Citation Nr: 21065656 Decision Date: 10/27/21 Archive Date: 10/27/21 DOCKET NO. 16-43 044 DATE: October 27, 2021 REMANDED Service connection for fatigue, including chronic fatigue, is remanded. A rating higher than 30 percent for posttraumatic stress disorder (PTSD) is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1976 to January 1988. In September 2020, the Veteran testified before the undersigned Veterans' Law Judge; a copy of the transcript is associated with the record. Service Connection for Fatigue The Board regrets additional delay. A March 2021 VA examination and a subsequent May 2021 addendum found that the Veteran does not meet the criteria under 38 C.F.R. § 4.88a to be considered a diagnosis of chronic fatigue syndrome. The examiner, however, did not provide an opinion as to whether the Veteran's diagnosed fatigue was a sign and/or symptom of an undiagnosed illness or medically unexplained chronic multisymptom illness. The Board's November 2020 remand specifically requested such an opinion be obtained. As such, remand is necessary to obtain another addendum opinion regarding the potential link between the Veteran's diagnosed fatigue and his service in Southwest Asia. Higher Rating for PTSD The Board finds that the Veteran's April 2021 VA examination regarding the severity of his PTSD is inadequate. As noted by the Veteran in his September 2021 Informal Hearing Presentation, the VA examination failed to find that the Veteran had PTSD. The Board notes the Veteran has a longstanding diagnosis of PTSD and, as such, finds that a new examination is warranted. The matters are REMANDED for the following action: 1. Obtain an VA examination opinion from the March 2021 and May 2021 examiner regarding the possible link between the Veteran's diagnosed fatigue and his active duty service in Southwest Asia. If that examiner is unavailable, obtain such an addendum opinion from a physician (M.D.) who has not previously examined the Veteran. The examiner must provide an opinion as to whether it is at least as likely as not (50% probability or more) that the Veteran's diagnosed fatigue is a sign and symptom of an undiagnosed illness or medically unexplained chronic multisymptom illness, even if the condition does not meet the criteria for chronic fatigue syndrome for VA purposes 2. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected posttraumatic stress disorder (PTSD). The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran's disability under the rating criteria. The examiner must attempt to elicit information regarding the severity, frequency, and duration of symptoms. To the extent possible, the examiner should identify any symptoms and social and occupational impairment due to PTSD. JOHN Z. JONES Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Parrish, 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.