Citation Nr: 21000090 Decision Date: 01/04/21 Archive Date: 01/04/21 DOCKET NO. 16-04 984 DATE: January 4, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disorder is remanded. REASONS FOR REMAND The Veteran had active service in the Army from October 1969 to June 1972. The appeal originates from a July 2013 decision of a Department of Veterans Affairs (VA) Regional Office. The matter was remanded for additional development in July 2018. In December 2020, the Veteran withdrew his April 2019 request for a Board hearing. Entitlement to service connection for an acquired psychiatric disorder is remanded. The Veteran contends that he has posttraumatic stress disorder (PTSD) related to various in-service stressors. See March 2018 VA Examination. The matter was initially remanded in November 2017 for a VA examination with opinion and again in July 2018 for an addendum opinion concerning the etiology of the Veteran’s psychiatric diagnoses. The examination and addendum opinion were respectively obtained in March 2018 and January 2019. The addendum opinion indicated that the Veteran did not have a clinical diagnosis of PTSD, that an acquired psychiatric disorder was less likely as not related to service, and that a personality disorder was less likely as not subject to superimposed disease or injury in service. In April 2020, the Veteran submitted a private medical opinion from a physician providing a DSM-5 diagnosis of PTSD and relating the disorder to service. As there is evidence of a new psychiatric diagnosis potentially related to service, the Veteran should be afforded a new VA examination. Consideration is given to the April 2020 private opinion’s finding of a nexus between PTSD and service. The Board has some concern as to the credibility of the opinion. In the videoconference interview on which it was based, the Veteran reported the onset of depression and anxiety during active service. The physician found that the Veteran has had intermittent depressive episodes beginning in active service and that he developed depression and anxiety at that time. These findings, however, appear to be inconsistent with the Veteran’s medical history, including his own reporting. At the April 1972 separation examination, he was evaluated as psychiatrically normal and denied a history of depression or excessive worry in a contemporaneous report of medical history. VA treatment records show that he received substance abuse treatment in August 1995 at which time he was diagnosed with polysubstance dependence but no other psychiatric disorder. He received followup treatment for months afterwards but did not report depression or anxiety, expressing “no complaints” in December 1995. The Veteran was referred for treatment of depression many years later in March 2011. He denied having any psychiatric history other than substance abuse. Similarly, he reported no mental health history in May 2011. Although the physician indicated review of the record and provided a medical chronology, the April 2020 private opinion does not seem to recount this pertinent evidence or address its significance. As such, a VA examination with opinion would be of assistance in adjudicating the claim.   The matter is REMANDED for the following action: Schedule the Veteran for an examination to determine the nature and etiology of any acquired psychiatric disorder. The examiner is asked to address the following: 1. Identify/diagnose any psychiatric disorder that exists or has existed during the appeal. Specify whether the Veteran has had PTSD, depressive/anxiety disorder, substance abuse disorder, or a personality disorder. If a diagnosis of PTSD is made, the stressor relied on should be noted in the record. If a diagnosis of PTSD is not made, the examiner should specify which criteria were not met. The examiner must address the April 2020 private opinion which provides a DSM-5 diagnosis of PTSD. 2. For any acquired psychiatric disorder, is it at least as likely as not that the disorder had its onset in or is otherwise etiologically related to active service? 3. For any substance abuse disorder, is it at least as likely as not that the disorder was proximately caused or underwent any incremental increase in disability, regardless of its permanence, due to an acquired psychiatric disorder? The term “incremental increase in disability” means additional impairment of earning capacity.  Objective measurement, or numerical quantification, is not required to ascertain an increase in disability.  Moreover, any “incremental increase in disability” need not be permanent. 4. For any personality disorder, is it at least as likely as not that the disorder was subject to superimposed disease or injury during service? MICHAEL A. HERMAN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Alhinnawi 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.