Citation Nr: 18155652
Decision Date: 12/04/18	Archive Date: 12/04/18

DOCKET NO. 15-08 793A
DATE:	December 4, 2018
REMANDED
Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD) and a panic disorder with agoraphobia, is remanded.
REASONS FOR REMAND
The Veteran had active service from September 2001 to September 2005.  This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an October 2012 rating decision.  The Veteran initially made separate claims for service connection for PTSD and a panic disorder, but these have been recharacterized as a claim for any acquired psychiatric condition.  Clemons v. Shinseki, 23 Vet. App. 1 (2009).
1. Entitlement to service connection for an acquired psychiatric disorder, to include PTSD and a panic disorder with agoraphobia, is remanded.
A new VA examination is required.  Since the September 2012 VA examination, the Veteran has provided statements regarding traumatic events that she encountered as a military police officer, as well as statements and media reports regarding typhoons and missile threats that she experienced while stationed in Guam.  A new opinion addressing this evidence is required.  Additionally, the September 2012 VA examiner’s rationale as to why the Veteran’s psychiatric condition was not incurred in or caused by service is that the Veteran had reported at previous VA treatment records that she had panic attacks and other psychiatric symptoms that predated her service.  No psychiatric condition was noted at the time of her entrance into active service, consequently a new opinion is required addressing whether there is clear and unmistakable evidence of a pre-service psychiatric condition and an opinion as to whether that condition was aggravated by the Veteran’s service.
The matter is REMANDED for the following action:
Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any acquired psychiatric disability.  The entire claims file must be reviewed and all necessary tests completed.
For each acquired psychiatric disability diagnosed, the examiner must opine whether it clearly and unmistakably (undebatable) preexisted the Veteran’s service.  If the examiner finds it did clearly and unmistakably preexist service, the examiner must opine whether it was clearly and unmistakably not aggravated by service.  If the examiner finds that it either did not clearly and unmistakably preexist service, or was not clearly and unmistakably aggravated by service, the examiner must opine whether it is at least as likely as not related to an in-service injury, event, or disease, including the Veteran’s experience during typhoons during her service in Guam, the Veteran’s experiences as a military police officer, or the Veteran’s fear of a missile attack.
The examiner is advised that the Veteran is competent to report her symptoms/history and that such reports must be acknowledged and considered in formulating any opinion.  If her reports are discounted, the examiner should provide a reason for doing so.  
A rationale for all requested opinions shall be provided.  If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation stating why this is so.  In so doing, the examiner shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question.

 
A. ISHIZAWAR
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	Steven H. Johnston, Associate Counsel