Citation Nr: 21065515 Decision Date: 10/26/21 Archive Date: 10/26/21 DOCKET NO. 15-42 502A DATE: October 26, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disorder is remanded. REASONS FOR REMAND The Veteran had two periods of active duty for training (ACDUTRA) with the U.S. Marine Corps Reserves from May 29, 1996 to August 17, 1996 and from June 16, 1997 to August 16, 1997. The Veteran was also stationed at Fort Sherman in Panama from May 29, 1998 to June 12, 1998 presumably on ACDUTRA although there is no Certificate of Release or Discharge for this period. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a July 2013 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Board remanded the matter in April 2019 and May 2021, and it has been returned for further appellate review. Unfortunately, remand is again required. 1. Entitlement to service connection for an acquired psychiatric disorder is remanded. This matter is remanded to secure an adequate medical opinion on the etiology of the claimed psychiatric disorder. Where VA provides the veteran with an examination in a service connection claim, the examination must be adequate. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). The VA opinion of record is unclear regarding the Veteran's dates of service and the onset of schizophrenia, and the examiner provided an insufficient rationale regarding the etiology of schizophrenia. The Veteran asserts that schizophrenia had onset during a period of ACDUTRA. By way of background, the service treatment records (STRs) and service personnel records (SPRs) show that on a September 1995 questionnaire the Veteran reported using cannabis 5 times prior to entrance into service. The December 1995 entrance examination did not note any psychiatric abnormality, to include any personality deviation. The Veteran was disciplined for insubordination in August 1998, and afterwards was noted to have consistent unsatisfactory participation. The Veteran did not receive any ACDUTRA points from December 27, 1998 onward, and there is no other evidence of any periods of ACDUTRA after June 1998. Private treatment records show the Veteran was hospitalized at a psychiatric center in May 1999 and the diagnoses advanced were psychosis not otherwise specified, depressive disorder not otherwise specified, and antisocial personality disorder. May 2000 correspondence from a private mental health provider shows the Veteran was diagnosed with schizophrenia, and the Veteran's mother forwarded this letter to the U.S. Marine Corps. The Veteran was discharged from the Reserves in December 2000 due to schizophrenia. March 2006 private medical records document the Veteran's mother's testimony that the Veteran's behavior started to change around age 22 when he began to act oddly and was reclusive. He was also carrying firearms in the trunk of his car, and he wore his uniform with full gear while at home. In June 2020 correspondence, the Veteran wrote that schizophrenia began in June 1998 when he was in Panama. At a December 2019 VA examination, the Veteran reported that prior to service, he only drank alcohol on the weekends and used cannabis "a few times." After service, he used alcohol, cannabis, ecstasy, and PCP. That examiner found that schizophrenia first had onset in 1999. Most recently, a June 2021 VA examiner opined that schizophrenia was not etiologically related to the Veteran's period of service. In support of that opinion, the examiner found that the Veteran had symptoms of schizophrenia in service, but he also had antisocial behaviors and substance abuse prior to service. Thus, the examiner concluded the schizophrenia was more likely than not related to his history of substance use that preceded military service. The examination report contains notations that the Veteran's report of pre-military substance abuse was unclear. The report also notes the Veteran experienced paranoid ideation and auditory hallucinations during service, he was hospitalized for 4 months during service, and that the onset of his psychotic symptoms was concurrent with his use of PCP and cannabis. The opinion is inadequate because the examiner does not appear to have only considered the dates of the Veteran's ACDUTRA when providing their opinion, as the Veteran did not have ACDUTRA after June 1998. The examiner also failed to adequately address medical and lay evidence indicating the Veteran did not have a significant substance abuse problem prior to service but did have a substance abuse problem after June 1998. This is particularly significant as the Veteran has asserted his symptoms began around June 1998. For these reasons, the June 2021 opinion is inadequate, and remand is required for an addendum. The matters are REMANDED for the following action: 1. After any additional records are associated with the claims file, obtain an addendum opinion regarding the etiology of the claimed psychiatric disorder from a VA examiner. The entire claims file must be made available to and be reviewed by the examiner. If an examination is deemed necessary, it shall be provided. An explanation for all opinions expressed must be provided. (a.) The examiner must provide an opinion regarding whether it is at least as likely as not (50 percent or greater probability) that a psychiatric disorder had onset in, or is otherwise related to the following periods of service only: May 29, 1996 to August 17, 1996, June 16, 1997 to August 16, 1997, and May 29, 1998 to June 12, 1998. (b.) The examiner's attention is directed to the following: 1) the September 1995 SPR and December 2019 VA examination report noting that prior to service the Veteran only had limited alcohol and cannabis use; 2) the Veteran's assertion that symptoms of schizophrenia first had onset in June 1998 during a qualifying period of service; 3) SPRS showing disciplinary actions beginning in August 1998; and 4) private psychiatric evaluations dated June 1999, February 2000, and March 2006 detailing the onset of the Veteran's symptoms and his history of substance abuse. LAURA COLLINS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Smith, 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.