Citation Nr: 18160323
Decision Date: 12/26/18	Archive Date: 12/26/18

DOCKET NO. 17-43 019
DATE:	December 26, 2018
REMANDED
Entitlement to service connection for an acquired psychiatric disability, to include posttraumatic stress disorder (PTSD), anxiety and depression is remanded.
REASONS FOR REMAND
The Veteran served on active duty from December 1970 to July 1976.
This case comes before the Board of Veteran’s Appeals (Board) on appeal of a July 2017 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO).
Entitlement to service connection for an acquired psychiatric disability is remanded.
The Veteran was afforded a VA examination in October 2015, with an addendum medical opinion provided in November 2015.  The November 2015 medical opinion reflects that the Veteran does not have a current diagnosis for PTSD, but rather has nightmare disorder and unspecified depressive disorder.  While the medical opinion indicated that these disorders were not caused by or a result of events in service, and explained that nightmare disorder was unrelated because they did not involve his military experiences or military stressors, it was unclear why the clinician concluded that unspecified depressive disorder was not caused by or the result of events in service.  In this regard, no explanation was provided for the conclusion.  See Stefl v. Nicholson, 21 Vet. App. 102, 124-25.  Also, “[A] medical examination report must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two.”  Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008).
Accordingly, this claim is remanded for a supplemental medical opinion.
The matter is REMANDED for the following action:
1.   Obtain a supplemental opinion from the clinician who prepared the November 2015 VA medical opinion.  If the provider is not available, obtain an opinion from another appropriate medical professional.  If the reviewer determines that additional examination of the Veteran is necessary to provide a reliable opinion, such examination should be scheduled.  However, the Veteran should not be required to report for another examination as a matter of course, if it is not found to be necessary.
The clinician should provide an explanation (i.e. rationale) for the conclusion that unspecified depressive disorder is not “as least as likely as not” related to the Veteran’s active service.
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2. Readjudicate.
 
 C.A. SKOW
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	C. E., Associate Counsel