Citation Nr: 18150515 Decision Date: 11/15/18 Archive Date: 11/15/18 DOCKET NO. 17-09 035 DATE: November 15, 2018 ORDER Entitlement to service connection for posttraumatic stress disorder (PTSD) is granted. Entitlement to service connection for depressive disorder is granted. REMANDED Entitlement to service connection for an acquired psychiatric disorder other than PTSD and depressive disorder, to include anxiety disorder, adjustment disorder, and neurocognitive disorder, is remanded. FINDINGS OF FACT Resolving reasonable doubt in the Veteran’s favor, he has a current diagnosis of PTSD related to service. Resolving reasonable doubt in the Veteran’s favor, he has a current diagnosis of depressive disorder related to service. CONCLUSIONS OF LAW The criteria for entitlement to service connection for PTSD have been met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.304. The criteria for entitlement to service connection for depressive disorder have been met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from October 1955 to October 1958. Although the Veteran filed a claim for service connection for PTSD, the evidence of record reflects additional diagnoses relating to the Veteran’s psychiatric disorders. Accordingly, the Board expanded the claim to include any acquired psychiatric disorders. Clemons v. Shinseki, 23 Vet. App. 1 (2009) (the scope of a mental health disability claim includes any mental disability that may reasonably be encompassed by the claimant’s description of the claim, reported symptoms, and the other information of record). The Board notes that the Veteran was granted extensions of time to submit evidence. The most recent extension of time was granted in October 2018, for 60 days. The Veteran submitted additional evidence later in October 2018, and waived the remainder of the extension. Therefore, the Board may proceed with adjudication of this matter. 1. Entitlement to service connection for PTSD is granted. 2. Entitlement to service connection for depressive disorder is granted. The Veteran contends that he experiences PTSD and depression as a result of an event in service, when he witnessed the casualties resulting from an accident in which a car was run over by a military tank. Resolving all reasonable doubt in favor of the Veteran, the Board concludes that the Veteran has current diagnoses of PTSD and depressive disorder that are related to service. 38 U.S.C. §§ 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). The Veteran reported that he and other military police responded to an accident in Germany in 1956 in which a U.S. tank collided with a car. He reported that the accident resulted in two or three civilian casualties, and that the bodies were torn apart with body parts stuck in the treads of the tank. He reported that he and others spent hours trying to put the body parts together to identify the victims. He testified that the accident took place in the gap near Hersfield and that either the 5th or 14th Cavalry was involved in the accident. The Veteran’s reports are consistent and credible, and supported by evidence in the record. The Veteran’s DD Form 214 shows that he served as a policeman and supports his reported dates of service in Germany. Evidence submitted by the Veteran shows that the 14th Cavalry was responsible for patrolling the interzonal border between Hersfield and Bamberg, where the Veteran reported the incident took place, at the time the Veteran reported the incident took place. See Veteran’s October 2018 Submission. A July 2018 private treatment letter shows the Veteran has current diagnoses of PTSD and depressive disorder. The psychologist opined that the Veteran’s PTSD and depressive disorder are related to service. The psychologist noted the incident in service, and the Veteran’s reports that he felt changed after it. The Veteran reported that he felt horrified, deeply disturbed, and emotionally numb following the in-service incident. He reported that he experienced mood difficulties, problems sleeping, nightmares, and distress following the accident in service. He reported that he avoids trauma-related reminders, and that he is hypervigilant when driving. The psychologist noted that the Veteran’s ex-wife reported that the Veteran’s attitude and demeanor changed when he experienced a memory of the in-service incident. The psychologist noted that the Veteran reported psychiatric symptoms relating to the in-service accident. The psychologist explained that the Veteran’s current condition is related to service because of the difficulties the Veteran experienced in service following the incident and the presence of the Veteran’s psychiatric condition directly following service. Other evidence in the record supports the July 2018 opinion linking the Veteran’s PTSD and depressive disorder to service. The Veteran’s VA treating primary care physician opined that the Veteran