Citation Nr: 18160055
Decision Date: 12/21/18	Archive Date: 12/20/18

DOCKET NO. 17-12 284
DATE:	December 21, 2018
REMANDED
Entitlement to service connection for an acquired psychiatric disorder other than posttraumatic stress disorder (PTSD), to include major depressive disorder, is remanded.
REASONS FOR REMAND
The Veteran served on active duty in the United States Army from September 1988 to March 1989.
This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO).
The Veteran’ s claim of entitlement to service connection for major depressive disorder has been recharacterized as reflected on the title page, to include consideration of all psychiatric disorders reasonably raised by the record other than service-connected PTSD.  Clemons v. Shinseki, 23 Vet. App. 1 (2009). 
Regarding diagnosed major depressive disorder, the June 2015 VA examiner rendered a negative nexus opinion, highlighting that the Veteran was discharged in 1989 and was not diagnosed or treated for a mental health condition for over twenty years.  The Veteran asserts that her depression is the result of her military sexual trauma.  See February 2016 Correspondence.  Moreover, military sexual trauma was conceded by the RO in the June 2015 rating decision.  Further, the Veteran’s service treatment records show that she was diagnosed with a personality disorder in February 1989.  As the June 2015 examiner failed to address the Veteran’s relevant service treatment records, an addendum opinion is required on remand.  See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007).  Additionally, as the RO has granted service connection for PTSD, the issue of entitlement to secondary service connection for an acquired psychiatric disability other than PTSD is now at issue.  A medical opinion specifically addressing secondary service connection should also be secured on remand.  Finally, updated VA and private treatment records should be obtained. 
The matters are REMANDED for the following action:
1. Obtain any outstanding VA treatment records.
2. With any necessary assistance from the Veteran, obtain all outstanding private treatment records.  If any records are unavailable, notify the Veteran pursuant to 38 C.F.R. § 3.159(e).
3. Then obtain an addendum opinion from the June 2015 VA examiner (or other qualified examiner, if unavailable) regarding the etiology of the Veteran’s acquired psychiatric disorder other than PTSD.  No additional examination is necessary, unless the examiner determines otherwise.  After a review of the claims file, the examiner is requested to provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s major depressive disorder:
(a) is related to service, to include as due to conceded military sexual trauma, the January 1989 suicide attempt, and/or her in-service diagnosis of a personality disorder in February 1989.  In addressing the Veteran’s in-service personality disorder, pleases discuss whether the Veteran’s major depressive disorder was superimposed upon her personality disorder during service.
(b)	is proximately due to her service-connected PTSD; or
(c)	has been aggravated (worsened beyond natural progression) by her service-connected PTSD.
A comprehensive rationale must be furnished for all opinions expressed.  If the examiner cannot provide the requested opinion 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.
 
S. BUSH
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	K. Forde, Counsel