Citation Nr: 21062350 Decision Date: 10/07/21 Archive Date: 10/07/21 DOCKET NO. 19-35 408 DATE: October 7, 2021 ORDER Entitlement to service connection for acquired psychiatric disorder, to include adjustment disorder with mixed anxiety and depressed mood, is granted. FINDING OF FACT The medical evidence of record as it now stands is in relative equipoise as to whether diagnosed acquired psychiatric disorder, to include adjustment disorder with mixed anxiety and depressed mood, was at least as likely as not incurred during active service or is caused by an event, injury or illness during active service. CONCLUSION OF LAW Resolving reasonable doubt in the Veteran's favor, the criteria for entitlement to service connection for acquired psychiatric disorder, to include adjustment disorder with mixed anxiety and depressed mood, have been met. 38 U.S.C. §§ 1110, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303 (2020). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from January 1961 to February 1981, during part of which service he was deployed to the Republic of Vietnam. Service Connection Service connection will be granted if the evidence demonstrates that a current disability resulted from a disease or injury incurred in active service or that a preexisting injury or disease was aggravated by active service. 38 U.S.C. §§ 1110, 1131 (2012); 38 C.F.R. § 3.303 (a) (2020). Establishing service connection generally requires: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred in or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Entitlement to service connection for acquired psychiatric disorder, to include adjustment disorder with mixed anxiety and depressed mood. As in the Board's previous Remands of this claim, the Board notes again in the service treatment records (STRs) a series of reports by the Veteran, presentations and testing during active service, which include the following. An April 1980 Texas Department EMS Ambulance Activity Report shows the Veteran was seen for a complaint of chest pain. A subsequent April 1980 consultation record shows he had been seen 3 nights prior for acute onset of left-anterior chest pain while watching television, which radiated to his left shoulder, but electrocardiogram (EKG) results were negative. A May 1980 STR shows the Veteran reported a history of intermittent sensation of fluttering in his heart which he felt was caused by anxiety. It was noted to resolve with relaxation. He was to return in 2 months and have a treadmill consultation (stress test) before retirement. The treatment provider suspected he had sinus tachycardia. In July 1980, reported with a chief complaint of anxiety. The treatment provider's impression was anxiety rection, for which he prescribed supporting therapy/relaxation therapy. Based on the Veteran's reports of anxiety, fatigue and leg weakness, he underwent a July 1980 Multistage Treadmill test; however, results were negative. In the October 1980 Report of Medical History for retirement purposes (separation examination), the examiner found the Veteran's psychiatric evaluation to be normal. Nonetheless, the Veteran reported past or current depression or excessive worry. Based on the foregoing active-service evidence, the Board has previously found these various pieces of evidence show mental health issues were either directly raised by the Veteran or clinical testing of body-systems ostensibly unrelated to mental health, such as heart and vascular systems, gave indication of signs and symptoms possibly reflecting the presence of anxiety. The Board in its Remands sought opinions, those produced focused on the absence of determinative evidence based on complaints, treatment and diagnoses, rather than analyzing the above evidence for its direct or implied significance and the Board ultimately found all requested opinions for one reason or another to be inadequate for VA adjudication purposes. A Remand by the Board confers on a claimant, as a matter of law, the right to compliance with the Board's prior remand requests, now as yet unfulfilled. See Stegall v. West, 11 Vet. App. 268 (1998). However, further directing the production of opinions for relevant discussion and analysis of the above evidence would be in effect a waste of resources, as psychiatric professionals apparently have been unable to evaluate adequately the evidence shown during active service and, consequently, the claim is held in equipoise. Therefore, based on the STRs, VA treatment records and VA examination reports, acquired psychiatric disorder, to include adjustment disorder with mixed anxiety and depressed mood, has been established as a current disability showing a causal relationship between that disability and the event, injury or illness occurring in active service. See 38 38 U.S.C. § 1154 (b); Shedden v. Principi, 381 F.3d at 1166-67. Although the July 2018 VA examination for PTSD at the outset stated the Veteran does not have a diagnosis of PTSD which conforms to testing criteria for that disorder, the Veteran nonetheless has provided and the file corroborates competent and credible evidence of the incurrence during active service of acquired psychiatric disorder, to include adjustment disorder with mixed anxiety and depressed. For these reasons and resolving reasonable doubt in the Veteran's favor, the Board finds evidence for service connection for this claim to be in equipoise and the claim is therefore granted. See 38 U.S.C. § 5107 (2012); 38 C.F.R. § 3.102 (2020). EMILY TAMLYN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board P. Franke, Associate 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.