Citation Nr: 21064245 Decision Date: 10/19/21 Archive Date: 10/19/21 DOCKET NO. 14-36 902 DATE: October 19, 2021 REMANDED Entitlement to service connection for acquired psychiatric disorder is remanded. REASONS FOR REMAND The Veteran had active military service from January 1991 to April 1991 and from January 1992 to October 1994. This matter comes to the Board of Veterans' Appeals (the Board) following a May 2014 rating decision in which the Agency of Original Jurisdiction (AOJ) denied entitlement to service connection for posttraumatic stress disorder (PTSD). The Veteran and his brother-in-law testified in a hearing before the undersigned Veterans Law Judge in January 2018. A transcript of this hearing is of record. This appeal was most recently before the Board in June 2020 when it was remanded for further development. The AOJ undertook the directed development, and the matter has now returned to the Board for readjudication. 1. Entitlement to Service Connection for Acquired Psychiatric Disorder The Veteran's primary contention is that he has PTSD as a result of his military service in the Philippines in 1991 and 1992. The Veteran was also diagnosed with major depressive disorder in July 2014 and generalized anxiety disorder in October 2015; as such, the Board previously recharacterized the Veteran's claim as entitlement to service connection for any acquired psychiatric disorder pursuant to the holding in Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009). The Veteran received a Department of Veterans Affairs (VA) examination for his PTSD in February 2020. For the reasons to follow, however, the Board concludes that the Veteran's claim must be remanded to obtain an addendum opinion that addresses the Veteran's other psychiatric diagnoses, including major depressive disorder and generalized anxiety disorder, When VA provides an examination, it must ensure that the examination is adequate. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). To be adequate, a medical examination report must contain clear conclusions, supporting data, and a reasoned medical explanation connecting the two. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008). The examination should be based upon consideration of the Veteran's prior medical history and describe the disability and symptoms in sufficient detail to allow the Board to make a fully informed decision. Stefl v. Nicholson, 21 Vet. App. 120, 123 (2007). During the February 2020 VA examination, the examiner opined that a PTSD diagnosis would be warranted if the Veteran's reported in-service stressors are confirmed. To date, VA has been unable to verify these stressors. In addition, the February 2020 examiner stated that if the reported stressors cannot be validated, the Veteran's diagnosis would be major depressive disorder, which would not be related to military service. She did not provide a rationale as to why the Veteran's major depressive disorder is unrelated to his military service. As such, a remand is warranted for an addendum opinion to determine whether it is at least as likely as not that the Veteran's major depressive disorder is related to his military service. The Veteran has also been diagnosed with generalized anxiety disorder. This diagnosis was not addressed in the February 2020 examination report. As no VA examiner has opined on whether the Veteran's diagnosed generalized anxiety disorder is at least as likely as not related to his active military service, the Board cannot make a fully informed decision on the Veteran's claim. An addendum opinion is therefore necessary to address this issue as well. The matter are REMANDED for the following action: Obtain an addendum opinion from the examiner responsible for the February 2020 VA examination report. If the same examiner is not available, the request should be forwarded to an appropriate clinician. The Veteran's claims file must be made available to the examiner. After reviewing the claims file, with any necessary examination and testing, the examiner should address the following: (a.) Identify/diagnose any acquired psychiatric disorder that presently exists or that has existed during the appeal period, to include major depressive disorder and generalized anxiety disorder. The clinical significance, if any, of the VA treatment records showing the Veteran's July 2014 diagnosis of major depressive disorder and October 2015 diagnosis of generalized anxiety disorder should be discussed. (b.) For each psychiatric diagnosis made, state whether it is at least as likely as not that the disorder had its onset during service or is otherwise etiologically related to the Veteran's active service. (c.) The examiner is advised that none the Veteran's claimed stressors have been verified to include those pertaining to engaging with hostile enemy or terrorist forces during the 1991 and/or 1992 Balikatan exercise in the Philippines. (d.) Provide a rationale to support the opinions proffered. MICHAEL A. HERMAN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R.M. Sachs, 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.