Citation Nr: 21066243 Decision Date: 10/29/21 Archive Date: 10/29/21 DOCKET NO. 17-57 350 DATE: October 29, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disorder, to include PTSD and generalized anxiety disorder (claimed as panic disorder), is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1966 to January 1968. This matter comes before the Board of Veterans' Appeals (Board) from a May 2016 rating decision of the Department of Veterans Affairs (VA) RO in Salt Lake City, Utah. In April 2019 the Board remanded the claim to obtain an addendum opinion to address the Veteran's generalized anxiety disorder and secondary service connection. 1. Entitlement to service connection for an acquired psychiatric disorder, to include PTSD and generalized anxiety disorder (claimed as panic disorder). The Veteran contends that he is entitled to service connection for an acquired psychiatric disorder, to include PTSD and generalized anxiety disorder, as they are related to his active duty service. He claims that his in-service stressors include participation in activities during his tour in Vietnam that are related to fear of hostile military/terrorist activity, which include observing a fellow serviceman's death in a helicopter crash and mortar attacks. On remand, the Veteran was afforded a VA examination in December 2019. The examiner found that the Veteran's generalized anxiety disorder was less likely than not due to service, and generally concluded it was not due to service-connected disabilities. He also found that the Veteran's panic attacks were in remission without providing an opinion on whether it was due to service, and found that the Veteran did not meet the diagnostic criteria for PTSD. The Board finds the December 2019 VA examination inadequate. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). The examiner did not consider all of the Veteran's mental health diagnoses during the period on appeal. Service connection for a disability can be granted so long as the disability exists at any point during the appeal period. See McClain v. Nicholson, 21 Vet. App. 319 (2007). During the period on appeal (from October 2015), VA treatment records show diagnoses of PTSD, agoraphobia, panic attacks and generalized anxiety disorder. See e.g. December 2016, April 2017 VA Treatment records and December 2019 VA Examination. Moreover, the examiner failed to discuss the Veteran's mental health in relation to his service-connected disabilities and any medications taken therefor, as requested in the April 2019 Board remand. VA treatment records and the Board's April 2019 Board remand document several instances of panic and/or anxiety in relation to the Veteran's physical The matters is REMANDED for the following actions: 1. Update the record for additional VA or private treatment records. The most recent VA treatment records date to December 2019. 2. Schedule the Veteran for an examination by an appropriate clinician to clarify and identify each of the Veteran's mental health diagnosis(es) since the date of the claim (October 2015). The claims file must be reviewed, and the following questions must be addressed: a. Identify all mental health disorders from 2015 forward to include PTSD, generalized anxiety disorder, agoraphobia and a panic disorder currently present or present at any point pertinent to the current claims (even if now asymptomatic or resolved). b. If a diagnosis of PTSD is appropriate, the examiner should, (a) clearly identify the stressor(s) underlying the diagnosis, (specifically addressing the Veteran's reported stressors involving fear of hostile military activity, and discuss whether any such stressor(s) is/are sufficient to support such a diagnosis; and (b) fully explain how the diagnostic criteria are met, to include comment upon the link, if any, between the stressor(s) and the Veteran's symptoms. If the diagnostic criteria for PTSD are not met, the examiner should explain why. The examiner must consider the positive PTSD screening in December 2016. c. For each identified mental health disorder other than PTSD, the examiner should opine as to whether it is at least as likely as not (i.e., a 50 percent probability or greater), that such (i) had its onset during the Veteran's active service; (ii) if a psychosis, was present to a compensable degree within the first post-service year; or, (iii) is otherwise medically-related to the Veteran's period of active service, to include his reported in-service stressors. d. For each identified mental health disorder other than PTSD that is deemed to not be at least as likely as not etiologically related to the Veteran's service on a direct basis, the examiner should also provide an opinion as to whether it is at least as likely as not (i.e., a 50 percent probability or greater) that such disability was caused, or aggravated (made worse) beyond its natural progression by the Veteran's service-connected disabilities, to include medication taken therefor. e. The examiner must consider the lay statements made by the Veteran and others regarding his mental health complaints. MARJORIE A. AUER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Kelsey Love, 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.