Citation Nr: 18151610 Decision Date: 11/19/18 Archive Date: 11/19/18 DOCKET NO. 15-04 290 DATE: November 19, 2018 REMANDED Entitlement to service connection for cause of death is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1967 to May 1970. This matter comes before the Board of Veterans’ Appeals (Board) from a June 30, 2014 rating decision. In June 2015 the Veteran’s widow filed a substantive appeal (VA Form 9). The Veteran’s widow (appellant) seeks service connection for the cause of the Veteran’s death and has alleged that the primary or contributory cause of his death was posttraumatic stress disorder (PTSD). The death certificate lists the immediate cause of death as cerebral concussion with the underlying cause of death a gunshot wound to the head. The death certificate indicates that the Veteran shot himself in the head at home and that the circumstances indicated suicide. At the time of his death, the Veteran was service-connected for a perforated eardrum and a scar on the left side of his head. However, the Veteran’s eardrum and scar had both healed and Veteran was rated at 0 percent for both injuries. The appellant asserts that the Veteran acquired PTSD because of his experiences while serving in the Republic of Vietnam, and that his July 1988 suicide was the result of that psychiatric disorder. Specifically, in her statements in support of her November 2013 claim, she noted that the Veteran served in combat in Vietnam after they were married, and the Veteran who returned from the war was not the same man she married. The appellant stated, after his return from Vietnam, the Veteran was filled with anger, rage, isolation, and distrust, which led to his decision to self-medicate with alcohol. Further, the statements provided by the Veteran’s children and sister corroborate the appellant’s observations of Veteran’s symptoms after he returned from Vietnam. The Board finds these descriptions to be competent and highly credible lay evidence of psychiatric symptomatology. The Veteran was wounded and hospitalized in May 1968 in Vietnam when he was stationed at a forward artillery firing position. The Veteran was hit in the head and neck by fragments from a hostile rocket round. The Veteran’s combat injury is evidenced by a telegram to the Veteran’s parents notifying them about their son’s injury at the hands of a hostile force. The Veteran’s DD-214 demonstrates the Veteran’s heroic service and sacrifice in a combat zone, as he was awarded 4 Bronze Stars, a Purple Heart, and an Army Commendation Medal. As noted above, there is lay testimony from the appellant and her children describing the Veteran’s behavior after he came home from Vietnam and displayed symptoms of psychiatric disability. The Board notes, however, that these lay contentions alone are not sufficient to either establish an actual diagnosis of PTSD, or another psychiatric disability, or to link the Veteran’s death to any service-related psychiatric disability. Due to the evidence from the record describing changes in the Veteran’s behavior following his service in Vietnam, his subsequent suicide, and the suggestion, by his widow, of a link between the Veteran’s suicide and his in-service experiences, the Board finds that a VA medical opinion that addresses whether the Veteran had an acquired psychiatric disorder that was related to service, and, if so, whether that disorder was the cause of his death, should be obtained on remand. See 38 U.S.C. § 5103A; 38 C.F.R. § 3.159 (c); McLendon v. Nicholson, 20 Vet. App. 79 (2006). Accordingly, the case is REMANDED for the following action: 1. Ask the appellant to submit any additional evidence or argument she has in her possession that may further her claim, to include any information regarding specific combat experiences the Veteran described to her and any additional details regarding the psychiatric symptoms he displayed prior to his death. 2. The AOJ should refer the Veteran’s claims folder to a VA examiner for a medical opinion to address the etiology of the cause of the Veteran’s death. The VA examiner is requested to review all pertinent records associated with the claims file, including the service treatment records, military personnel records, and the appellant’s and other lay assertions. (a.) The examiner should provide an opinion as to whether it is at least as likely as not (50 percent probability or more) that the Veteran had an acquired psychiatric disorder, to include PTSD, at the time of his death. Please explain why or why not, specifically considering and discussing the lay statements of record discussing his psychiatric symptoms, including those submitted by his widow, his children, and his sister in December 2013. The examiner is on notice that the statements provided by the Veteran’s spouse and other family member are credible and should be accepted as an accurate depiction of their experience with regard to the Veteran’s psychiatric symptoms. (b.) For any diagnosed psychiatric disorder, the examiner should provide an opinion as to whether is it at least as likely as not (50 percent probability or more) that the disorder had its onset in service, is related to an in-service stressor, including combat service in the Republic of Vietnam, or is otherwise related to service. Please explain why or why not, specifically considering and discussing (1) the lay statements of record discussing the Veteran’s symptoms following his return from Vietnam, including those submitted by his widow, his children, and his sister in December 2013; (2) the information contained in the Veteran’s military personnel records; and (3) any other information in the Veteran’s claim folder the examiner finds relevant. (c.) If the VA examiner determines that the criteria for a diagnosis of PTSD were met, please specify the stressor(s) supporting the diagnosis. (d.) If the Veteran did have PTSD related to his military service, the examiner should state whether it is at least as likely as not (50 percent probability or more) that the Veteran’s PTSD caused his death; contributed substantially or materially to his death; combined with another disorder to cause his death; or aided or lent assistance to his death. 3. Readjudicate the appeal. The appellant has the right to submit additional evidence and argument on the matter the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board of Veterans’ Appeals or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C. §§ 5109B, 7112 (West 2014). R. FEINBERG Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. St. Laurent