Citation Nr: 21061447 Decision Date: 10/04/21 Archive Date: 10/04/21 DOCKET NO. 19-13 425 DATE: October 4, 2021 REMANDED Entitlement to service connection for major depressive disorder is remanded. REASONS FOR REMAND The Veteran served on active duty from January 2005 to April 2006. This case comes before the Board of Veterans' Appeals (Board) on appeal of a January 2019 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge (VLJ) in an August 2020 Board hearing. The Veteran was afforded a VA examination in January 2019. The examiner found there was no evidence that the Veteran's major depressive disorder, recurrent, severe, which clearly and unmistakably existed prior to service, was aggravated beyond its natural progression by depression and depressive neurosis during service. The examiner also stated that the in-service diagnosis of depression and depressive neurosis was a likely recurrence of the depression the Veteran was diagnosed with in 1999, prior to service. The examiner went on to write that the Veteran did not serve in combat and there is no evidence that his condition would have been any different in a civilian job. The Board finds the VA examination is inadequate. The VA examination failed to address and consider the Veteran's in-service occupation and experiences. The examiner essentially found that since the Veteran was not in combat, his depression was not aggravated. However, the Veteran served in Germany as a hospital service specialist for a year. None of the Veteran's experiences while on active duty were noted. As mentioned above, the examiner found no evidence that the Veteran's condition would have been any different in a civilian job. However, the potential duties and experiences in a hospital where injured service members are evacuated to from combat are not comparable to any civilian job. During the August 2020 Board hearing, the Veteran stated that some of his symptoms during his active service included increased substance abuse, distancing himself from family and friends, and a lack of desire or interest to do anything constructive or entertaining in his life. The Veteran also stated that the last four or five months that he was in Germany, he felt like it was "kind of a blur that never really ended." The Veteran also took issue with how his VA examination was carried out. The Veteran stated that they did not spend any time asking about his military service, which upset him. He felt that the examiner just wanted to find a reason to deny the claim. Overall, the Veteran felt he was not being listened to. Additionally, the record shows that the Veteran has been seen at a VA medical center for his depression. The Veteran has discussed suicidal ideations with VA medical staff. There is no evidence that the Veteran had suicidal ideations prior to his active service. Private medical records from June and July 1999, prior to the Veteran's active service, show the Veteran's health care provider found the Veteran was not suicidal. The Board finds that another VA examination is warranted to allow the Veteran to provide a detailed and complete history of his active duty service and how his symptoms of depression were reportedly aggravated. The matter is REMANDED for the following action: 1. Contact the Veteran and request authorization to obtain any outstanding records pertinent to his claim, to include any private treatment records, following proper VA procedures under 38 C.F.R. § 3.159(c). 2. After completing the requested development, afford the Veteran a new VA mental health examination with an appropriate clinician to determine the nature and etiology of his claimed depression. The Veteran's claims file, including this remand, the January 2019 VA examination/opinion, and the August 2020 Board hearing transcript, must be made available for review by the examiner in conjunction with the addendum opinion. The examiner must review the claims folder, and this fact must be noted in the accompanying medical report. Based upon a review of the claims file, the examiner must answer the following: a.) Ascertain whether the Veteran's claimed depression clearly and unmistakably preexisted service. b.) If the examiner finds that the Veteran's claimed depression clearly and unmistakably preexisted service, the VA examiner is requested to provide an opinion as to whether the Veteran's claimed depression was clearly and unmistakably NOT aggravated by service. The VA examiner is reminded that the response to this question must be phrased in the exact terms (clearly and unmistakably NOT aggravated) presented in this remand. c.) If any of the Veteran's claimed depression did NOT clearly and unmistakably preexist service, the VA examiner is requested to provide an opinion as to whether the Veteran's claimed depression is at least as likely as not (at least an approximate balance of positive and negative evidence) etiologically related to service. The VA examiner is reminded that the response to this question must be phrased in the exact terms (at least as likely as not) presented in this remand. All opinions must be supported by a rationale that is consistent with the opinions presented. A. C. MACKENZIE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Hetman 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.