Citation Nr: 21003442 Decision Date: 01/21/21 Archive Date: 01/21/21 DOCKET NO. 11-10 441 DATE: January 21, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD), adjustment disorder, depressive disorder, and unspecified insomnia disorder, is remanded. Entitlement to special monthly compensation (SMC) based on the need for aid and attendance or housebound status is remanded. REASONS FOR REMAND The Veteran served on active duty for training from July 1997 to February 1998, and on active duty from July 1998 to May 2002. This matter has been previously remanded by the Board of Veterans’ Appeals (Board), most recently in March 2019. While further delay is regrettable, the Board finds remand of both claims is again necessary. 1. Service connection for an acquired psychiatric disorder. The Veteran asserts that he has an acquired psychiatric disorder related to his active duty service or, alternatively, as secondary to his service-connected disabilities. In March 2019, the Board remanded the claim in order to obtain a Department of Veterans Affairs (VA) opinion addressing all acquired psychiatric disorders diagnosed during the pendency of the appeal, that is, dating from at least March 2003 to the present. While an opinion was obtained in November 2019, the examiner addressed only PTSD and unspecified insomnia disorder, but not other diagnoses made during or close in time to the appeal period, including adjustment disorder and depressive disorder. Accordingly, the opinion is insufficient for purposes of determining entitlement to service connection and remand is again warranted so that an additional opinion may be obtained. 2. Entitlement to SMC based on the need for aid and attendance or housebound status. As noted in the March 2019 remand, a decision on the issue of entitlement to service connection for an acquired psychiatric disorder could significantly impact a decision on the issue of entitlement to SMC. Accordingly, the issues are inextricably intertwined and a remand of the claim for entitlement to SMC is also required. Updated VA treatment records, as well as any identified, relevant private treatment records, should be obtained and associated with the record. The matters are REMANDED for the following actions: 1. Ask the Veteran to identify all outstanding treatment records relevant to his acquired psychiatric disorder and SMC claims. All identified VA records should be added to the claims file. All other properly identified records should be obtained if the necessary authorization to obtain the records is provided by the Veteran. If any records are not available, or the Veteran identifies sources of treatment but does not provide authorization to obtain records, appropriate action should be taken (see 38 C.F.R. § 3.159(c)-(e)), to include notifying the Veteran of the unavailability of the records. 2. After records development is completed, the claims file should be sent to an appropriate examiner to offer an opinion as to whether it is at least as likely as not (50 percent probability or greater) that any acquired psychiatric disorder diagnosed at any point during the pendency of the appeal, that is since around March 2003, had onset during service or is otherwise related to an in-service injury, event, or disease. The examiner should also address whether any acquired psychiatric disorder diagnosed at any point during the pendency of the appeal is at least as likely as not (a) caused by, or (b) aggravated by (worsened beyond natural progression) service-connected disability. In offering the opinion, the examiner must consider all diagnoses during the pendency of the appeal, specifically including, but not limited to, PTSD (e.g., June 2, 2011 statement from Dr. N.O.V. suggesting “there is medical evidence diagnosing the condition as PTSD”), unspecified insomnia disorder (e.g., November 12, 2019 VA PTSD examination report), adjustment disorder (e.g., December 19, 2002 VA psychiatry form), and depressive disorder (e.g., November 30, 2004 VA mental disorders examination report; March 5, 2010 VA psychiatry note). If the examiner believes any of these diagnoses is not correct, that should be explained. (Continued on the next page.) The need for an examination is left to the discretion of the examiner. A rationale for all opinions offered is requested as adjudicators are precluded from making any medical findings. Nathan Kroes Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. D. Bruce, 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.