Citation Nr: 18152718 Decision Date: 11/27/18 Archive Date: 11/23/18 DOCKET NO. 17-58 308 DATE: November 27, 2018 REMANDED Entitlement to service connection for an acquired psychiatric disorder, to include as secondary to service-connected residuals of frostbite of the hands, is remanded. REASONS FOR REMAND As there are multiple psychiatric diagnoses of record, the Board has recharacterized the claim for service connection for an anxiety disorder to include any acquired psychiatric disorder. See Clemons v. Shinseki, 23 Vet. App. 1 (2009). The service connection issue for an acquired psychiatric disorder was initially characterized as a claim requiring new and material evidence to reopen; however, for the following reasons, the Boards finds that the prior decision was not final and new and material evidence is not required. The AOJ denied service connection for the Veteran's claimed anxiety disorder in a January 2013 rating decision. The Veteran did not submit any additional evidence or notice of disagreement within one year of that letter. However, additional service personnel records were associated with the file in June 2016, including a December 1984 general counseling form, which referenced that in November 1984 and December 1984, the Veteran had received Article 15’s for pass abuse and abandoning his place of duty as Arms Room Guard, lost his RCP card under questionable circumstances, contracted VD, and was awarded a profile prohibiting exposure in cold weather to 15 minutes, noting that if his performance and behavior did not improve, he could be administratively discharged. This evidence received subsequent to the January 2013 rating decision relates to the Veteran’s acquired psychiatric disorder claim. Accordingly, the Board will reconsider the Veteran’s claim for an acquired psychiatric disorder, to include as secondary to residuals of frostbite of the hands. See 38 C.F.R. § 3.156 (c). Entitlement to service connection for an acquired psychiatric disorder, to include as secondary to service-connected residuals of frostbite of the hands is remanded. The Board cannot make a fully-informed decision on the issue of entitlement to service connection for an acquired psychiatric disorder because no VA examiner has addressed the nature and etiology of the Veteran’s claimed psychiatric disorder. The Veteran contends that his psychiatric disorder is related to his other service-connected disabilities, in particular the residuals of frostbite of his hands. The Veteran’s VA treatment records document multiple psychiatric diagnoses, including for a generalized anxiety disorder, dysthymia, a personality disorder, and an alcohol use disorder. In a May 2015 statement, the Veteran emphasized the traumatic nature of his experience with frostbite in service, describing the pain and anxiety he felt in connection with the experience, and further noting his concerns that he would be discharged in connection with the disability, noting that he was in the infantry and did not want to break his family tradition of military service. Additionally, in a June 2017 VA contract examination addressing the Veteran’s hand and finger conditions, the contract examiner noted that the Veteran’s frostbite residuals irritated him, affected his concentration and mental well-being, and caused him to see a psychiatrist. The Veteran has not yet received a VA examination which directly addresses his claimed acquired psychiatric disorder, and the Board finds that the evidence of record meets the low threshold for obtaining a VA examination in this case. Therefore, on remand, a VA examination should be provided to determine the nature and etiology of the Veteran's claimed acquired psychiatric disorder. See 38 U.S.C. § 5103A (d) (2012); McLendon v. Nicholson, 20 Vet. App. 79 (2006). The matter is REMANDED for the following action: Schedule the Veteran for a VA examination by a psychiatrist or a psychologist who has not previously examined the Veteran. The examiner is asked to determine if the Veteran currently meets (or met at any time during the pendency of this appeal, even if currently resolved) the diagnostic criteria for a diagnosis of depression, anxiety, or any other psychiatric disorder. The examiner must clearly identify each psychiatric disorder found at any time during the course of the appeal (to include depression, anxiety, or a personality disorder). If the examiner finds the Veteran currently does not, and did not at any time during the course of the appeal, meet the diagnostic criteria for a diagnosis of depression, anxiety, or any other psychiatric diagnosis, the examiner must explain why the psychiatric diagnoses reflected in the record during the course of the appeal are not valid diagnoses. The examiner must opine as to whether any currently diagnosed psychiatric disorder is at least as likely as not (a 50 percent or greater probability) the result of disease or injury in service. If not, then the examiner must opine as to whether the diagnosed psychiatric disorder is at least as likely as not either proximately due to, or aggravated by, the service-connected residuals of frostbite of the hands. The opinions must address both causation and aggravation in the context of secondary service connection to be deemed adequate. The examiner is advised aggravation means an increase in the severity of the underlying disability beyond its natural progression. If aggravation is found, the examiner should attempt to quantify the degree of additional disability resulting from the aggravation. The examiner is advised the Veteran is competent to report his symptoms and history, and such reports must be specifically acknowledged and considered in formulating any opinion. If the examiner rejects the Veteran's reports, he or she must provide a reason for doing so. The examination report must include a complete rationale for the opinions provided. M. HYLAND Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD B. Reed, Associate Counsel