Citation Nr: 18151771 Decision Date: 11/20/18 Archive Date: 11/20/18 DOCKET NO. 16-50 989 DATE: November 20, 2018 REMANDED Service connection for a psychiatric disability, to include bipolar disorder and depression, is remanded. REASONS FOR REMAND The Veteran served on active duty in the Navy from July 1986 to October 1987. This matter is on appeal from a February 2016 rating decision. On March 7, 2018, the Veteran elected to participate in VA’s Rapid Appeals Modernization Program (RAMP), selecting the option for “Supplemental Claim.” However, appeals that have been activated by the Board are not eligible for RAMP processing. This appeal was activated by the Board on February 16, 2018, prior to the receipt of the Veteran’s RAMP opt-in election. 1. Service connection for a psychiatric disability is remanded. Every veteran is presumed to have been in sound condition at entry into service except as to defects, infirmities, or disabilities noted at the time of such entry, or where clear and unmistakable evidence demonstrates that the injury or disease existed before entry and was not aggravated by such service. 38 U.S.C. § 1111 (2012). If a condition is noted on an entrance examination report, the presumption of soundness does not attach - the only benefits that can be awarded are for aggravation of such condition by application of 38 U.S.C. § 1153 (2012) and 38 C.F.R. § 3.306 (2017). Wagner v. Principi, 370 F.3d 1089, 1096 (Fed. Cir. 2004). However, a history of preservice existence of conditions recorded at the time of examination does not constitute a notation of such conditions but will be considered together with all other material evidence in determinations as to inception. 38 C.F.R. § 3.304(b)(1). During the Veteran’s October 1985 entrance examination, the examiner found the Veteran to be psychiatrically normal. The presumption of soundness therefore attaches. At the time of the examination, the Veteran also denied any history of depression, excess worry, or nervous trouble of any sort. However, during a June 1987 psychological evaluation, a treatment provider diagnosed a mixed personality disorder and found that it existed prior to the Veteran’s entrance into active duty service. In addition, a VA examiner opined in February 2016 that the Veteran’s current depression was likely due in part to childhood stressors. The record thus indicates that the Veteran might have had a psychiatric disability prior to his active duty service and no VA examiner has provided an opinion as to whether clear and unmistakable evidence demonstrates that a psychiatric disability existed before entry and was not aggravated by such service. For these reasons, a remand is warranted to obtain a medical opinion. The matter is REMANDED for the following action: 1. Arrange for an opinion by an appropriate to determine the etiology of the Veteran’s psychiatric disability. The entire claims file and a copy of this remand must be made available to the examiner for review, and the examiner must specifically acknowledge receipt and review of these materials in any reports generated. A new examination is only required if deemed necessary by the examiner. The examiner must provide opinions as to the following: a. whether a psychiatric disability clearly and unmistakably existed prior to service entrance and, if so, b. whether any such disability was clearly and unmistakably not aggravated (i.e., not permanently worsened beyond the natural progression) during or as a result of service. c. If the examiner does not find that a psychiatric disability clearly and unmistakably existed prior to service entrance, then the examiner must provide an opinion as to whether it is at least as likely as not (a probability of 50 percent or greater) that any current psychiatric disability, including bipolar disorder or depression, began in service, was caused by service, or is otherwise related to the Veteran’s active service. Although an independent review of the claims file is required, the Board calls the examiner’s attention to the following: a. The June 1987 psychological evaluation diagnosing a mixed personality disorder and finding that it existed prior to enlistment. b. The Veteran’s report during an October 2014 private treatment appointment of childhood sexual trauma and of a family history of bipolar disorder. c. The Veteran’s September 2015 statement in which he opined that his conduct during his active duty service was an early manifestation of his current psychiatric disability. d. The February 2016 VA examiner’s opinion that the Veteran’s current depression was likely caused in part by childhood stressors. e. The February 2018 private treatment provider’s opinion that the symptoms of the Veteran’s current bipolar disorder had their onset during his active duty service. f. The May 2018 VA examiner’s opinion that the Veteran’s conduct during his active duty service was not an early manifestation of his current bipolar disorder. The rationale for any opinion expressed should be provided. If an opinion cannot be made without resort to speculation, the examiner should so state and provide reasoning as to why a conclusion would be so outside the norm that such an opinion is not possible. (Continued on the next page)   2. Readjudicate the claim. If the decision is unfavorable to the Veteran, issue a Supplemental Statement of the Case and allow the applicable time for response. Then, return the case to the Board. D. Martz Ames Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Ryan Frank, Counsel