Citation Nr: 18159766 Decision Date: 12/20/18 Archive Date: 12/19/18 DOCKET NO. 14-12 255 DATE: December 20, 2018 REMANDED Service connection for a psychiatric disability is remanded. REASONS FOR REMAND The Veteran served on active duty in the Navy from December 1974 to November 1977. The Veteran testified before the undersigned Veterans Law Judge during a June 2017 hearing. This matter is on appeal from an April 2011 rating decision. The Veteran’s claims for service connection for posttraumatic stress disorder (PTSD) and depression have been recharacterized as a psychiatric disability to include PTSD and major depressive disorder. See Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009). The Board previously remanded this issue in January 2018. While the Board regrets the additional delay in adjudicating this Veteran’s appeal, a review of the record reveals that there has not been complete and adequate compliance with the prior remand directives to allow for a decision to be entered. The United States Court of Appeals for Veterans Claims (Court) has held that if the Board proceeds with final disposition of an appeal and the remand orders have not been complied with, the Board itself errs in failing to ensure compliance. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Service connection for a psychiatric disability is remanded. Once VA undertakes the effort to provide an examination when developing a service connection claim, even if not statutorily obligated to do so, it must provide one that is adequate for purposes of the determination being made. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). The Veteran was afforded a VA examination in March 2018. The examiner found that the Veteran did not have and had never been diagnosed with a psychiatric disorder. The Veteran’s VA treatment records at the time of the examination, however, noted a March 2009 diagnosis of a recurrent moderate episode of major depressive disorder and a June 2013 diagnosis of depression not otherwise specified. In addition, a VA treatment record from April 2018, after the most recent VA examination, notes diagnoses of unspecified depression and an adjustment disorder. A medical opinion based on an inaccurate factual premise has limited, if any, probative value. Reonal v. Brown, 5 Vet. App. 458, 461 (1993). For this reason, a remand is warranted to obtain an additional medical opinion. The matter is REMANDED for the following action: 1. Arrange for an opinion by an appropriate clinician for the purpose of determining the etiology of the Veteran’s psychiatric disability. The entire claims file and a copy of this remand must be made available to the examiner for review. A new examination is only required if deemed necessary by the examiner. The examiner must provide opinions as to the following: a. Whether it is as likely as not (a probability of 50 percent or greater) that any current psychiatric disability had its origin in service or is related to the Veteran’s active service. b. Whether it is as least as likely as not that any current psychiatric disability was caused by the Veteran’s service-connected residuals of right knee and right ankle injuries, including as a result of pain. c. Whether it is as least as likely as not that any current psychiatric disability was aggravated beyond its natural progression by the Veteran’s service-connected residuals of right knee and right ankle injuries. The examiner is advised that, for the purposes of the Veteran’s claim, a current disability is one present at any point since VA received his claim on September 14, 2010, even if it subsequently resolved. Although an independent review of the claims file is required, the Board calls the examiner’s attention to March 2009, June 2013, and April 2018 VA treatment records that note diagnoses of psychiatric disabilities. The rationale for any opinion expressed should be provided. If an opinion cannot be made without resort to speculation, the examiner should so state and provide reasoning as to why a conclusion would be so outside the norm that such an opinion is not possible. (Continued on the next page)   2. Readjudicate the claim. If the decision is unfavorable to the Veteran, issue a Supplemental Statement of the Case and allow the applicable time for response. Then, return the case to the Board. D. Martz Ames Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Ryan Frank, Counsel