Citation Nr: 18154875 Decision Date: 11/30/18 Archive Date: 11/30/18 DOCKET NO. 16-28 493 DATE: November 30, 2018 REMANDED Entitlement to service connection for an acquired psychiatric condition, to include posttraumatic stress disorder (PTSD), is remanded. REASONS FOR REMAND The Veteran honorably served on active duty from February 1976 to December 1983. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a November 2014 decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Roanoke, Virginia. 1. Entitlement to service connection for an acquired psychiatric condition, to include posttraumatic stress disorder (PTSD), is remanded. The Veteran has been screened positive for PTSD and has had a suggested PTSD diagnosis as recently as May 2016. See May 2016 Mental Health Diagnostic Study Note by J.P., L.C.S.W. The Veteran has attributed his PTSD symptoms to several in-service stressors including his tour aboard the USS LaMoure City LST-1194 where he was deployed to Russia. He reported near confrontations with hostile forces that he described as “stressful and frightening.” See April 2014 statement. The Veteran also described events occurring during his tour aboard the USS Hermitage LSD-34 including being shelled by hostile small arms fire off the coast of Lebanon. The Veteran has not been afforded a VA examination to determine the nature or cause of any acquired psychiatric condition (including PTSD). VA is required to provide examination when there is insufficient medical evidence to decide the claim, but the record otherwise contains competent evidence of a current disability or recurrent symptoms, evidence of an in-service event, and evidence of an indication of a nexus. See McLendon v. Nicholson, 20 Vet. App. 79, 83 (2006); Waters v. Shinseki, 601 F.3d 1274 (Fed. Cir. 2010); 38 C.F.R. § 3.159(c)(4)(i). Finally, the Veteran’s competent reporting of in-service stressors indicate that any current PTSD diagnosis could be related to a fear of hostile military or terrorist activities. This information should be elicited from the Veteran during the VA examination. 38 C.F.R. 3.304(f)(3). The matter is REMANDED for the following action: 1. Obtain any updated (from April 2018 to the present) VA treatment records for association with the claims file. 2. Ask the Veteran to identify any other psychological treatment records and to authorize VA to obtain those records for association with the claims file. 3. Then schedule the Veteran for an examination with an appropriate examiner to evaluate the nature and cause of the claimed acquired psychiatric condition (to include PTSD). The Board regrets the need to remand the matter to the RO; however, the Board is unable to adjudicate the Veteran’s case until it has the requested information. Therefore, the Board must ask the VA examiner and the RO to ensure compliance with the instructions and directives below (that is, full and thoroughly explained answers to each of the questions) to avoid delays in adjudication. Examination Instructions The examiner should answer the following questions based on (1) a review of the claims file and (2) interview and examination of the Veteran. Please note that an opinion based solely on the lack of documented in-service treatment or the lack of medical literature supporting a claim would not be legally adequate for the Board to decide the claim. [The Board draws the examiner and RO’s attention to the April 2014 Statement, May 2014 and June 2014 Statements in Support of Claim for Service Connection for PTSD, and June 2014 Correspondence] a) Please identify any CURRENT acquired psychological conditions (to include PTSD). b) Is it at least as likely as not (a 50 percent or better probability) that ANY acquired psychiatric condition (to include PTSD) had its onset in or is otherwise related to the Veteran’s service? (Continued on the next page)   The examiner must consider the Veteran’s statements about the in-service traumatic events that occurred during his tours of duty discussed above. A detailed explanation (rationale) is requested and very much appreciated for all opinions provided. (By law, the Board is not permitted to rely on any conclusion that is not supported by a thorough explanation.) L. BARSTOW Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Kyle McKone, Law Clerk