teen she went to mental health center, inpatient, because she was getting in trouble i.e.: stealing a car and smoking pot. Diagnosed as having PTSD from parents divorce.”  
(b.) If preexisting service, did the psychiatric condition worsen (i.e., increase in severity) during service?  If yes, was that worsening due to the natural progress of the disease? 
How certain are you in your answers to questions (a) and (b)?  Would any medical professional with the same information reasonably be able to reach a different conclusion?
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(c.) If you determined in questions (a) and (b) that a psychiatric condition preexisted service, does the current diagnosis represent the present manifestation of that same condition.
 
C. BOSELY
Acting Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	D. Lauritzen, Associate Counsel