Citation Nr: 20038696 Decision Date: 06/05/20 Archive Date: 06/05/20 DOCKET NO. 14-38 758 DATE: June 5, 2020 REMANDED Entitlement to compensation under the provisions of 38 U.S.C. § 1151 for a March 2010 surgical procedure performed in a VA medical center (VAMC) is remanded. REASONS FOR REMAND The Veteran had active service from July 1964 to June 1966. He died in November 2019. The Veteran’s surviving spouse has been substituted in this appeal by the Agency of Original Jurisdiction (AOJ). The claim was most recently before the Board of Veterans’ Appeals in August 2019 when it was remanded for additional development. There has not been substantial compliance with the remand directives and the claim must be remanded again. Stegall v. West, 11 Vet. App. 268 (1998). Entitlement to compensation under the provisions of 38 U.S.C. § 1151 for a March 2010 surgical procedure performed in a VAMC is remanded. In August 2019 the Board remanded the claim for an opinion as to whether the Veteran had a current psychiatric disability which is etiologically related to a MRSA diagnosis. The March 2020 VA medical opinion obtained is inadequate. The examiner ultimately provided a negative opinion because there was no evidence that the Veteran may have had any residuals, physical and/or mental/psychiatric disabilities related to this condition and/or treatment for it. The examiner said she did not find any evidence of the Veteran ever having any mental/psychiatric complaints, he never had need of evaluation or referral to a mental health provider for any mental/psychiatric conditions. However, the examiner did not comment on the significance of notations in the VA treatment records that the Veteran was coping with psychosocial problems related to illness, an order for a psychiatry service consult due to an episode of altered mental state that may be secondary to medications, or a notation of a provisional diagnosis of depressive disorder due to medical condition. See VA Treatment, November 2018. The matters are REMANDED for the following action: 1. Forward the record to an appropriate clinician to obtain an addendum opinion on the 1151 claim. a. The examiner must determine whether the Veteran had a psychiatric disability as a residual of MRSA, at any time during the period on appeal, from June 2010 to the present. In answering this, the examiner should specifically consider and discuss as necessary the VA Treatment records dated in 2018 that show that the Veteran was coping with psychosocial problems related to illness, an order for a psychiatry service consult due to an episode of altered mental state that may be secondary to medications, or a notation of a provisional diagnosis of depressive disorder due to medical condition. The examiner must also comment on the Veteran’s statements that his MRSA carrier diagnosis had an emotional impact on him. If, and only if, the clinician identified a diagnosis of MRSA, or residuals thereof, during the period on appeal, the examiner should address the following: b. Is it at least as likely as not that the Veteran’s residual of MRSA disability was caused by VA treatment in March 2010 and was the result of careless, negligence, lack of proper skill, error in judgement, or similar instance of fault on the part of VA? c. If the response to (b) is no, is the Veteran’s residual of MRSA disability caused by VA treatment due to an event not reasonably foreseeable? A complete rationale must be provided for any opinion offered. M.E. LARKIN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Robert J. Burriesci, 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.