Citation Nr: 18106957 Decision Date: 06/01/18 Archive Date: 05/31/18 DOCKET NO. 15-22 837 DATE: June 1, 2018 REMANDED ISSUE The Veteran served on active duty from June 1979 to May 1981. 1. BIPOLAR DISORDER WITH DEPRESSED MOOD, CLAIMED AS MAJOR DEPRESSION is remanded. The Veteran contends that his acquired psychiatric disorder, bipolar disorder with depressed mood, is related to his active service. The Veteran argues that since he was attacked in the military he has been living with paranoia and unable to sleep. He says he still has dreams about the incident. He further states the he did not start using drugs or alcohol until he entered the military and this is also when he began fighting his “higher ups”. See July 2013 VA Psychological Examination. The Veteran was examined by VA in July 2013 and was diagnosed with bipolar disorder, with depressed mood. The Veteran reported that he began to isolate in the military and get into fights. He reported increasing his alcohol use and starting drug experimentation in the military. He also reported that he has abstained from drugs and alcohol since 2007. When addressing the etiology of the Veteran’s acquired psychiatric disorder, the VA examiner opined “It is as likely as not, that the Veteran’s current mental health condition is due to or the result of his service connected conditions described above.” Id. The rationale provided was that the “Veteran contends that his behavior was manageable until he was in the service and drug use began to escalate. In the service, he was exposed to new and challenging situations and chose drug use as a way of dealing with his anxieties.” Id. In August 2013 VA requested an addendum to the July 2013 medical opinion because the VA examiner failed to show how the Veteran’s service connected disabilities (which at the time of the examination were tinnitus and a left forearm condition) affected his psychiatric condition. An addendum was provided to VA in September 2013 by the same examiner who conducted the original VA psychological examination. This time the VA examiner offered a contrasting opinion. The VA examiner opined, “It is less likely than not that his diagnosed bipolar disorder with depression is related to his service connected conditions noted above.” See July 2013 VA Medical Addendum Opinion. The rationale provided was that the “Veteran was not treated for any mental health condition while in service. He was not diagnosed with a mental health condition until 2008 (27 years post discharge).” Id. Additionally, the examiner noted the Veteran’s STRs showed a pattern of misconduct. The examiner also remarked on the Veteran’s separation conditions. The examiner stated that the Veteran’s medical conditions “are less likely than not a sole reason for his current diagnosis of bipolar disorder with depression.” Id. No explanation or rationale was provided for this statement. The examiner noted the Veteran’s VA treatment records show ongoing problems with drug and alcohol. However the Veteran’s VA treatment records suggest the Veteran has denied drug and alcohol abuse since 2007-2008. In light of the reasons above, the Board finds that new examination is warranted in order to determine the etiology of the Veteran’s diagnosed bipolar disorder with depression. The matter is REMANDED for the following action: 1. Schedule the Veteran for a VA psychological examination with a new VA examiner. The examiner should review the record. All indicated tests should be conducted and the results reported. After examining the Veteran and reviewing the record, together with the results of any testing deemed necessary, the examiner should identify any and all acquired psychiatric disorders associated with the Veteran. Once this has been completed the examiner should list all diagnosed psychiatric disorders from August 2011 forward, and determine: (a). Whether it is at least as likely as not (50 percent probability or more) the Veteran’s acquired psychiatric disorder(s) is/are caused by or related to the Veteran’s active service and if NOT; (b). Whether the Veteran’s diagnosed acquired psychiatric disorder(s) was/were caused or aggravated by (i.e., made worse) his service connected disabilities. In doing so the examiner shall consider the Veteran’s statements about being followed and attacked while in service and any other lay statements offered by the Veteran. A complete rationale must be provided for all opinions asserted.   2. After completing the above, and any other development as may be indicated by any response received as a consequence of the actions taken in the preceding paragraphs, the claims remaining on appeal should be readjudicated based on the entirety of the evidence. If any benefit sought remains denied, the Veteran and his representative should be issued a supplemental statement of the case. An appropriate period of time should be allowed for response. MARJORIE A. AUER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD T. N. Shannon, Associate Counsel