Citation Nr: A20007328 Decision Date: 04/30/20 Archive Date: 04/30/20 DOCKET NO. 190912-34321 DATE: April 30, 2020 ORDER Service connection for anxiety and depression is denied. REMANDED Service connection for insomnia is remanded. FINDING OF FACT Anxiety and depression are symptoms of the Veteran’s service-connected posttraumatic stress disorder (PTSD). CONCLUSION OF LAW The criteria for service connection for anxiety and depression have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from April 2009 to September 2012. In September 2019, the Veteran filed a Decision Review Request: Board Appeal regarding a June 2019 rating decision. The Veteran selected a direct review, electing to not submit further evidence and declining a Board hearing. Anxiety and Depression The Veteran has sought service connection for anxiety and depression. The Veteran is service connected for PTSD. The most recent VA examination regarding the Veteran’s PTSD found that he did not have any other diagnosed acquired psychiatric disorders other than PTSD, but that anxiety and depression were symptoms of his PTSD. As indicated by the VA medical professionals that examined the Veteran, the Veteran’s symptoms of anxiety and depression are clearly associated with his diagnosis of PTSD and overlap with his PTSD. Thus, separate ratings are not appropriate. Further, because all psychiatric disorders, with the exception of eating disorders, are evaluated under the General Rating Formula for Mental Disorders, a single evaluation will be assigned that encompasses all of the Veteran’s psychiatric symptoms, including anxiety and depression. Thus, the Veteran would not be entitled to separate ratings for symptoms or impairment of PTSD, depression, or anxiety as 38 C.F.R. § 4.14 provides that rating such manifestations of a disability under multiple diagnoses (i.e., pyramiding) is to be avoided. Accordingly, the Board finds that the RO properly rated the Veteran’s PTSD in a single rating, and entitlement to a separate rating for anxiety and depression is denied. REASONS FOR REMAND Insomnia The Veteran has sought service connection for insomnia. The Board notes that prior to the June 2019 rating decision on appeal, a VA examination specifically regarding the Veteran’s insomnia was not conducted. As such, the Board finds that remand is required to correct this pre-decision duty to assist error. The matter is REMANDED for the following action: Schedule the Veteran for a VA examination to determine the etiology of his insomnia. The claims file should be made available to the examiner for review. Any tests or studies deemed necessary should be conducted, and the results should be reported in detail. After review of the claims file and examination of the Veteran, the examiner must opine as to the following: (a.) Whether the Veteran’s insomnia is a symptom of his service connected PTSD with anxiety and depression or his diagnosed sleep apnea, or whether the Veteran as likely as not has a separate diagnosis of insomnia. Please explain why or why not. (b.) If a separate diagnosis of insomnia is found, opine as to whether it is at least as likely as not (50 percent probability or greater) that it had its onset in service or is related to any in-service disease, event, or injury, to include the in-service complaints. The examiner is asked to note the Veteran’s in-service diagnosis of and treatment for insomnia. (Continued on the next page)   (c.) If the answer to (b) is negative, opine whether it is at least as likely as not that insomnia is proximately due to, caused by, or aggravated by the Veteran’s service-connected PTSD with anxiety and depression. A rationale for every opinion offered must be provided. JOHN Z. JONES Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Parrish, 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.