Citation Nr: 21062676 Decision Date: 10/08/21 Archive Date: 10/08/21 DOCKET NO. 19-02 065 DATE: October 8, 2021 ORDER Entitlement to service connection for breast cancer is withdrawn. REMANDED Entitlement to service connection for an acquired psychiatric condition is remanded. FINDING OF FACT In December 2020, prior to the promulgation of a decision in the appeal, the Board received notification from the Veteran that a withdrawal of the appeal for entitlement to service connection for breast cancer is requested. CONCLUSION OF LAW The criteria for withdrawal of an appeal by the Veteran is met. 38 U.S.C. § 7105; 38 C.F.R. § 19.55. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served in the United States Army from September 1982 to March 1983, August 1990 to July 17, 1992, and from August 1992 to February 1994. The Veteran also served in the National Guard. In December 2020, the Veteran testified at a Board hearing. The transcript is of record. The issues have been recharacterized to comport with the evidence of record. The issue of entitlement to service connection for bipolar disorder and/or posttraumatic stress disorder (PTSD) has been recharacterized as service connection of a psychiatric disorder in accordance with Clemons v. Shinseki, 23 Vet. App. 1 (2009). 1. Entitlement to service connection for breast cancer The Board may dismiss any appeal which fails to allege specific error of fact or law in the determination being appealed. 38 U.S.C. § 7105. An appeal may be withdrawn as to any or all issues involved in the appeal at any time before the Board promulgates a decision. 38 C.F.R. § 19.55. Withdrawal may be made by the appellant or by his or her authorized representative. Id. In the present case, the Veteran, with her authorized representative present at the December 2020 hearing stated that she is dropping the claim for entitlement to service connection for breast cancer and specified understanding of the consequences. As such, the claim is withdrawn and there remain no allegations of errors of fact or law for appellate consideration. Accordingly, the Board does not have jurisdiction to review the appeal and it is dismissed. REASONS FOR REMAND 1. Entitlement to service connection for acquired psychiatric condition The VA has a duty to assist, which includes providing a medical examination when necessary to make a decision on a claim. 38 C.F.R. § 3.159(c)(4)(i) (2017). The record contains sufficient evidence to trigger the VA's duty to assist by providing a VA examination. However, a VA examination to discuss the nature and etiology of the Veteran's psychiatric condition has not been provided. Therefore, a remand for VA examination and opinion to determine the etiology of any diagnosed psychiatric condition is warranted. See McLendon v. Nicholson, 20 Vet. App. 79 (2006). The Board notes that the evidence of record includes a private medical opinion from treating psychiatrist Dr. A.S. who opined that it is more likely than not that military service was a contributing factor to the Veteran's diagnosis of bipolar disorder type I and PTSD. Dr. A.S. noted that the Veteran had been her patient since February 2016 and was diagnosed with bipolar disorder in 2000 when hospitalized during annual training. However, Dr. A.S. failed to provide a rationale to support the opinion. A medical examination report must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. See Nieves- Rodriguez v. Peake, 22 Vet. App. 295 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). As such, this opinion is inadequate and a remand is necessary for further development. The matters are REMANDED for the following action: 1. Obtain updated VA and/or private treatment records. If such records are unavailable, the Veteran's claim file must be clearly documented to that effect and the Veteran notified in accordance with 38 C.F.R. § 3.159(e). 2. Schedule the Veteran for a VA examination with a VA psychiatrist or psychologist to determine the nature and etiology of any acquired psychiatric disorder. The claims file should be made available to the examiner in conjunction with the examination. Any medically indicated tests should be accomplished, and all pertinent symptomatology and findings must be reported in detail. The examiner should list all psychiatric disorders present during the time period of the claim. With regard to each identified acquired psychiatric disorder present during the claim, the VA examiner should provide an opinion as to whether it is at least as likely as not (50 percent probability or more) that any diagnosed psychiatric disorder originated during or is otherwise etiologically related to the Veteran's military service. If PTSD is diagnosed, the specific stressors giving rise to the condition must be identified. In providing the requested opinions, the examiner is advised that the term "at least as likely as not" does not mean within the realm of possibility, but that the weight of medical evidence both for and against a conclusion is so evenly divided that it is medically sound to find in favor of causation as to find against causation. The examiner must consider and address the following: 1) the Veteran's statements and testimony that she was awake for 10 days straight and felt like she was having a breakdown during her annual training for National Guard See Correspondence December 2020; 2) the buddy statements describing the Veteran as acting out of character and being admitted to the hospital; 3) the articles linking sleep loss and bipolar disorder See Correspondence June 2018 and Medical Treatment Record Non-Government Facility; and 3) the private medical records reflecting the Veteran's admission and diagnosis in July 2000. If the medical professional cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation for why an opinion cannot be rendered. In so doing, the medical professional shall 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). G. A. WASIK Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. A. Prinsen 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.