Citation Nr: 21003367 Decision Date: 01/21/21 Archive Date: 01/21/21 DOCKET NO. 18-11 498 DATE: January 21, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disorder, diagnosed as recurrent depressive disorder, to include as secondary to service-connected disabilities, is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Air Force from October 1968 to September 1972. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2015 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The undersigned Veterans Law Judge presided over a Board hearing in November 2020. A transcript of this hearing is of record. Entitlement to service connection for an acquired psychiatric disorder, diagnosed as recurrent depressive disorder, to include as secondary to service-connected disabilities is remanded. The Veteran is seeking service connection for an acquired psychiatric disorder, diagnosed as recurrent depressive disorder. Specifically, he asserts his depressive disorder was aggravated by his service-connected bilateral hearing loss and tinnitus disabilities. The Veteran has been treated by private physicians as well as the VA for psychiatric symptoms since service. The VA has regularly subjected him to depression screens and questionnaires regarding his symptoms. At times, the Veteran has scored negatively and positively for depression. Other VA treatment records show no signs of depression, with the Veteran denying depression outright, while at other times stating he had a prior depressive disorder, but it had resolved completely. Although a depressive disorder diagnosis is noted in his VA treatment records, there is no indication that a thorough evaluation was conducted in accordance with 38 C.F.R. § 4.125. In June 2016, the Veteran’s then private treating physician submitted a letter opining that his depressive symptoms are related to his service-connected bilateral hearing loss and tinnitus. In October 2020 the Veteran submitted a second opinion from a different private physician stating his recurrent depressive disorder was aggravated by his hearing loss and tinnitus, based on the physician’s observations and discussions with the Veteran. Both private physicians, in forming their opinions, do not appear to have reviewed the Veteran’s VA treatment history. As there is contradictory and insufficient medical evidence, the Veteran should be afforded a VA examination to determine the nature of his acquired psychiatric disorder and the relationship, if any, of such disability to service. See McLendon v. Nicholson, 20 Vet. App. 79, 83 (2006). The matters are REMANDED for the following action: 1. Obtain any and all treatment records from VA facilities from which the Veteran has received treatment. If the Veteran has received additional private treatment, he should be afforded an appropriate opportunity to submit the medical records of such treatment. 2. Schedule the Veteran for a VA examination by an appropriate clinician to determine the nature, extent, onset, and etiology of his acquired psychiatric condition. The claims file should be provided to the examiner(s) for review. All indicated studies deemed necessary by the examiner(s) should be performed, and all findings of those tests should be reported in detail. The examiner should also provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that any currently diagnosed acquired psychiatric disorder is etiologically related to the Veteran’s period of active duty service. The examiner should also provide an opinion as to whether it is at least as likely as not (a 50 percent or greater probability) that any currently diagnosed acquired psychiatric disorder is etiologically related or has been aggravated by his service-connected bilateral hearing loss and/or tinnitus. In providing this opinion, the examiner should consider the June 2016 and October 2020 private medical opinions. If the examiner cannot provide any of the requested opinions without resorting to speculation, he or she should provide an explanation stating why this is so. In so doing, the examiner should explain whether the inability to provide a more definitive opinion is the result of a need for additional information or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question(s). 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. B.T. KNOPE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. McDonald