Citation Nr: 21068040 Decision Date: 11/08/21 Archive Date: 11/08/21 DOCKET NO. 10-11 261A DATE: November 8, 2021 REMANDED Entitlement to service connection for posttraumatic stress disorder (PTSD), including as secondary to service-connected disabilities, based upon substitution of the Appellant as the Claimant, is remanded. Entitlement to service connection for an acquired psychiatric disability, including depression, including as secondary to service-connected disabilities, based upon substitution of the Appellant as the Claimant, is remanded. REASONS FOR REMAND The Veteran had active duty service from August 1972 to July 1974. He passed away in August 2011 and the Appellant is his surviving daughter. These matters come before the Board of Veterans' Appeals (Board) on appeal from an August 2007 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO), which, in pertinent part, denied service connection for a nervous disability and PTSD. These matters were before the Board in November 2015, at which time they were deferred to obtain evidence determining who was the proper Appellant. In a subsequent September 2019 decision, the RO recognized the current Appellant, K.B., as the valid substitute claimant. If accrued benefits are deemed payable, the benefits will be divided equally among the members of the joint class. The Board notes that the Appellant failed to report to the hearing scheduled in September 2021. Thus, this hearing request has been deemed waived. 1. Entitlement to service connection for posttraumatic stress disorder (PTSD), including as secondary to service-connected disabilities, based upon substitution of the Appellant as the Claimant, is remanded; 2. Entitlement to service connection for an acquired psychiatric disability, including depression, including as secondary to service-connected disabilities, based upon substitution of the Appellant as the Claimant, is remanded. During his lifetime, the Veteran was assessed with PTSD, major depressive disorder, and a personality disorder. He asserted that his psychiatric disabilities commenced in service, including due to bombs on his ship and being denied treatment for his stomach pains. The Veteran's service-treatment records reveal that he was assessed with alcoholism and passive aggressive personality disorder in January and March 1974, respectively. While undergoing therapy for his ulcer disease, it was noted that he became hostile towards the staff. It was "felt" that he had passive aggressive personality existing prior to enlistment and he was recommended for separation from service because of unsuitability. Subsequent treatment records reveal that he was assessed with duodenal ulcer and anxiety reaction in June 1975. He underwent rehabilitation for alcohol and drug abuse in November 1996 and was assessed with dysthymia. The Veteran was afforded a VA examination in February 2009, at which time he was assessed with major depressive disorder. The examiner noted that it was less likely than not that his dysthymia noted in November 1996 was related to his treatment in service. The examiner reasoned that the symptoms treated in service were a manifestation of his personality disorder and alcohol abuse and less likely than not an early manifestation of his current depressive disorder. However, it was likely that his personality disorder was related to his current depressive disorder. After a review of the evidence, the Board finds that the VA medical opinion is insufficient to determine the present claim. In this regard, the examiner failed to acknowledge or discuss the Veteran's PTSD diagnosis. Moreover, although a personality disorder is a congenital or developmental defect, which is not a disease for disability compensation purposes, the Veteran may be awarded service connection for an acquired psychiatric disability that was superimposed on the personality disorder during service. See 38 C.F.R. §§ 3.303(c), 4.9. In the present case, the examiner noted that his personality disorder was related to his current depressive disorder but did not indicate whether his depressive disorder was superimposed on his personality disorder during service. Accordingly, the Board finds that a new medical opinion is warranted on remand. The matters are REMANDED for the following action: Forward the claims file, including a copy of this remand, to an appropriate VA examiner to provide an opinion as to the nature and etiology of the Veteran's psychiatric disabilities prior to his passing. The claims file, including a copy of this remand, should be reviewed and such review should be noted in the examination report. The examiner should discuss any psychiatric disability identified during the pendency of this claim, including depression, PTSD, anxiety, and personality disorder. If the examiner finds that a diagnosis identified in the Veteran's treatment records is not correct, including PTSD, anxiety, and/or depression, the examiner should discuss the proper psychiatric disorder and whether or not any identified psychiatric disorder is a symptom of a separate disorder and/or a separate and distinct disability. For each identified psychiatric disability, the examiner should respond to the following: A. Is it at least as likely as not (probability of at least 50 percent) that the Veteran's psychiatric disability had its onset in and/or is otherwise etiologically related to his period of active service? B. If not directly related, is it at least as likely as not (probability of at least 50 percent) that the Veteran's psychiatric disability was caused and/or aggravated (any incremental increase in disability) by his service-connected disabilities, including any associated pain? If aggravation is found, is there medical evidence created prior to aggravation or between the aggravation and current level of disability that shows a baseline of the psychiatric disability prior to aggravation? C. With regard to any diagnosed personality disorder, is it at least as likely as not (probability of at least 50 percent) that an acquired psychiatric disability was superimposed during service on the personality disorder noted therein? The examiner must provide a comprehensive rationale for each opinion provided. Specifically, the examiner should review and discuss the Veteran's service-treatment records, post-service records, and statements submitted in April and November 2007. The examiner is advised that the Veteran was competent to report his symptoms and history, and such reports are to be considered in formulating any opinion. If any opinion cannot be given without resorting to speculation, the examiner should explain why and state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), the record (additional facts are required), or the examiner does not have the knowledge or training. As appropriate, the AOJ should conduct additional development or supplement the record. Eric S. Leboff Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Merrick 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.