Citation Nr: 21064758 Decision Date: 10/21/21 Archive Date: 10/21/21 DOCKET NO. 17-48 594 DATE: October 21, 2021 REMANDED A rating in excess of 30 percent for major depressive disorder (MDD). Service connection for a stroke condition. REASONS FOR REMAND The Veteran served on active duty from September 1987 to December 1994. The case is on appeal from a July 2017 rating decision. In September 2017, the Veteran filed a Form 9 limiting the case to the issues of entitlement to a rating in excess of 30 percent for MDD and secondary service connection for a stroke. 1. A rating in excess of 30 percent for MDD. The Veteran contends that he should have a higher rating for his service-connected MDD. He was last afforded a VA examination in May 2017. In his Form 9, the Veteran asserts that he was concerned with the accuracy of the May 2017 VA examination. Additionally, he provided that his MDD may have gotten worse since the May 2017 examination, and that this is reflected in his medical records from the VA Medical Center (VAMC) in St. Louis. Thus, as there is evidence of possible worsening of his MDD since the most recent May 2017 examination, the Board finds that the Veteran should be afforded a new VA examination on remand to determine the severity of his MDD. See Snuffer v. Gober, 10 Vet. App. 400, 403 (1997). 2. Service connection for a stroke condition. Additionally, the Veteran asserts that he suffers stroke as a result of his MDD. Not only is this issue intertwined with the Veteran's aforementioned increased rating claim, but he has not been afforded a VA examination to properly address whether they are related. Harris v. Derwinski, 1 Vet. App. 180, 183 (1991). As such, on remand, a VA examination is warranted with a medical opinion to determine the etiology of the Veteran's strokes. See McLendon v. Nicholson, 20 Vet. App. 79 (2006). In light of the remand, updated VA treatment records should be obtained. The matters are REMANDED for the following action: 1. Obtain VA treatment records dated since September 2021. 2. Schedule the Veteran for a VA examination (or telehealth interview, review of the record, etc. if an in-person examination is not feasible) by an appropriate medical professional to assess the current severity of his service-connected MDD. 3. Thereafter, schedule the Veteran for a VA examination (or telehealth interview, review of the record, etc. if an in-person examination is not feasible) by an appropriate medical professional to determine the nature and etiology of the Veteran's strokes. All necessary tests should be conducted. (a.) The examiner should first identify whether the Veteran has been diagnosed with having strokes. (b.) If so, the examiner should provide an opinion as to: - Whether it is at least as likely as not (a 50 percent probability or greater) that the condition had its onset during, or is otherwise related to, the Veteran's military service; and - Whether it is at least as likely as not (a 50 percent probability or greater) that the condition was caused or aggravated by service-connected MDD. Aggravation is an increase in severity beyond the natural progress of the disease. If aggravation is found, the examiner must attempt to quantify the extent of additional disability resulting from aggravation. A complete rationale should be provided for any opinions expressed. RYAN T. KESSEL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Becton, 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.