Citation Nr: 18157126 Decision Date: 12/11/18 Archive Date: 12/11/18 DOCKET NO. 16-56 852 DATE: December 11, 2018 REMANDED Service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD), is remanded. Service connection for erectile dysfunction, to include as secondary to PTSD, is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1997 to January 1998, October 2001 to April 2002, and February 2003 to May 2006. These matters come to the Board of Veterans’ Appeals (Board) from a September 2014 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Montgomery, Alabama. 1. Entitlement to service connection for an acquired psychiatric disorder, to include PTSD, is remanded. The Board finds that further development is required prior to adjudicating the Veteran’s claim. See 38 C.F.R. § 19.9. In his November 2016 substantive appeal, the Veteran asserted that his PTSD is due to holding a servicemember in his arms that died from alcohol poisoning, which was collaborated by a buddy statement. This incident occurred while the Veteran was stationed in Germany in 2006. The Veteran’s DD Form 214 reflects that he served in Germany in 2006. Accordingly, his active duty period in Germany is verified. Post-service treatment records reflect a positive screen for PTSD, and diagnoses for anxiety and depression. In addition, the record provides that the Veteran was hospitalized in September 2015 at Parkridge Valley Hospital in Chattanooga, Tennessee, for mental health reasons. The hospital records, however, are not included in the claims file. Furthermore, it appears as though the RO did not attempt to verify the Veteran’s stressor after he submitted the buddy statement. Thus, the claim is being remanded to afford the Veteran a VA examination to determine whether a current psychiatric disorder, to include PTSD, is related to service, to obtain other relevant medical records, and to afford the Veteran proper development of his in-service stressor. McLendon v. Nicholson, 20 Vet. App. 79 (2006). 2. Entitlement to service connection for erectile dysfunction is remanded. The Board finds the Veteran’s claim for service connection for erectile dysfunction is inextricably intertwined with the issue of entitlement to service connection for PTSD, which is being remanded for further adjudication. Therefore, a final decision on the issue of entitlement to service connection for erectile dysfunction cannot be rendered at this time. See Harris v. Derwinski, 1 Vet. App. 180 (1991) (two issues are “inextricably intertwined” when they are so closely tied together that a final decision on one issue cannot be rendered until a decision on the other issue has been rendered). The matters are REMANDED for the following actions: 1. Obtain the Veteran’s VA treatment records for the period from January 2017 to the Present. 2. Ask the Veteran to complete a VA Form 21-4142 for any non-VA medical providers that treated his claimed psychiatric disorder since service discharge to include Parkridge Valley Hospital. Make two requests for the authorized records from any sources identified, unless it is clear after the first request that a second request would be futile. 3. Attempt to corroborate the Veteran’s in-service stressor, including his holding a servicemember in his arms that died from alcohol poisoning while he was stationed in Germany. If more details are needed, contact the Veteran to request the information. Advise the Veteran that he may submit additional lay statements that may tend to corroborate his claimed stressor(s), including the dates and locations thereof. All attempts to verify any reported PTSD stressors must be documented in the claims file. 4. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any psychiatric disorder that may be present It should be noted that the Veteran is competent to attest to factual matters of which he had first-hand knowledge, including observable symptomatology. If there is a medical basis to support or doubt the history provided by the Veteran, the examiner should provide a fully reasoned explanation. (a) The examiner should identify all current psychiatric disorders. He or she should specifically indicate whether the Veteran has PTSD. (b) For each diagnosis identified other than PTSD, the examiner should state whether it is at least as likely as not (a 50 percent or greater probability) that the disorder manifested in or is otherwise related to the Veteran’s military service, including any symptomatology therein. (c) Regarding PTSD, the RO should provide the examiner with a summary of any verified in-service stressors, and the examiner must be instructed that only these events may be considered for the purpose of determining whether exposure to an in-service stressor has resulted in PTSD. The examiner should consider the criteria of the DSM-5 in determining whether the diagnostic criteria to support the diagnosis of PTSD has been satisfied. If a PTSD diagnosis is deemed appropriate, the examiner should then comment upon the link between the current symptomatology and any verified in-service stressor. 5. If service connection is established for a mental health disability, schedule the Veteran for a VA examination to determine the nature and etiology of his erectile dysfunction. The examiner should opine as to whether it is at least as likely as not that the Veteran has a current diagnosis of erectile dysfunction, and whether that diagnosis is related to his military service, to include as secondary to any diagnosed psychiatric disorders. 6. Ensure that the VA medical opinions obtained include a complete rationale for the conclusions reached. The medical opinions must support the conclusions reached with an analysis that is adequate for the Board to consider and weigh against other evidence of record; medical opinions must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. If an opinion cannot be expressed without resort to speculation, ensure that the clinician so indicates and discusses why an opinion is not possible, to include whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. 7. Readjudicate. C.A. SKOW Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Griffey, Associate Counsel