Citation Nr: 18149297 Decision Date: 11/09/18 Archive Date: 11/09/18 DOCKET NO. 16-32 700 DATE: November 9, 2018 REMANDED Entitlement to an acquired psychiatric disorder, to include post traumatic stress disorder (PTSD) and depressive disorder is remanded. REASONS FOR REMAND The Veteran served on active duty with the United States Navy from March 1969 to December 1970, including service in the Vietnam War. Entitlement to an acquired psychiatric disorder, to include PTSD and unspecified depressive disorder is remanded. To ensure that VA has met its duty to assist, the Board finds that remand is necessary for another VA examination to assess whether the Veteran meets the criteria for a diagnosis of PTSD related to an in-service stressor. The record shows that the Veteran served on the USS Enterprise during the Vietnam era. He is not a combat Veteran. He reports that he has been traumatized by an in-service event, which he reports as witnessing a bomb drop and crush a sailor when a strap broke during a weapons transfer to his ship from a destroyer—he noted that he feared for his life because he thought the dropped bomb would explode. Although a December 2015 VA PTSD examination reflects that the Veteran did not meet the diagnostic criteria for a diagnosis of PTSD, the Veteran subsequently submitted evidence, a July 2016 medical opinion from Dr. V.G., showing that the Veteran carries a diagnosis for PTSD. As such, the Board believes that another VA examination is necessary to decide the appeal. It is noted that the July 2016 medical opinion does not reflect clearly that the diagnosis was in accordance with 38 C.F.R. § 4.125. Also, the Board notes that the Veteran’s treatment records and December 2015 initial PTSD examination note a diagnosis of depression. The December 2015 VA medical opinion states that the etiology of the Veteran’s unspecified depressive disorder is unknown, but is not likely related to the Veteran’s period of military service. As a rationale, the opinion offers only that Veteran reported varying times of onset for depression. The December 2015 medical opinion is contradicted by the February 2016 Corona Readjustment Counseling Veterans Center letter stating that the Veteran has been diagnosed and is being treated for having incurred depression during his period of active service. The Board notes that the February 2016 Corona Readjustment Counseling Veterans Center letter also provides no rationale for its conclusion of service connection. The Board finds that neither the December 2015 medical opinion, nor the February 2016 Corona Readjustment Counseling Veterans Center letter provides an adequate rationale concerning the etiology of the Veteran’s unspecified depressive disorder. Accordingly, the appeal is REMANDED for the following action: 1. After the Veteran’s reported stressors have been developed, schedule the Veteran for a psychiatric examination to determine the nature and etiology of any post traumatic stress disorder (PTSD). If the Veteran is found to meet the diagnostic criteria for a diagnosis of PTSD in accordance with 38 C.F.R. § 4.125, the examiner must explain how the diagnostic criteria are met and opine whether it is at least as likely as not related to a verified in-service stressor. Additionally, the examiner should opine on whether depression or any other acquired psychiatric disorder is at least as likely as not related to an in-service injury, event, or disease, to include any verified in-service stressor event. The examiner should accept the Veteran’s history of experiencing symptoms of depression upon returning from Vietnam, unless otherwise shown by the record. 2. Ensure that the VA medical opinion obtained includes a complete rationale for the conclusions reached. The medical opinion must support the conclusions reached with an analysis that is adequate for the Board to consider and weigh against other evidence of record; medical opinions must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. If an opinion cannot be expressed without resort to speculation, ensure that the clinician so indicates and discusses why an opinion is not possible, to include whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. (Continued on the next page)   3. Readjudicate. C.A. SKOW Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD B. Riordan, Associate Counsel