Citation Nr: 18156898 Decision Date: 12/11/18 Archive Date: 12/11/18 DOCKET NO. 09-07 025 DATE: December 11, 2018 REMANDED Entitlement to service connection for an acquired psychiatric disorder is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1969 to January 1972. This matter comes before the Board of Veterans’ Appeals (Board) from a July 2007 rating decision. The Veteran died in December 2011. His surviving spouse has been properly substituted as the claimant and appellant in this case. In September 2015, the Board remanded the appeal for additional development. In December 2017, the Board in pertinent part denied the claim of entitlement to service connection for an acquired psychiatric disorder. The appellant appealed the Board’s decision to the U.S. Court of Appeals for Veterans Claims (Court). While the matter was pending before the Court, in August 2018, the appellant’s then-attorney and a representative of VA’s General Counsel filed a joint motion for partial remand. In August 2018, the Court granted the parties’ motion, vacated the Board’s December 2017 decision denying service connection for an acquired psychiatric disorder, and remanded the matter for action consistent with the terms of the joint motion. Entitlement to service connection for an acquired psychiatric disorder is remanded. During his lifetime, the Veteran asserted he became depressed and paranoid after basic training, and that these symptoms continued while on active duty. He related that after separation from service in 1972, he could not hold a steady job due to his paranoia and depression, adding that he had a “complete breakdown” in 1990 and was admitted to a VA hospital where he was diagnosed with paranoid schizophrenia and severe depression. Lay statements from family members included observations that he had become withdrawn and quiet since military service and no longer seemed to enjoy the company of family or others. Service treatment records are silent for complaints, diagnosis, or treatment for psychiatric problems. Treatment records from the Alexandria VA Medical Center reflect the Veteran was admitted for in-patient psychiatric treatment in April 1991. He reported a long history of feeling very nervous and paranoid with depression and crying spells since age 17, explaining that he believed other people were looking at him and talking about him with disapproval. (Another record reflects he experienced these symptoms for 17 years or since 1974). He elaborated that he had held numerous jobs as a mechanic, but usually for less than 6 months because he believed people were talking about him and he would quit. Over the years, his paranoia had generalized from coworkers to family and then to the general public. His wife indicated he had secluded himself at home and would not go anywhere, he had threatened to kill himself, and he had never been able to handle a job for any length of time because of paranoid feelings. The diagnosis was probable paranoid personality disorder with depressed and anxious mood. Subsequent VA treatment records reflect ongoing treatment and medication management for paranoid schizophrenia, psychosis, and depressive disorder with exacerbations and additional in-patient hospitalizations when the Veteran stopped taking his anti-psychotic and other psychotropic medications. On the date of his death in December 2011, he had been admitted in part for psychiatric symptoms. He had stopped taking his medications again, stopped eating, expressed suicidal and homicidal ideation, exhibited explosive behavior, and maxed out all of his credit cards on a shopping spree one week earlier. The diagnosis included paranoid schizophrenia with depressed mood. The Board finds a VA medical opinion is necessary to determine whether the Veteran had a psychiatric disorder related to military service. The matter is REMANDED for the following action: Provide the Veteran’s entire electronic claims file and a complete copy of this REMAND to a VA psychiatrist or psychologist for review. After reviewing the claims file, the reviewing examiner should provide an opinion as to whether it is at least as likely as not (i.e., a 50 percent or greater probability) that (1) any acquired psychiatric disability, including schizophrenia and depressive disorder, had its onset during service; (2) whether a psychosis manifested to a compensable degree within one year of separation from service; or (3) whether any acquired psychiatric disability was otherwise medically related to the Veteran’s military service. A medical analysis and rationale are to be included with all opinions expressed. In providing the requested opinion, the reviewing examiner should consider the Veteran’s lay statements, including to treatment providers, describing a long history of feeling paranoid and depressed and his wife’s account in April 1991 that these symptoms had consistently interfered with the Veteran’s ability to retain employment. K. Conner Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD L. Kirscher Strauss, Counsel