Citation Nr: 21062268 Decision Date: 10/06/21 Archive Date: 10/06/21 DOCKET NO. 13-19 259 DATE: October 6, 2021 REMANDED Entitlement to a rating higher than 50 percent prior to October 29, 2016 for major depressive disorder and anxiety disorder with features of generalized anxiety disorder (GAD) and post-traumatic stress disorder (PTSD) is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1990 to July 2001. The Department of Veterans Affairs (VA) is grateful for her service. Entitlement to a rating higher than 50 percent before Oct 29, 2016 for major depressive disorder and anxiety disorder with features of GAD and PTSD is remanded. In an October 2019 decision, the Board of Veterans' Appeals (Board) denied a higher rating than the 50 percent assigned for major depressive disorder and anxiety disorder with features of GAD and PTSD. The Veteran appealed this denial to the United States Court of Appeals for Veterans Claims (Court), and by an April 2021 Memorandum Decision the Court "set aside" the Board's decision, based on the Court's finding that the Board had provided inadequate reasons and bases for its decision. The Court remanded the case to the Board for readjudication. In October 2019, the Board issued its decision containing a thorough analysis addressing the nature, severity, and impact on functioning of the Veteran's major depressive disorder and anxiety disorder with features of GAD and PTSD, which analysis was, as noted, by some measure deficient in its discussion of some discrete aspects of some reported symptoms, even while the Board provided a thorough analysis of the overarching nature of the Veteran's disability over the claim period in question and the disability's impact on her function in both work or professional and social settings. The holes in the record and hence in the Board's adjudication, which the Court identified in its Memorandum Decision, consisted of failure to adequately address the impact of the Veteran's reported passive suicidal ideation on her functioning, and failure to adequately address the impact of her inconsistently reported (and at times denied) auditory and visual hallucinations. As the Court noted, The assessment of a mental health condition is "symptom-driven," and VA must note the veteran's "objectively-observable symptomatology." Vazquez-Claudio v. Shinseki, 713 F.3d 112, 116 (Fed. Cir. 2013). If the Board fails to adequately assess evidence of a symptom experienced by the veteran, or fails to consider a symptom's impact, then the Board's reasons or bases for its denial of a higher rating are inadequate. Bankhead v. Shulkin, 29 Vet. App. 10, 22 (2017); see Gilbert v. Derwinski, 1 Vet. App. 49, 57 (1990) (establishing that "the Board must identify those findings it deems crucial to its decision and account for the evidence which it finds to be persuasive or unpersuasive."). The Board must comment on any evidence favorable to the veteran and, if it rejects that evidence, must explain its reasons for doing so. Caluza v. Brown, 7 Vet. App. 498, 506 (1995), aff'd per curiam, 78 F.3d 604 (Fed. Cir. 1996) (table). In this case, medical examiners have not meticulously addressed every alleged symptom and its impact over the entire claim period. Specifically, the record is relatively sparse as to the nature of these reported symptoms of passive suicidal ideation and hallucinations, and their discrete impacts on the Veteran's functioning. The Board cannot adequately address the discrete impacts of these reported symptoms absent adequate evidence. The VA may only consider independent medical evidence to support its findings and is not permitted to base decisions on its own unsubstantiated medical conclusions. See Colvin v. Derwinski, 1 Vet. App. 171, 175 (1991). Accordingly, the Board must remand the claim for an examiner to retrospectively address the discrete impacts of these symptoms on the Veteran's functioning over the rating period in question. The matter is REMANDED for the following actions: 1. Obtain a records-based psychological examination to address retrospectively the impacts of the Veteran's passive suicidal ideation, and, separately, the impacts of the Veteran's inconsistently reported auditory and visual hallucinations, on her social functioning and her work or occupational functioning during the claim period between June 2011 and October 2016. Her auditory hallucinations may be noted to be reflected by her statements in January 2011 and May 2012, and her visual hallucinations by her statement in December 2012 (reporting seeing bugs on walls), while the examiner should also note that she denied auditory and visual hallucinations upon examination. The claims file should be thoroughly reviewed for this examination. If any additional tests or studies are necessary, these should be obtained; and if an in-person examination is found to be necessary to address these retrospective questions, this should also be obtained. The examiner should provide complete explanations, supported by evidence and medical knowledge, for the examiner's opinions. (Continued on the next page) 2. Thereafter, readjudicate the appealed claim. L. CHU Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Schechter 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.