Citation Nr: 18157060 Decision Date: 12/11/18 Archive Date: 12/11/18 DOCKET NO. 17-00 370 DATE: December 11, 2018 REMANDED Entitlement to service connection for a psychiatric disorder to include depression, to include as secondary to service-connected traumatic brain injury (TBI), is remanded. REASONS FOR REMAND The Veteran had active duty service in the United States Army from January 1996 to July 2001. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an October 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Cleveland, Ohio. 1. Entitlement to service connection for a psychiatric disorder to include depression, to include as secondary to service-connected TBI, is remanded. The Veteran asserts that his psychiatric disorder, to include depression, is related to his active service. He also essentially asserts that his psychiatric disorder is secondary to his service-connected TBI. Initially, the Board notes that during the course of the appeal, the Veteran was awarded service connection for a TBI. In August 2016, the Veteran attended a VA examination for his TBI. Following the examination, the TBI examiner opined that it was impossible to differentiate the Veteran’s psychiatric symptoms from his service-connected TBI. Subsequently, the Veteran was also afforded a VA examination in August 2016 for his psychiatric condition. The psychiatric examiner simply opined that the Veteran’s psychiatric symptoms were independent from the Veteran’s TBI, and that the Veteran’s depression was less likely as not due to his TBI. After a review of the evidence, the Board finds the medical opinions of record inadequate to determine if the Veteran’s psychiatric condition is related to his active service or is secondary to his service-connected TBI. In addition, the VA psychiatric examiner’s opinion was conclusory in nature and the examiner did not provide a thorough and well-reasoned rationale for her findings. Thus, a remand is required to obtain a more complete medical opinion as to the nature and etiology of the Veteran’s psychiatric disorder and to reconcile the contradicting examination opinions. See 38 U.S.C. § 5103A(d) (2012); 38 C.F.R. § 3.310 (2015); Barr v. Nicholson, 21 Vet. App. 303, 312 (2007) (holding that when VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate); Bloom v. West, 13 Vet. App. 185, 187 (1999) (a medical opinion without supporting clinical data or other rationale does not provide the required degree of medical certainty). The matters are REMANDED for the following action: 1. Schedule the Veteran for an appropriate VA examination to determine the nature and etiology of the Veteran’s psychiatric disorder. The electronic claims file must be reviewed by the examiner. All indicated studies and testing must be conducted, and all pertinent symptomatology must be reported in detail. After a review of the claims file, the examiner should provide answers to the following questions: (A). Identify all psychiatric disorders that are currently present. (B). Is it at least as likely as not (50 percent probability or greater) that the Veteran’s psychiatric disorder, had its onset in service or is caused by or related at least in part to his active service? (C). Is it at least as likely as not that the Veteran’s psychiatric disorder is caused or aggravated by his service-connected TBI? In providing all of the requested opinions, the examiner should consider the Veteran’s competent lay claims regarding the observable symptoms he has experienced. The VA examination report must include a complete rationale for all opinions expressed. If the examiner feels that any of the requested opinions cannot be rendered without resorting to speculation, the examiner must state whether the need to speculate is caused by a deficiency in the state of general medical knowledge (i.e. no one could respond given medical science and the known facts) or by a deficiency in the record or the examiner (i.e. additional facts are required, or the examiner does not have the needed knowledge or training). Michael J. Skaltsounis Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Rescan, Associate Counsel