Citation Nr: 18148578 Decision Date: 11/08/18 Archive Date: 11/07/18 DOCKET NO. 09-28 109 DATE: November 8, 2018 REMANDED Service connection for an acquired psychiatric disorder, other than schizophrenia, is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1979 to October 1979. The case is on appeal from a June 2008 rating decision. The Veteran had a Board hearing in August 2010. Service connection for an acquired psychiatric disorder, other than schizophrenia, is remanded. In the February 2011 Board decision, the regional office (RO) was direct to adjudicate a claim of whether new and material evidence had been submitted to reopen a claim of service connection for schizophrenia. The Board indicated that, if the claim were denied, it would only exercise jurisdiction over the issue if the Veteran appealed. The RO denied the claim in a January 2015 rating decision which the Veteran has not appealed. Therefore, any claims pertaining to service connection for schizophrenia are not before the Board. However, pursuant to Clemons v. Shinseki, 23 Vet. App. 1 (2009), the Board will recharacterize the Veteran’s claim as one for service connection for an acquired psychiatric disorder generally, other than schizophrenia. The Board denied service connection for a psychiatric disorder, including depression, in an April 2016 decision. The Veteran appealed that decision to the United States Court of Appeals for Veterans Claims (Court). In March 2017, the Court granted a joint motion for remand (JMR), that vacated the April 2016 decision and remanded the claim to the Board. The Board again denied the claim in July 2017, and the Veteran again appealed to the Court. In May 2018, the Court granted another JMR, and the case now returns to the Board. In the May 2018 JMR, the Board was asked to provide adequate reasons and basis for its credibility assessment of the Veteran’s statements and whether an examination is warranted. The Board finds that an examination is warranted. A veteran is entitled to a VA examination of a claimed condition when there is a currently diagnosed disorder, or symptoms thereof, a claimed in-service event or injury, and an indication that the in-service event or injury is related to service. McLendon v. Nicholson, 20 Vet. App. 79 (2006). The Veteran has a diagnosis of major depressive disorder (MDD). At the Board hearing, he testified that his depression was caused by intense training during service and that he spoke with a military chaplain. He also testified that his treating doctor said that his depression could be from his service. This statement meets the low threshold articulated by the Court in McLendon of an indication of a relationship between the claimed condition and service. Further, in past Board decisions and JMRs, it has been noted that depressive symptoms may have onset as early as 1981. The Veteran testified that his active duty service was actually from June 1979 to May 1984; however, these service dates have not been verified, and the Board has found that the Veteran served active duty from June 1979 to October 1979. However, the potential onset of depressive symptoms is only a few years after service. Therefore, a VA examination is warranted and a medical opinion should also be obtained. To aid the examiner, a brief history of the Veteran’s relevant mental health treatment is outlined below. The Veteran was treated at Larned State Hospital in 1991 following odd behaviors that first manifested after twelve days in prison. The diagnostic impression included polysubstance dependence and differential diagnoses of a single episode of severe major depression with mood incongruent psychotic features, malingering, and antisocial personality disorder. The Veteran was admitted to the hospital for treatment, including daily antidepressant medication. Three weeks later in August 1991 the Veteran was reevaluated. The Veteran reported a history of psychiatric placement beginning in April 1982 with the first of four admissions to Osatomie State Hospital, though these records are unavailable. At that time, his mother reported that the Veteran was experiencing auditory and visual hallucinations and paranoid ideation. Hospital staff believed he had a brief reactive psychosis due to substance abuse. His subsequent three admissions also involved substance abuse. These hospitalizations showed a pattern of being very difficult and uncooperative with bizarre and unpredictable behavior at admission followed by a very quick response to treatment with total elimination of the bizarre behavior. On March 10, 2006, the Veteran was admitted to a VA Medical Center (VAMC) after waking up with suicidal thoughts in the morning. He had started walking to Topeka on the highway when a former coworker saw him and drove him the rest of the way to the VAMC. The initial nursing note reflects that the Veteran and his girlfriend had just broken up. He stated that he felt depressed. Later that day he was unable to give reasons for his suicidal thoughts, stating that he suddenly felt overwhelmed by his “fiancée,” “not sure if he had already married her or what she was thinking.” He moved from topic to topic, unblinking. He stated that he was not taking his psychiatric of diabetic medication. In a VA treatment record two days later, the Veteran reported that he had been in his usual state of health until around 1981 when he noted the onset of not being able to think clearly. He reported no combat or court-martials during his service, but he was often counseled for his drug use, which included cocaine, marijuana, and alcohol. There is no mention in these records of depression during service Later in March 2006, the Veteran denied combat, traumatic experiences, and medical/psychological/substance abuse problems or treatment during service. He stated that he had been suffering from depression at the time of his aggravated arson in 1990 and was not a mature adult at that time. In his December 2007 claim, the Veteran reported feelings of depression due to his interaction with the government. His symptoms included feelings of being paranoid, anxiety attacks, and fatigue all the time. In his June 2008 notice of disagreement, the Veteran stated that he felt that his squad leader did very little to help him while he was in service. He reported that he was given extra duties all the time and felt that there was a lot of intense pressure on him. He stated that he did not know that services were available for treatment of this condition. At his August 2010 Board hearing, the Veteran reported that he began having symptoms of depression, including nightmares, while in basic training and went to the chaplain. He further testified that his depression has continued ever since with his initial diagnosis of schizophrenia being in 1981. The Veteran further testified that one of his VA physicians from the Topeka VAMC had said his depression could be from service. The Veteran estimated that this occurred in either 2008 or 2009. Although there are some records reflecting treatment by this doctor, a corresponding record showing an association between the Veteran’s depression and his service could not be located. Such statement, if available, would be helpful to the claim. In addition to examination, the Veteran and his representative should be afforded an opportunity to submit such evidence on remand as well. Updated VA treatment records should also be obtained in light of the remand. The matter is REMANDED for the following action: 1. Contact the Veteran and ask him to provide or authorize VA to obtain the statement from his treating psychologist that connected his MDD to service which he referenced at the Board hearing in 2010. 2. Obtain updated VA treatment records dated since 2009. 3. Thereafter, afford the Veteran a VA psychiatric examination in connection with the claim. First, the examiner should identify the Veteran’s current psychiatric disorder(s), including any that have existed during the pendency of the claim (since December 2007). The examiner should then provide an opinion as to whether an identified psychiatric disorder at least as likely as not had its onset during, or is otherwise related to, the Veterans service (June 1979 to October 1979). A complete rationale should be provided for any opinion rendered. RYAN T. KESSEL Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. George