Citation Nr: 18133136 Decision Date: 09/07/18 Archive Date: 09/07/18 DOCKET NO. 16-07 947 DATE: September 7, 2018 REMANDED Entitlement to service connection for acquired psychiatric disorder is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1980 to March 1983 and from August 4, 1984 to August 18, 1984. The Board notes that based on the evidence of record, the Board has re-characterized the Veteran’s claim of entitlement to service connection for schizophrenia, paranoid type, more broadly as a claim of entitlement to service connection for an acquired psychiatric disorder. See Clemons v. Shinseki, 23 Vet. App. 1 (2009) (the scope of a disability claim includes any disability that may reasonably be encompassed by the claimant’s description of the claim, reported symptoms, and the other information of record). With respect to the Veteran’s claim for service connection for an acquired psychiatric disorder, further development is required. Here, in a December 2015 VA examination report for mental disorders, the VA examiner diagnosed the Veteran with schizoaffective, depressive type, multiple episodes. Additionally, the Veteran’s service treatment records note treatment for a mental disorder and a diagnosis for paranoid schizophrenia. Nevertheless, the VA examiner ultimately opined that the Veteran’s current diagnosis is less likely than not incurred in or caused by his service. The rationale provided was that the Veteran disclosed that his symptoms began in high school and not during his military service. In a subsequently February 2016 VA Form 9, the Veteran stated that he did not tell the VA examiner that his symptoms began in high school, and asserted that his symptoms began during service. The Veteran was scheduled for a VA examination on June 19, 2017. The record indicates the Veteran failed to report to the examination. The Board points out that during this time, based on the Veteran’s medical records, he was noted as homeless. Additionally, on July 28, 2017, the Veteran was seen in the emergency room in Washington VA Medical Center for suicidal and homicidal ideation. Furthermore, there is no indication in the record as to whether a notice was sent to his last known address or whether a phone call was mad. Thus, the Board is left to speculate on whether there was adequate notice provided to the Veteran. Notably, during this time the Veteran appeared to be homeless and subsequently was in the hospital. Given the specific set of circumstances of this case, the Board finds that another attempt to schedule a VA examination is warranted. The matter is REMANDED for the following action: 1. Verify the Veteran’s current contact information, including his current mailing address and telephone number. 2. Obtain, if any, outstanding VA and non-VA medical records. 3. Schedule the Veteran for a VA examination to ascertain the nature and etiology of his psychiatric disorder, to include schizoaffective, depressive type, multiple episodes, and paranoid schizophrenia. Any and all studies, tests, and evaluations deemed necessary by the examiner should be performed. After performing any required tests, and reviewing the entire record, the examiner should provide an opinion responding to the following questions: (a) Delineate all psychiatric disorders currently exhibited by the Veteran, to include to include schizoaffective, depressive type, multiple episodes, and paranoid schizophrenia. If any previously diagnosed disorder, such as paranoid schizophrenia is not found upon examination, an explanation must be provided. For each disability, the examiner should address the following whether the Veteran’s acquired psychiatric disorder: 1. Did the Veteran’s acquired psychiatric disorder, to include schizoaffective, depressive type, multiple episodes, and paranoid schizophrenia; or pre-manifestations of an acquired psychiatric disorder, clearly and unmistakably (obviously or manifestly) exist prior to entrance into service? The examiner is asked to verify whether the Veteran’s symptoms began in high school, prior to his entry to service. 2. If it is the VA examiner’s opinion that any acquired psychiatric disorder or pre-manifestations of such disorders clearly and unmistakably preexisted service, was any preexisting acquired psychiatric disorder or pre-manifestations of such disorders clearly and unmistakably (obviously or manifestly) not aggravated (not permanently worsened beyond the natural progression) during active service? Note: The term “aggravated” means an increase in severity of the underlying disability that is not due to the natural progress of the disease. In addressing aggravation, the VA examiner is requested to discuss whether there has been any measurable worsening of the condition during service, and if so, whether such worsening constitutes an increase in disability. 3. If the VA examiner’s opinion is that any other psychiatric disability found did not clearly and unmistakably preexist service, the examiner should indicate whether it is at least as likely as not that it had its onset in service, or in the case of a psychosis, had its onset in the year immediately following service, or is otherwise the result of a disease or injury in service. Any opinion expressed by the VA examiner must “contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008). 4. The Veteran is hereby notified that it is his responsibility to report for the examination and to cooperate in the development of the claim. The consequences for failure to report for a VA examination without good cause may include denial of the claim. 38 C.F.R. §§ 3.158, 3.655. In the event that the Veteran does not report for the examination, documentation should be obtained and associated with the electronic claims file which shows that notice scheduling the examination was sent to the last known address. It should also be indicated whether any notice that was sent was returned as undeliverable. YVETTE R. WHITE Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD D. Abdelbary, Associate Counsel