Citation Nr: 18147920 Decision Date: 11/06/18 Archive Date: 11/06/18 DOCKET NO. 16-42 553 DATE: November 6, 2018 REMANDED Entitlement to service connection for an acquired psychiatric disability, to include posttraumatic stress disorder (PTSD), bipolar disorder, and a psychotic disorder, is remanded. Entitlement to a total rating based on individual unemployability due to service connected disability (TDIU) is remanded. REASONS FOR REMAND The Veteran had active air service from March 1981 to September 1986. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from an April 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Nashville, Tennessee. 1. Service Connection – Acquired Psychiatric Disability With regard to the Veteran’s claim for entitlement to service connection for an acquired psychiatric disability, a review of the record shows the Veteran contends that she was sexually harassed while stationed in the Philippines. She also contends she has experienced panic attacks, anxiety, and bipolar disorder symptomatology since active service. Her service treatment records show treatment for psychiatric complaints during active service. Medical evidence indicates the Veteran was treated for depression prior to active service. In March 2015, the Veteran was afforded a VA examination. However, the Board finds that the medical evidence, to include the March 2015 VA examination report, is insufficient to decide the claim on appeal. In this regard, the Veteran was afforded a VA examination for her claimed psychiatric disabilities in March 2015. The VA examiner failed to adequately opine as to the nature and etiology of her claimed psychiatric disabilities. Specifically, the VA examiner did not adequately address her pre-service treatment and diagnosis of depression, nor did the VA examiner adequately address her claims of sexual harassment and treatment for emotional stress during active service. Thus, the Board concludes that the Veteran should be afforded a new VA examination to determine the nature and etiology of any currently present acquired psychiatric disability. 2. TDIU The Board notes that the issue of entitlement to a TDIU is inextricably intertwined with the claim of entitlement to service connection for a psychiatric disability. Harris v. Derwinski, 2 Vet. App. 180, 183 (1991). Hence, a determination on the claim for TDIU should be deferred pending final dispositions of the claim currently on appeal. The matters are REMANDED for the following action: 1. Identify and obtain any pertinent, outstanding VA and private treatment records and associate them with the claims file. 2. Then, schedule the Veteran for a VA examination by a psychiatrist or a psychologist with appropriate expertise to determine the nature and etiology of any currently present acquired psychiatric disabilities. The claims file must be made available to, and reviewed by the examiner. Any indicated studies must be performed. Based on the examination results and a review of the record, the examiner should first identify all psychiatric disabilities present during the pendency of the claim, and proximate thereto. Then, the examiner should provide an opinion as to whether any diagnosed psychiatric disability clearly and unmistakably existed prior to the Veteran’s active service, and if so, was clearly and unmistakably NOT aggravated by such service. The examiner should note that the Veteran’s lay statements alone are not a sufficient basis to support a finding that a disability clearly and unmistakably existed prior to service. With regard to any diagnosed psychiatric disability NOT found to clearly and unmistakably exist prior to the Veteran’s active service, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent or better probability) that any such disability had its onset during active service, or is otherwise etiologically related to such service, to include any identified military sexual trauma sustained therein. The rationale for all opinions expressed must be provided. 3. Confirm that the VA examination report and any opinions provided comport with this remand, and undertake any other development found to be warranted. 4. Then, readjudicate the issues on appeal. If a decision is adverse to the Veteran, issue a supplemental statement of the case and allow appropriate time for response. Then, return the case to the Board. Kristin Haddock Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Mariah N. Sim, Associate Counsel