Citation Nr: 18158323 Decision Date: 12/14/18 Archive Date: 12/14/18 DOCKET NO. 17-00 464 DATE: December 14, 2018 REMANDED Entitlement to service connection for posttraumatic stress disorder (PTSD) is remanded. Entitlement to service connection for an anxiety disorder is remanded. Entitlement to service connection for a dysthymic disorder (claimed as depression) is remanded. REASONS FOR REMAND The Veteran served in the United States Navy from September 1964 to July 1966. These matters come before the Board of Veterans’ Appeals (Board) on appeal from an August 2013 and March 2017 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Cleveland, Ohio. 1. Entitlement to service connection for posttraumatic stress disorder (PTSD) is remanded The Veteran and his representative assert that the Veteran is entitled to service connection for PTSD because he claims it originated due to his active duty service. While the Board sincerely regrets further delay, additional development is required before the Veteran's claim for service connection to PTSD may be adjudicated on the merits. With respect to the Veteran's claim, the Board notes that the Veteran's last VA examination in June 2013 did not find that the Veteran's symptoms met the criteria for PTSD under the DSM-IV criteria. However, as the Veteran's appeal was certified to the Board after August 4, 2014, at which time the regulations regarding the evaluation of mental disorders were changed to reflect the updated DSM-5 criteria, a new examination is warranted to determine whether the Veteran has PTSD under DSM-V that is related to his period of active service. 2. Entitlement to service connection for an anxiety disorder is remanded The Veteran and his representative assert that the Veteran is entitled to service connection for an anxiety disorder because it originated during his active duty service. With respect to the Veteran's claim, the Board finds that at the Veteran's last VA examination in June 2013 for PTSD, the examiner did not fully address the etiology of this claimed disorder, and also apparently concluded that the Veteran’s anxiety disorder may have preexisted service since the entry evaluation noted that the Veteran had “nervous troubles” when he entered service. However, a mere statement of medical history by the Veteran is not sufficient to rebut the presumption of soundness. A veteran is presumed to be in sound condition when examined and accepted into the service except for defects or disorders noted when examined and accepted for service. 38 U.S.C. § 1111, 1137 (2012). In order to rebut the presumption of sound condition under 38 U.S.C. § 1111, VA must show by clear and unmistakable evidence both that the disease or injury existed prior to service and that the disease or injury was not aggravated by service. The disease or injury must be clearly specified or diagnosed on the induction examination; vague symptoms are not enough to rebut the presumption. Preliminarily, the Board finds that there is no evidence that undebatably shows that the Veteran had a diagnosed anxiety disorder prior to or at the time of entry into active service. Therefore, the Board will address this claim as a direct service connection claim. While the Board sincerely regrets further delay, additional development is required before the Veteran's claim for service connection of an anxiety disorder may be adjudicated on the merits. An examination is warranted and necessary to determine whether the Veteran’s anxiety disorder is related to his period of active service. 3. Entitlement to service connection for a dysthymic disorder (claimed as depression) is remanded The Veteran and his representative assert that the Veteran is also entitled to service connection for a dysthymic disorder because it originated during active service. With respect to the Veteran's claim, the Board finds that the Veteran's last VA examination in June 2013 for PTSD also did not fully address the Veteran’s claim for a dysthymic disorder. While the Board sincerely regrets further delay, additional development is required before the Veteran's claim for service connection of for a dysthymic disorder may be adjudicated on the merits. An examination is warranted and necessary to determine whether the Veteran’s dysthymic disorder is related to his period of active service. The matter is REMANDED for the following action: 1. Obtain and outstanding VA and private treatment records and associate them with the Veteran's claims file. 2. After the above development has been completed and all records associated with the claims file, the Veteran must be afforded a VA examination by an examiner with appropriate expertise to determine the nature and etiology of the Veteran's claimed acquired psychiatric disorders, to include PTSD, an anxiety disorder, and a dysthymic disorder. Any and all studies, tests, and evaluations that are deemed necessary by the VA examiner should be performed. The claims folder, including a copy of this remand, should be reviewed by the examiner. The Veteran's claims file, to include a copy of this remand, should be made available to the examiner. Following a complete review of the record, the examiner is asked to provide: a. A determination as to whether the Veteran meets the criteria for a diagnosis of PTSD under the criteria of DSM-V. b. If the Veteran has a diagnosis of PTSD pursuant to DSM-V, provide an opinion as to whether it is at least as likely as not (50 percent probability or greater) that the diagnosis is due at least in part to the claimed fear he felt during his reported in-service event. c. Provide an opinion as to whether it is at least as likely as not (50 percent probability or greater) that any diagnosed PTSD otherwise originated during, or is etiologically related to, active duty service. d. Provide an opinion as to whether it is at least as likely as not (50 percent probability or greater) that any diagnosed anxiety disorder originated during, or is etiologically related to, active duty service. e. Provide an opinion as to whether it is at least as likely as not (50 percent probability or greater) that any diagnosed dysthymic disorder originated during, or is etiologically related to, active duty service. A complete rationale must be provided for all opinions rendered. If the examiner cannot provide the requested opinions without resorting to speculation, he or she should expressly indicate this and provide a supporting rationale as to why an opinion cannot be made without resorting to speculation. Michael J. Skaltsounis Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. R. Montalvo, Associate Counsel