Citation Nr: 21066428 Decision Date: 11/01/21 Archive Date: 11/01/21 DOCKET NO. 15-27 537 DATE: November 1, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD) and a depressive disorder, is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Army from January 2008 to June 2011, to include service in Iraq. He also had service in the Army National Guard, to include a period of active duty for training from September 2006 to July 2007. His decorations include the National Defense Service Medal, the Global War on Terrorism Service Medal, and the Iraq Campaign Medal with Campaign Star. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a November 2013 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in San Juan, Puerto Rico. The issue on appeal was previously before the Board in July 2018 and April 2020, when it was remanded to the agency of original jurisdiction (AOJ) for additional development. On both occasions, after taking further action, the AOJ confirmed and continued the prior denial and returned the case to the Board. Although the Board sincerely regrets the additional delay, another remand is necessary to ensure that there is a complete record upon which to decide the Veteran's claim and to ensure compliance with the prior remand directives. See Stegall v. West, 11 Vet. App. 268 (1998). Entitlement to service connection for an acquired psychiatric disorder is remanded. The Veteran contends that he has an acquired psychiatric disorder, to include PTSD and depressive disorder, due to events that occurred during service. In the April 2020 remand, the Board directed the AOJ to obtain a new VA examination to determine the nature and etiology of the Veteran's acquired psychiatric disabilities, to include PTSD and depressive disorder. The Veteran was provided a VA examination in September 2021. The examiner found that the Veteran did not meet the criteria for a diagnosis of PTSD but confirmed a diagnosis of substance-induced mood disorder and a history of cocaine/cannabis use disorder. In March 2014, the Veteran was hospitalized for three days due to worsening mood and anxiety symptoms, as well as self-harm ideas. See July 2014 VA treatment records. The Veteran reported using substances to control symptoms related to his PTSD, to include panic attacks, flashbacks, and nightmares. He reported sleep disturbances, being isolated and avoiding crowds. On discharge, he was diagnosed with PTSD, alcohol use disorder, cocaine use disorder, and cannabis use disorder. Under applicable law, even though the Veteran may not have had a diagnosis of PTSD at the time of the September 2021 examination, he can still be service connected for the condition if he had the disability at any time during the pendency of his claim, even if the condition has since resolved. See McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). The examiner did not reconcile his conclusions with the fact that the Veteran had been diagnosed with PTSD by other VA care providers during the period on appeal. As noted above, pursuant to the April 2020 remand, the Board directed the AOJ to determine the nature and etiology of the Veteran's depressive disorder. The examiner offered no opinion as to whether the Veteran had a depressive disorder, and thus did not opine if a depressive disorder was related to service. Significantly, a depressive disorder was noted during service. See April 2011 Service Treatment Record. Because the opinion provided is not entirely responsive to the Board's remand directives, additional development is necessary. See, e.g., Barr v. Nicholson, 21 Vet. App. 303, 311 (2007) (once VA has provided an examination, it is required to provide an adequate one, regardless of whether it was legally obligated to provide an examination in the first place). This matter is REMANDED for the following action: 1. Obtain copies of records pertaining to any VA treatment the Veteran has received since the time that such records were last procured, following the procedures set forth in 38 C.F.R. § 3.159. The evidence obtained, if any, should be associated with the record. 2. Arrange to provide the record on appeal to the VA examiner who previously offered opinions with respect to the Veteran's acquired psychiatric disability in September 2021. The examiner should be asked to again review the record and indicate whether it is at least as likely as not (i.e., whether it is 50 percent or more probable) that the Veteran met the DSM-5 diagnostic criteria for PTSD at any time since February 2012 (when his most recent claim for service connection was received). If it is the examiner's opinion that it is unlikely that the Veteran met the DSM-5 criteria for PTSD during that time, the examiner should reconcile that conclusion with the fact that the Veteran was contemporaneously diagnosed with PTSD by other VA care providers during that same time frame. Conversely, if it is the examiner's opinion that it is at least as likely as not that the diagnostic criteria for PTSD were met, the examiner should provide an opinion as to whether it is also at least as likely as not that PTSD is attributable to a verified in-service stressor, to include the Veteran's participation in combat. If the examiner finds that the Veteran met the DSM-5 criteria for psychiatric disorders other than PTSD during the appeal period, including a depressive disorder, the examiner should provide a further opinion, with respect to each such disorder, as to whether it is at least as likely as not that the disorder had its onset in, or is otherwise attributable to, service. In so doing, the examiner should comment on the medical significance, if any of the fact that the Veteran's service treatment records in an April 2011 report indicate a diagnosis of depression. If the September 2021 examiner is no longer employed by VA or is otherwise unable to provide the opinion(s) requested, arrange to obtain the requested information from another qualified examiner. The need for another examination and/or telephonic or video interview of the Veteran is left to the discretion of the examiner selected to offer the requested opinions. A complete medical rationale for all opinions expressed must be provided. 3. After completing the above, and any other development as may be indicated by any response received as a consequence of the actions taken in the preceding paragraphs, the issues on appeal should be readjudicated based on the entirety of the evidence. If any benefit sought remains denied, the Veteran and his representative should be issued a supplemental statement of the case. An appropriate period of time should be allowed for response. DAVID A. BRENNINGMEYER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Joseph T. Leonard, 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.