Citation Nr: 18155516
Decision Date: 12/04/18	Archive Date: 12/04/18

DOCKET NO. 16-04 686
DATE:	December 4, 2018
REMANDED
Service connection for a psychiatric disorder, to include posttraumatic stress disorder (PTSD) is remanded.
 
REASONS FOR REMAND
The Veteran served on active duty from February 1971 to April 1972.  
The case is on appeal from an October 2014 rating decision.  
In November 2018, the Veteran testified at a Board hearing.  
Service connection for a psychiatric disorder, to include PTSD. 
The Veteran previously underwent a VA examination in March 2013.  That examiner found that the Veteran’s symptoms did not meet the diagnostic criteria for PTSD under DSM-IV criteria.  Instead, the examiner diagnosed the Veteran with major depressive disorder (MDD).  The examiner reported that the Veteran indicated that his first significant depressive episode occurred when his son died 10 years prior.  The examiner determined that the Veteran did not meet the full criteria for a PTSD diagnosis, and that there is no medical evidence of record to directly connect his anxiety and depressive symptoms with his in-service experiences.
However, VA medical records since the March 2013 VA examination include a PTSD diagnosis.  In addition, the examiner did not provide an opinion as to whether any non-PTSD psychiatric disorder is related to service.
Moreover, the Veteran has advanced a number of stressors, not all of which were considered by the VA examiner.  Stressors advanced by the Veteran related to Vietnam deployment include children thrown in front of the truck the Veteran drove and generally fearing for his life while being stationed in Vietnam. 
In view of this information, the Board finds that a new VA examination is warranted to determine whether the Veteran in fact has PTSD and, if so, whether it is due to an in-service stressor, as well as whether any other psychiatric disorder is related to service.
In light of the remand, updated VA treatment records should be obtained. 
The matter is REMANDED for the following action:
1. Obtain updated VA treatment records dated since October 2018. 
2. Schedule the Veteran for a VA psychiatric examination.  The claims file should be made available to the examiner for review and any indicated testing should be done.
The examiner should first identify whether the Veteran has a psychiatric disorder(s), including specifically PTSD.  If PTSD is not diagnosed, it should be explained why this is so.
If PTSD is diagnosed, identify the stressor(s) upon which the diagnosis is based.  This should include an opinion as to whether the in-service stressor is adequate to support a diagnosis of PTSD and whether the Veteran’s symptoms are related to that claimed stressor, including to any fear of hostile military activity in Vietnam.
For any diagnosis other than PTSD, is it at least as likely as not (i.e., at least equally probable) that the disorder had its onset directly during, or is otherwise related to, the Veteran’s service? 
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A complete rationale or explanation should be provided for any opinion reached.
 
RYAN T. KESSEL
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	E. Gray