Citation Nr: 18160176 Decision Date: 12/26/18 Archive Date: 12/26/18 DOCKET NO. 14-22 645 DATE: December 26, 2018 REMANDED Entitlement to service connection for a psychiatric disorder, to include posttraumatic stress disorder (PTSD), but not including persistent depressive disorder, is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1987 to October 1998, from July 2005 to December 2005, from June 2006 to June 2008, from May 2009 to April 2011, and from June 2011 to February 2012, with additional service in the Reserves. In his June 2014 Substantive Appeal (VA Form 9), the Veteran requested a hearing before the Board. In October 2016 correspondence, he withdrew his hearing request. Accordingly, the Board finds his hearing request has been withdrawn. By way of history, the Veteran filed a claim for service connection for PTSD in March 2012. On that same form, he filed a claim for service connection for adjustment disorder with anxiety. In December 2012, the Agency of Original Jurisdiction (AOJ) granted service connection for an anxiety disorder, not otherwise specified (NOS). In the course of increased rating claims for that disability, the AOJ has recharacterized the Veteran’s psychiatric disorder as persistent depressive disorder (previously rated as anxiety disorder, NOS). Entitlement to service connection for a psychiatric disorder, to include PTSD, but not including persistent depressive disorder, is remanded. Initially, the Board notes that claims for service connection for psychiatric disorders, to include PTSD, may encompass claims for service connection for all diagnosed psychiatric disorders. Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009). Accordingly, although the Veteran is already service-connected for persistent depressive disorder (previously rated as anxiety disorder, NOS), service connection may still be available for any other diagnosed psychiatric disorders The Veteran’s claim was remanded by the Board in April 2018 to afford him a VA examination to determine the etiology of his current psychiatric disorders. The Board’s remand directives were specific. They required that the examiner identify all current psychiatric disorders found on examination or at any time during the course of the appeal. If any previously diagnosed disorder, to include PTSD and/or anxiety disorder, was no longer present, the examiner was instructed to provide an explanation for a finding of no disability. Further, the Board directed the examiner to provide an etiology opinion for each diagnosed psychiatric disorder found. The Veteran was afforded a June 2018 VA examination and the examiner found there was no diagnosis of PTSD because the Veteran did not meet all of the DSM criteria for a diagnosis. Unfortunately, there was no explanation for the discrepancy between the Veteran’s VA treatment records, which document a diagnosis of PTSD, and the finding of no diagnosis on that examination. The examiner also diagnosed unspecified bipolar and related disorder and unspecified anxiety disorder; however, the examiner failed to provide opinions regarding the etiology of those diagnosed psychiatric disorders. Accordingly, a remand is required to obtain medical opinions and, if the medical professional designated to provide the opinions finds one is warranted, an examination. The matter is REMANDED for the following action: 1. Obtain a medical opinion from, if possible, the examiner who performed the June 2018 VA examination to determine the etiology of the diagnosed psychiatric disabilities at that examination. A new examination of the Veteran is only required if the medical professional designated to provide the opinions finds one is warranted. The medical professional is informed that the Veteran is already service-connected for persistent depressive disorder, but that opinions regarding the diagnoses found at the June 2018 VA examination are still required. Following a complete review of the evidence of record, the medical professional is requested to provide the following opinions: (a) Provide an explanation for the determination that there was no diagnosis of PTSD found on the June 2018 VA examination. This opinion must be reconciled with the Veteran’s VA treatment records which document a diagnosis of PTSD. (b) Determine whether it is at least as likely as not (50 percent probability or higher) that the Veteran’s unspecified bipolar and related disorder began during or is related to any of his periods of active duty service, to include as due to reported in-service incidents. (c) Determine whether it is at least as likely as not (50 percent probability or higher) that the Veteran’s unspecified anxiety disorder began during or is related to any of his periods of active duty service, to include as due to reported in-service incidents. (d) If the medical professional finds that the diagnoses found on the June 2018 examination (unspecified bipolar and related disorder and unspecified anxiety disorder) are misdiagnoses, or represent a progression of the Veteran’s service-connected persistent depressive disorder, a complete explanation for any such finding must be provided. A complete rationale for all opinions is required. All questions on the appropriate Disabilities Benefits Questionnaire must be completed in full. If the examiner is unable to provide any opinion without resorting to speculation, he or she must explain why this is so. 2. The Veteran is informed that it is his responsibility to report for any scheduled examination and to cooperate in the development of the claim and that the consequences for failure to report for any VA examination without good cause may include denial of a claim. See 38 C.F.R. §§ 3.158, 3.655 (2017). In the event that the Veteran does not report for any scheduled examination, documentation showing that he was properly notified of the examination must be associated with the record. 3. The AOJ must review the medical opinions to ensure they are adequate and comply with the Board’s specific remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998) (holding that Regional Office compliance with Board remand directives is not discretionary or optional). If deficient in any manner, corrective action must be taken at once. (CONTINUED ON NEXT PAGE) 4. Then, the Veteran’s claims must be readjudicated. If any benefit sought on appeal is not granted to the Veteran’s satisfaction, the Veteran and his representative must be provided a Supplemental Statement of the Case and be given an adequate opportunity to respond. Thereafter, the case should be returned to the Board for further appellate action. MICHAEL MARTIN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Jessica O'Connell, Associate Counsel