exhibited many PTSD symptoms caused by events in service. See June 2018 VA Treatment Letter. A May 2014 VA treatment record noted that the Veteran is reliving military trauma with nightmares, flashbacks, and intrusive thoughts. The Veteran’s ex-wife reported that the Veteran cried during war movies and after witnessing a dead animal on the road, and told her that these events triggered memories of the incident in service. See April 2014 Statement. Accordingly, the Board finds that the evidence is at least in equipoise as to whether the Veteran has current diagnoses of PTSD and depressive disorder related to service. Resolving all reasonable doubt in the Veteran’s favor, the Board finds that service connection for PTSD and depressive disorder is warranted. REASONS FOR REMAND 1. Entitlement to service connection for an acquired psychiatric disorder other than PTSD and depressive disorder, to include anxiety disorder, adjustment disorder, and neurocognitive disorder, is remanded. The Veteran’s claims file also shows diagnoses of anxiety disorder, adjustment disorder, and neurocognitive disorder. See July 2018 Private Treatment Letter; July 2014 VA Treatment Record. The VA treatment records note that the Veteran is reliving his military trauma, and explain that he is anxious about the intrusive memories. See October 2012 VA Treatment Record; May 2014 VA Treatment Record. A July 2018 private psychologist opined that the Veteran’s neurocognitive disorder is related to his stroke and that the stroke did not appear to be connected to service events. However, the psychologist’s opinion is inadequate. The psychologist qualified the opinion, explaining that it was “based on information available.” It does not appear that the psychologist reviewed the   Veteran’s complete VA treatment records. In an April 2014 VA treatment record, the Veteran asserted a connection between his in-service stressor and his mini-strokes. Accordingly, remand is appropriate in order to obtain VA medical opinion regarding whether the Veteran’s acquired psychiatric disorders (other than PTSD and depressive disorder) had an onset in service or are related to service. While this matter is on remand, outstanding private and VA treatment records should be obtained, including any relevant treatment records from Cary Medical Center and any VA treatment records from November 2017 to the present. The matter is REMANDED for the following action: 1. After securing any necessary authorization, obtain any private treatment records as the Veteran may identify relevant to his claim, to include records from Cary Medical Center. 2. Obtain outstanding VA treatment records, to include any VA treatment records from November 2017 to the present. 3. Obtain VA medical opinion to determine whether the Veteran’s acquired psychiatric disorders other than PTSD and depressive disorder are related to service. The electronic claims file should be made available to and be reviewed by the examiner. The examiner should identify all acquired psychiatric disorders other than PTSD and depressive disorder present at any time from March 2014 to the present, to include anxiety disorder, adjustment disorder, and neurocognitive disorder.   For each disorder, the examiner should opine as to whether it is at least as likely as not (a 50 percent or greater probability) that the disorder: (a) had an onset in service; (b) is otherwise related to an in-service injury, event, or disease; or (c) is caused by or aggravated by the Veteran’s service-connected PTSD or depressive disorder. The Veteran reported that during service he witnessed the casualties resulting from an accident in which a car was run over by a military tank, including mangled body parts stuck in the treads of the tank. He reported that this experience changed him. He reported that he felt horrified, deeply disturbed, and emotionally numb following the in-service incident. He reported that he experienced mood difficulties, problems sleeping, nightmares, and distress following the accident in service. He reported that he avoids trauma-related reminders, and that he is hypervigilant when driving. A July 2018 private psychologist opined that the Veteran’s neurocognitive disorder is related to his stroke and that the stroke did not appear to be connected to service events. In an April 2014 VA treatment record, the Veteran asserted a connection between his in-service stressor and his mini-strokes. A complete rationale should be given for all opinions and conclusions expressed.   4. After the above development, and any other development deemed necessary, readjudicate the claim. If the benefits sought on appeal remain denied, the Veteran and his attorney should be furnished a supplemental statement of the case and given the opportunity to respond thereto. MARJORIE A. AUER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Purcell, Associate Counsel