Citation Nr: 18149463 Decision Date: 11/09/18 Archive Date: 11/09/18 DOCKET NO. 17-50 671 DATE: November 9, 2018 REMANDED Entitlement to service connection for post-traumatic stress disorder (PTSD) is remanded. REASONS FOR REMAND The appellant is a Veteran who served on active duty from April 1969 to November 1970. The Veteran’s service includes a Vietnam Campaign Medal and a Vietnam Service Medal. This matter is before the Board of Veterans’ Appeals (Board) on appeal from an October 2016 rating decision by the Department of Veterans’ Affairs (VA) Regional Office (RO). Service connection for PTSD is remanded. The Veteran contends that he has PTSD due to events which he witnessed and experienced in service while in Vietnam. The Veteran contends that he is entitled to service connection for PTSD. He was afforded VA authorized examination concerning PTSD in October 2016, but the record is unclear as to whether a current diagnosis of PTSD exists. On October 2016 VA examination the VA examiner diagnosed the Veteran with dysthymia which is a mood disorder similar to depression and opined that the etiology of the dysthymia was not from the Veteran’s military service, but from more recent life events. However, the examiner opined that the Veteran may have suffered from PTSD “long ago” but that the condition has progressed and is no longer PTSD. Further, the VA examiner noted that the Veteran has not received any mental health services until recently and that the Veteran’s separation exam does not relate any mental health issues. Furthermore, the Veteran submitted a private medical opinion from Dr. H.J. in May 2016 in which the Veteran was diagnosed with PTSD. Dr. H.J. opined that the Veteran’s stress disorder is at least as likely as not related to his military service and that his stressors originate from a fear of hostile or terrorist activities. The record contains conflicting medical evidence as to whether the Veteran has a diagnosis of PTSD. Private treatment records from May 2016 note a diagnosis of PTSD. However, on October 2016 VA examination, the diagnosis was dysthymia. While, the VA examiner acknowledged the Veteran’s prior diagnoses of PTSD from the private provider, he did not reconcile his diagnosis with the prior diagnosis noted in the record. As there is conflicting evidence regarding whether the Veteran has (or during the pendency of the claim had) a PTSD diagnosis, an examination to secure an adequate medical opinion that reconciles the conflicting evidence is necessary. The Veteran stated on his Statement in Support of Claim from November 2016 that he was deployed to Vietnam from October 1969 to November 1970. He was stationed in Long Bihn, Vietnam where he performed his Military Occupational Specialty duties as a Lineman. He stated that during his tour of duty in Vietnam there were many horrific events including death and serious injury to fellow comrades and others. He stated that several of his friends were killed in Vietnam and that he lived under constant threat of enemy mortars, rockets and sniper fire and that his base came under attack many times. Additionally, he stated that he still has frequent nightmares about what he experienced in Vietnam. Given that there is a discrepancy as to whether the Veteran has a current PTSD disability, remand is necessary to schedule a VA examination to determine if the Veteran has an acquired psychiatric disability related to his military service. The matter is REMANDED for the following actions: 1. Schedule the Veteran for an appropriate VA psychiatric examination which answers the following questions: The VA examiner must provide a determination of whether it is at least as likely as not that, together with the exam, medical evidence of record - which includes the May 2016 private treatment record, in which the Veteran was diagnosed by a private provider with PTSD and the October 2016 VA examination in which the VA examiner opined that the Veteran may have had PTSD “long ago” amounted to a misdiagnosis or whether the Veteran indeed had a separate diagnosis of PTSD that ultimately resolved. If it is at least as likely as not that the Veteran did indeed have a diagnosis of PTSD during the appeal period, then the VA examiner must provide an opinion on whether it is at least as likely as not that the   Veteran’s PTSD or any other psychiatric disability was related to his military service. M. H. HAWLEY Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD E. Robert Cordingley, Associate Counsel