Citation Nr: 18151707 Decision Date: 11/20/18 Archive Date: 11/19/18 DOCKET NO. 16-43 232 DATE: November 20, 2018 REMANDED Entitlement to service connection for a left wrist condition is remanded. Entitlement to service connection for a left ankle condition is remanded. Entitlement to service connection for a skin condition is remanded. Entitlement to service connection for an acquired psychiatric disorder, claimed as posttraumatic stress disorder (PTSD) and depression, is remanded. REASONS FOR REMAND The Veteran served on active duty from July 2002 to July 2006 and from January 2008 to June 2009. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a January 2016 rating decision by the Seattle, Washington, Regional Office (RO) of the Department of Veterans Affairs (VA). 1. Entitlement to service connection for a left wrist condition is remanded. The Veteran contends that he currently has a left wrist condition stemming from constant strain during his military service. However, the Board finds that the post-service treatment records may not be complete. VA has a duty to assist claimants to obtain evidence needed to substantiate a claim. 38 U.S.C. § 5103A (2012); 38 C.F.R. § 3.159(c) (2018). This includes making as many requests as are necessary to obtain relevant records from a Federal department or agency, including, but not limited to, military records, VA medical records, records from facilities with which the VA has contracted, and records from Federal agencies such as the Social Security Administration. 38 C.F.R. § 3.159(c)(2). VA will end its efforts to obtain records only where it concludes that the records sought do not exist or that further efforts to obtain those records would be futile, such as where the Federal department or agency advises VA that the requested records do not exist or the custodian does not have them. 38 C.F.R. § 3.159(c)(2). The Board notes the presence of gaps within the VA treatment records from March 2014 to May 2015 and the most recent VA treatment record is dated September 2015. Therefore, an attempt to obtain any outstanding records, especially those dated from March 2014 to May 2015 and from September 2015, must be made on remand. 2. Entitlement to service connection for a left ankle condition is remanded. 3. Entitlement to service connection for a skin condition is remanded. 4. Entitlement to service connection for an acquired psychiatric disorder, claimed as PTSD and depression, is remanded. VA has a duty to assist claimants to obtain evidence needed to substantiate a claim. 38 U.S.C. § 5103A (2012); 38 C.F.R. § 3.159 (2018). VA’s duty to assist includes providing a medical examination when necessary to make a decision on a claim. 38 U.S.C. § 5103A(d); 38 C.F.R. § 3.159(c)(4). The RO did not provide the Veteran with an examination regarding his claims for a left ankle condition, a skin condition, and an acquired psychiatric disorder, claimed as PTSD and depression. Such development is necessary if the information and evidence of record does not contain sufficient competent medical evidence to decide the claim, but (1) contains competent evidence of diagnosed disability or recurrent symptoms of disability, (2) establishes that the Veteran suffered an event, injury or disease in service, or has a presumptive disease during the pertinent presumptive period, and (3) indicates that the claimed disability may be associated with the in-service event, injury, or disease, or with another service-connected disability. 38 C.F.R. § 3.159(c)(4); McLendon v. Nicholson, 20 Vet. App. 79, 83-86 (2006) (noting that the third element establishes a low threshold and requires only that the evidence “indicates” that there “may” be a nexus between the current disability or symptoms and active service, including equivocal or non-specific medical evidence or credible lay evidence of continuity of symptomatology). Here, the evidence of record indicates that there were complaints and treatment for symptomatology of a left ankle condition, skin condition, and an acquired psychiatric disorder during military service. Post-service treatment records also reveal that the Veteran was diagnosed with depression, pain in the left ankle, and dermatitis and psoriasis. Because there is evidence of currently diagnosed disabilities, an in-service event, and an indication that the current disabilities may be associated with the in-service event, remand for VA examinations is required. The matters are REMANDED for the following action: 1. Obtain and associate with the claims file all outstanding VA records of medical treatment, particularly those dated from March 2014 to May 2015 and from September 2015. If any requested records are not available, or the search for any such records otherwise yields negative results, that fact must clearly be documented in the claims file. Efforts to obtain these records must continue until it is determined that they do not exist or that further attempts to obtain them would be futile. The non-existence or unavailability of such records must be verified and this should be documented for the record. Required notice must be provided to the Veteran. 2. Once all outstanding records have been obtained and associated with the claims file to the extent possible, schedule the Veteran for appropriate examination to determine the nature and etiology of any diagnosed left ankle condition. Based on a review of the claims file, the results of the examination, and the Veteran’s statements regarding the development and treatment of his claimed disorder(s), the examiner is asked to diagnose all left ankle condition(s) and opine whether it is at least as likely as not (i.e., a 50 percent or greater probability) that any diagnosed left ankle condition had its onset in service or is otherwise linked to service. The claims file should be provided to the examiner for review in conjunction with the examination and such should be acknowledged. All appropriate testing should be accomplished. The Veteran’s lay statements, especially regarding his injuries and symptomatology during his military service, contained within the claims file and made at the examination, must be considered. All findings and conclusions should be set forth in a legible report. A clear rationale for all opinions rendered must be made. If the requested opinion cannot be provided without resort to speculation, the examiner should so state and explain why an opinion cannot be provided without resort to speculation. 3. Once all outstanding records have been obtained and associated with the claims file to the extent possible, schedule the Veteran for appropriate examination to determine the nature and etiology of any diagnosed skin condition Based on a review of the claims file, the results of the examination, and the Veteran’s statements regarding the development and treatment of his claimed disorder(s), the examiner is asked to diagnose all skin condition(s) and opine whether it is at least as likely as not (i.e., a 50 percent or greater probability) that any diagnosed skin condition had its onset in service or is otherwise linked to service. The claims file should be provided to the examiner for review in conjunction with the examination and such should be acknowledged. All appropriate testing should be accomplished. The Veteran’s lay statements, especially regarding the occurrence of a skin disorder and its symptomatology, contained within the claims file and made at the examination, must be considered. All findings and conclusions should be set forth in a legible report. A clear rationale for all opinions rendered must be made. If the requested opinion cannot be provided without resort to speculation, the examiner should so state and explain why an opinion cannot be provided without resort to speculation. 4. Once all outstanding records have been obtained and associated with the claims file to the extent possible, schedule the Veteran for appropriate examination to determine the nature and etiology of any acquired psychiatric disorder, to include depression and PTSD. Based on a review of the claims file, the results of the examination, and the Veteran’s statements regarding the development and treatment of his claimed disorder(s), the examiner is asked to diagnose all acquired psychiatric disorder(s) and opine whether it is at least as likely as not (i.e., a 50 percent or greater probability) that any diagnosed acquired psychiatric disorder had its onset in service or is otherwise linked to service. The claims file should be provided to the examiner for review in conjunction with the examination and such should be acknowledged. All appropriate testing should be accomplished. The Veteran’s lay statements, especially regarding his military stressors, contained within the claims file and made at the examination, must be considered. All findings and conclusions should be set forth in a legible report. A clear rationale for all opinions rendered must be made. If the requested opinion cannot be provided without resort to speculation, the examiner (CONTINUED ON NEXT PAGE) should so state and explain why an opinion cannot be provided without resort to speculation. BARBARA B. COPELAND Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD H. Yoo, Counsel