Citation Nr: 20007675 Decision Date: 01/29/20 Archive Date: 01/29/20 DOCKET NO. 19-10 236 DATE: January 29, 2020 REMAND Entitlement to service connection for an acquired psychiatric disorder, diagnosed as bipolar disorder, is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1975 to July 1979. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2016 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Boston, Massachusetts. The Veteran’s theory of entitlement best can be summarized via his November 2014 VA Form 21-0781a. In essence, the Veteran was part of the 341st Security Police Squadron at Malmstrom Air Force Base (AFB), Montana. Eventually, the Veteran and his Squadron were accused of theft, from a locked storage facility, of among other things, a boat motor. While the Veteran never formally was charged and eventually was reinstated to his position, he claims that this instance started the development of his psychiatric disorder. The Veteran eventually turned in his weapon and resigned from his position. If a veteran is entitled to a VA examination, the VA must provide an adequate examination and opinion. A medical opinion is adequate when it is based upon consideration of the veteran’s prior medical history and examinations and also describes the disability in sufficient detail so that the Board’s evaluation of the claimed disability will be a fully informed one. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). Additionally, when a nexus between a current disability and an in-service event is indicated, there must be a medical opinion that provides some non-speculative determination as to the degree of likelihood that a disability was caused by an in-service disease or incident to constitute sufficient medical evidence on which the Board can render a decision with regard to nexus. Jones v. Shinseki, 23 Vet. App. 382, 387 (2010). Evaluating the Veteran’s Military Occupational Specialty (MOS) performance reviews, it is clear that the Veteran received great reviews from his superiors. His last MOS review (from November 1978 to June 1979), however, reveals that the Veteran served in the capacity as an Administration Clerk. The Veteran’s superior indicated that the Veteran requires “close continuous supervision” for him to perform his duties. It was noted that the Veteran lacks “motivation and initiative,” which are “contributing factors to his inability to adapt to military life.” On numerous communications, the Veteran’s “bearing, behavior, and appearance caused great concern.” Because of this, the Veteran was placed “under an observation period for an extended period of time, whereas improvement was noted.” In August 2014, the VA provided the Veteran with a psychological examination, at which time the Veteran was diagnosed with bipolar disorder I. In opining that the Veteran’s psychiatric condition was not related to service, the VA examiner simply stated that the reason for the Veteran’s discharge was noted to be for behavioral problems and not for psychiatric reasons. In March 2016, the Veteran provided a letter from his treating VA psychiatrist, Dr. V.V., who opined that the Veteran’s condition “is more likely than not that [the Veteran’s] psychiatric condition occurred as a consequence of his military service and manifested the signs and symptoms of the disorder years later in his life.” In the Board’s view, neither opinion is sufficient for the Board to make a fully informed decision on the claim. Neither opinion specifically addresses the Veteran’s claimed in-service event articulated above. The August 2014 opinion merely states that, because the reason for discharge was attitudinal problems and not classified as psychiatric in nature, the Veteran’s bipolar disorder is unrelated to service. On the other hand, Dr. V.V. explains that psychiatric symptoms can manifest much later in life but does not provide any discussion about the Veteran’s particular situation or claimed stressor. Thus, because neither opinion is adequate, remand is required for VA to obtain an updated nexus opinion. See Jones, 23 Vet. App. at 387; 38 C.F.R. § 20.904(a). The matter is REMANDED for the following action: 1. Obtain any ongoing VA treatment records. Should they exist, associate them with the claims file. 2. Schedule the Veteran for a VA examination to assess the etiology of his diagnosed psychiatric disorder. The examiner shall answer the following: (a.) Is it at least as likely as not (a fifty percent probability or greater) that the Veteran’s bipolar disorder (or other diagnosed psychiatric disorder) occurred in, or is the result of, his period of active duty service? Note: The examiner is reminded that the term “as likely as not” does not mean “within the realm of medical possibility,” but rather that the evidence of record is so evenly divided that, in the examiner’s expert opinion, it is as medically sound to find in favor of the proposition as against it. A detailed rationale supporting the examiner’s opinions must be provided. The lack of documented treatment in service, while probative, cannot serve as the sole basis for a negative finding. If an opinion cannot be made without resort to speculation, the examiner should so state and provide reasoning as to why a conclusion would be so outside the norm that such an opinion is not possible. The Veteran has the right to submit additional evidence and argument on the matter that the Board has remanded. See Kutscherousky v. West, 12 Vet. App. 369, 372 (1999). This claim must be afforded expeditious treatment. The law requires that all claims that are remanded for additional development or other appropriate action by the Board or United States Court of Appeals for Veterans Claims must be handled in an expeditious manner. 38 U.S.C. §§ 5109B, 7112. Rachel Erdheim Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Trevor T. Bernard, 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.