Citation Nr: 20021388 Decision Date: 03/25/20 Archive Date: 03/25/20 DOCKET NO. 19-18 682A DATE: March 25, 2020 REMANDED Entitlement to service connection for posttraumatic stress disorder (PTSD) is remanded. Entitlement to service connection for a psychiatric disorder other than PTSD is remanded. REASONS FOR REMAND The Veteran had active service from August 1976 to September 1976 and from March 1977 to March 1981. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a December 2016 rating decision of the Department of Veterans Affairs (VA). In February 2020, VA sent a clarification letter to the Veteran to determine the status of his representation. The February 2020 letter, in part, notified the Veteran that if no response was received from him or his new representative regarding his choice of representation within 30 days of the date of the letter, it would be assumed that he wished to represent himself and review of his appeal would resume. To date, the Veteran has not responded or appointed another representative. As such, the Board will recognize the Veteran as pro se. Additionally, as this appeal is remanded for other matters, the Veteran will have the opportunity to appoint another representative if he so desires. Additional evidence, including updated VA treatment records, was received by VA following the issuance of the February 2018 statement of the case issued for the appeal herein. The Veteran did not waive review by the Agency of Original Jurisdiction (AOJ) of this additional evidence. In this regard, if new evidence is submitted with or after a substantive appeal received on or after February 2, 2013, then it is subject to initial review by the Board unless the Veteran explicitly requests consideration by the AOJ. Here, although the Veteran’s substantive appeal was filed after February 2, 2013, the Board interprets such exception as applying only to evidence submitted by the Veteran or his representative. As described above, the record does not reflect that the entirety of the additional evidence was submitted by the Veteran or his representative as VA treatment records are considered to have been developed by VA. However, as this appeal is remanded for other matters, there is no prejudice to the Veteran in this regard. 1. Entitlement to service connection for PTSD and entitlement to service connection for a psychiatric disorder other than PTSD are remanded. The Veteran asserts that he suffers from PTSD and paranoid schizophrenia as a result of his active service. Pursuant to Clemons v. Shinseki, 23 Vet. App. 1 (2009), the Board has recharacterized the Veteran’s claim for paranoid schizophrenia to include any psychiatric disorder other than PTSD. As emphasized in Clemons, though a Veteran may only seek service connection for one psychiatric disability, the Veteran’s claim cannot be limited only to that diagnosis but must rather be considered a claim for any mental disability that may be reasonably encompassed. Accordingly, the Veteran’s claim for service connection for paranoid schizophrenia has been recharacterized to encompass any psychiatric disorder other than PTSD. Additionally, as PTSD is manifested by symptoms distinct from that of psychiatric disabilities other than PTSD, and distinct VA regulations are applicable for a claim for service connection for PTSD, the claim for service connection for PTSD is characterized as a separate issue. In January 2019 VA treatment records, the Veteran was diagnosed with schizoaffective disorder. These records also documented the Veteran complained of PTSD with an in-service stressor consisting of a personal assault. In a July 2019 statement, the Veteran described, in part, an in-service stressor involving a personal assault. A remand is required to allow VA to attempt to corroborate the Veteran’s reported stressor and to send the Veteran notification as required under 38 C.F.R. § 3.304(f)(5). Additionally, in a May 2014 Social Security Administration decision, the Veteran was found to suffer from PTSD and paranoid schizophrenia. Although some records from the Social Security Administration are of record, they were submitted by the Veteran’s then representative. The record does not reflect VA has made an attempt to obtain complete records with regard to Social Security Administration disability benefits. The Board finds there is a reasonable possibility that additional existing Social Security Administration records may be relevant to the Veteran’s claims. Thus, upon remand, an attempt should be made to obtain all Social Security Administration disability benefits records. Finally, the Veteran has not been afforded a VA examination to determine the nature and etiology of any psychiatric disorder, including PTSD. In this regard, a September 1976 service record reflects the Veteran was discharged for unsuitability due to “personality disorders.” Accordingly, a remand is warranted for a VA examination. The matters are REMANDED for the following actions: 1. Make efforts to obtain all outstanding medical records in accordance with the duties set forth in 38 C.F.R. § 3.159(c). 2. Obtain and associate with the record all records pertaining to the Veteran concerning a claim for disability benefits from the Social Security Administration, to include all evidence and copies of all disability determinations. Document all requests for information as well as all responses in the claims file. 3. Send a proper notice letter to the Veteran with regard to his claim for PTSD claim pursuant to 38 C.F.R. § 3.304(f)(5). 4. Attempt to corroborate the Veteran’s in-service stressor(s), including a personal assault. If more details are needed, contact the Veteran to request the information. 5. After the Veteran’s reported stressor(s) have been developed, schedule the Veteran for a psychiatric examination to determine the nature and etiology of any psychiatric disorder, including PTSD. (a.) If the Veteran is diagnosed with PTSD, the examiner must explain how the diagnostic criteria are met and opine whether it is at least as likely as not related to a verified in-service stressor, including whether the evidence of record, in particular whether the Veteran’s lay statements, a statement made by his sister, and his service records, corroborate the claim that a personal assault occurred during a period of active service (38 C.F.R. § 3.304(f)(5)). (b.) If the Veteran is diagnosed with a personality disorder and another psychiatric disorder, including PTSD, the examiner must opine whether the psychiatric disorder was at least as likely as not superimposed on a personality disorder during active service and resulted in additional disability. (c.) If any other psychiatric disorders are diagnosed, the examiner must opine as to whether each diagnosed disorder clearly and unmistakably (undebatable) preexisted any period of the Veteran’s active service. If the examiner finds it did clearly and unmistakably preexist a period of active service, the examiner must opine whether it was clearly and unmistakably not aggravated by service. If the examiner finds that it either did not clearly and unmistakably preexist a period of active service, or was not clearly and unmistakably aggravated by service, the examiner must opine whether it is at least as likely as not related to an in-service injury, event, or disease. 6. Finally, after undertaking any other development deemed appropriate, readjudicate the issues on appeal. If any benefit sought is not granted, furnish the Veteran and his representative with a supplemental statement of the case and afford them an opportunity to respond before the record is returned to the Board for further review. M. ESPINOZA Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E. Hicks, 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.