Citation Nr: 21000573
Decision Date: 01/05/21	Archive Date: 01/05/21

DOCKET NO. 18-11 403
DATE: January 5, 2021

REMANDED

Entitlement to service connection for a psychiatric disorder, to include PTSD, a mood disorder, and a nightmare disorder is remanded.

REASONS FOR REMAND

The Veteran, who is the appellant in this case, had service from March 1965 to March 1967.

The Board previously considered this appeal in December 2019, and remanded the issue for additional development.  After the development was completed, the case returned to the Board for further appellate review.

1. Entitlement to service connection for a psychiatric disorder, to include PTSD, a mood disorder, and a nightmare disorder is remanded.

The Board notes that the February 2020 VA examination contains an inadequate medical opinion to the extent it did not provide a nexus opinion for each diagnosed psychiatric disability.  Specifically, the VA examiner provided a negative nexus opinion that applied to the nightmare disorder, but did not provide a nexus opinion on the mood disorder.  Once VA undertakes to provide a VA examination, it must ensure that the examination is adequate.  Barr v. Nicholson, 21 Vet. App. 303, 312 (2007).  Without further clarification, the Board is without medical expertise to determine the nature and etiology of the claimed disability.  Colvin v. Derwinski, 1 Vet. App. 171 (1991).  In light of the above, the Board finds that an addendum VA examination opinion must be obtained.

The matter is REMANDED for the following action:

1. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s diagnosed depressive disorder is at least as likely as not related to service.

In offering an assessment, the examiner must not only discuss the disorders diagnosed on current examination, but also any psychiatric disorder or disability diagnosed during this appeal.  

The examiner is asked to expressly address all relevant evidence, including, but not limited to, the following:

(a)	 The lay statements submitted by the Veteran and his spouse; 

(b)	 The Veteran’s VA treatment records, including his VA psychiatrist (Dr. M)’s diagnosis of a mood disorder; 

(c)	October 2016 VA treatment notes indicating that the Veteran has been diagnosed with chronic PTSD status post combat, and that he was treated at a Vet Center in 2012; and

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(d)	 The Veteran’s Vet Center treatment records describing the onset and breadth of his psychiatric symptomatology.

 

 

H. SEESEL

Veterans Law Judge

Board of Veterans’ Appeals

Attorney for the Board	R. Connally, 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.