Citation Nr: 20039964 Decision Date: 06/11/20 Archive Date: 06/11/20 DOCKET NO. 12-02 070 DATE: June 11, 2020 REMANDED Entitlement to service connection for an acquired psychiatric disorder to include posttraumatic stress disorder (PTSD) and adjustment disorder is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1974 to August 1976. This case is before the Board of Veterans’ Appeals (Board) on appeal from a May 2010 Regional Office (RO) rating decision. In that rating decision, the RO continued the denial of entitlement to service connection for PTSD as the evidence submitted was not material to the reason of the previous denial. In a June 2017 decision, the Board reopened the service connection claim for PTSD, but denied the Veteran’s underlying service connection claim for an acquired psychiatric disorder to include PTSD and adjustment disorder. The Veteran appealed the decision to the United States Court of Appeals for Veterans Claims (CAVC or Court). While his claims were pending at the Court, the Veteran's representative and the VA Office of General Counsel filed a Joint Motion for Partial Remand (Joint Motion) requesting that the Court vacate the Board's decision denying entitlement to service connection for an acquired psychiatric disorder to include PTSD and adjustment disorder and remand the case to the Board for further development and readjudication. In a June 2018 Order, the Court granted the Joint Motion. The case was returned to the Board. The case was remanded by the Board to the RO in November 2018 for additional development of the record pursuant to the June 2018 Court order. 1. Entitlement to service connection for an acquired psychiatric disorder to include posttraumatic stress disorder (PTSD) and adjustment disorder. The Veteran contends that he has PTSD related to experiences during active duty in Vietnam, including witnessing an aircraft crash while stationed at the Columbus Air Force Base as military police in October 1975. The Veteran believed one passenger died and another was injured as a result of the crash. The RO was able to corroborate that there was a mishap with a T-38A aircraft in October 1975. There was no information in the file relating to first responders on the scene, nor personnel involved in the recovery of human remains and/or aircraft parts. However, although the aircraft was a total loss, there were no fatalities as a result of mishap. VA outpatient treatment records show that the Veteran was given an Axis I diagnosis of PTSD in 2008, 2009, 2011, 2012, and 2013. Records from 2008-2018 also show that PTSD is noted as part of his primary medical history and listed as an active medical problem, and that he participated in PTSD therapy. He was also diagnosed with dysthymia and an anxiety disorder during VA outpatient treatment during the appeal period. According to the Joint Motion, the Board failed to discuss the evidence of a current diagnosis of PTSD in the VA treatment records, when concluding that the Veteran did not have a current diagnosis of PTSD in the June 2017 Board decision. In November 2018, the Board determined that the October 2016 VA examiner did not provide an adequate opinion as the examiner did not address the Veteran’s lay statements as to continuous symptoms and did not provide an opinion as to the etiology of the PTSD diagnosed earlier in the appeal period, during VA outpatient treatment. The Board remanded the claim to arrange for a new VA examination and medical opinion. A November 2019 VA examiner provided the opinion that the claimed condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The examiner explained that the Veteran did not meet the criteria for a diagnosis of PTSD. He further noted that the Veteran’s current distress appears related to a number of current situational factors including financial problems, chronic marital disorder, and his mother’s illness. The Veteran has sought treatment in periods of crisis. However, as noted above, VA treatment records reflect that the Veteran was diagnosed with PTSD, he was prescribed medication to treat such disorder, and he attended 12 sessions of cognitive processing therapy and prolong exposure treatment for PTSD in 2011 and 2012. In light of the foregoing, a remand is necessary to arrange for a VA examination and medical opinion to determine if the current diagnosis of PTSD is based, at least in part, on the in-service stressor of witnessing an aircraft crash. The matters are REMANDED for the following action: Arrange for the Veteran to undergo a VA examination with a psychiatrist or psychologist who has not previously examined the Veteran, to determine whether any current psychiatric disorder is related to active military service. Following review of the claims file and examination of the Veteran, the examiner is asked to address the following: (a.) Clearly identify all psychiatric disability(ies) diagnosed during the examination and documented in the claims file at any time during the relevant appeal period (even if currently resolved), to include PTSD. (b.) With respect to the Veteran’s diagnosed PTSD, as there is sufficient evidence that supports the Veteran’s in-service stressor, the remaining issue is whether it is at least as likely as not ((i.e., 50 percent or greater probability) that the Veteran’s PTSD is related to the in-service stressor of witnessing an aircraft crash. (c.) For any other acquired psychiatric disorder other than PTSD to include dysthymia, an anxiety disorder, and adjustment disorder whether it is at least as likely as not (i.e., 50 percent or greater probability) that the disorders first manifested in service or are otherwise causally or etiologically related to the Veteran’s military service, to include the in-service stressor of witnessing an aircraft crash. The examiner must reconcile this opinion with the Axis I diagnoses of PTSD from the VA records in 2008, 2009, 2011, 2012, and 2013. In so doing, the examiner should opine as to whether the Veteran’s mental health disorder was as likely as not, misdiagnosed as PTSD, but nevertheless had it’s onset during service or is otherwise related to service. (Continued on the next page)   The examiner must explain the reasoning for his or her opinions including a description of the evidence relied upon and rejected in reaching such opinions. In rendering the above opinions, the examiner should specifically discuss the Veteran’s mental health treatment records, as well as, the previous VA psychiatric examination, to include the findings and conclusions of those examiners. L. B. CRYAN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board B. Berry, 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.