Citation Nr: 20006320 Decision Date: 01/28/20 Archive Date: 01/24/20 DOCKET NO. 14-37 296 DATE: January 28, 2020 REMANDED Entitlement to service connection for an acquired psychiatric disorder, to include schizophrenia, is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1977 to April 1978. In June 2018, the Board reopened and remanded the claim for service connection for an acquired psychiatric disorder, to include schizophrenia for further development. As pertinent here, the Board asked that the examiner address March 1978 STRs indicating that the Veteran had significant psychological overlay in his medical complaint; a July 1978 VA examination report (only three months after discharge) indicating “Patient seems extremely slow mentally;” the lay assertions made by the Veteran’s brother in November 2010 about change in personality upon his return from active duty service; and the Veteran’s lay contentions. After a September 2018 VA examiner failed to address any of the above-mentioned evidence, in December 2018, the Board found that there was not substantial compliance with the June 2018 remand directives and remanded the claim in order to obtain an addendum medical opinion. Subsequently, in a May 2019 opinion, a VA examiner repeated almost verbatim the September 2018 VA examiner’s opinion, and again failed to address any of the above-mentioned evidence. This examiner again concluded that there was no evidence to support that the schizophrenia had its onset during active duty service or within a year of discharge without resorting to mere speculation. Importantly, both examiners concluded that there was no evidence of any psychiatric symptoms prior to 1985, contrary to the evidence of record, and evidence specifically noted by the Board in the previous remands. See Reonal v. Brown, 5 Vet. App. 458, 461 (1993) (holding that the Board may reject a medical opinion based on an inaccurate factual basis). Given this deficiency, an additional remand is necessary because there was no compliance with the Board’s June and December 2018 remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Regarding entitlement to a TDIU, the issue is inextricably intertwined with the issue being remanded and adjudication of TDIU must be deferred pending the proposed development. The matters are REMANDED for the following action: 1. Ensure that all outstanding VA treatment records are associated with the claims file. 2. Obtain another addendum from an appropriate examiner to determine the likely etiology of the Veteran’s acquired psychiatric disorder, to include schizophrenia. The claims file and a copy of this remand will be made available to the examiner, who will acknowledge receipt and review of these materials. After a review of the record, the examiner is asked to respond to the following: (a) Identify all currently diagnosed psychiatric disorders and indicate onset, to the extent possible. (b) Indicate the likelihood of the presence of a psychosis within the first post service year. (c) For each diagnosed psychiatric disorder, please provide an opinion as to whether it at least as likely as not (a 50 percent probability or greater) that any psychiatric disorder had its onset in service or is otherwise etiologically related to it. The examiner must address the following evidence: (i) March 1978 STRs indicating that the Veteran had significant psychological overlay in his medical complaint; (ii) a July 1978 VA examination report (only three months after discharge) indicating “Patient seems extremely slow mentally;” (iii) the November 2010 lay assertions made by the Veteran’s brother about change in personality upon return from active duty service; and, (iv) the Veteran’s lay contentions. (Continued on the next page)   A complete rationale should be provided for all opinions. If an opinion cannot be provided without resort to mere speculation, the examiner must provide a complete explanation stating why this is so and note what, if any, additional evidence would permit such an opinion to be made, while specifically considering the above-mentioned evidence. 3. Thereafter, ensure that there has been substantial compliance with the requested addendum questions, and then readjudicate the remanded claims, to include entitlement to a TDIU. S. B. MAYS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Yaffe, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.