Citation Nr: 21068717 Decision Date: 11/12/21 Archive Date: 11/12/21 DOCKET NO. 18-24 329 DATE: November 12, 2021 REMANDED Entitlement to service connection for a psychiatric disorder, to include posttraumatic stress disorder (PTSD) and bipolar disorder (claimed also as manic depression) is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from March 1979 to March 1982, to include over 2 years of foreign service. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a rating decision issued in September 2014 by a Department of Veterans Affairs (VA) Regional Office (RO). The Board previously denied the Veteran's claim for service connection for a psychiatric disorder in a June 2019 decision. The Veteran appealed the denial of that issue (and others) to the Court of Appeals for Veterans Claims (Court). In a September 2020 Memorandum Decision, the Court vacated the Board's denial of the Veteran's claim for service connection for a psychiatric disorder, while affirming the denial of the Veteran's other service connection claims. Thus, the issue of entitlement to service connection for a psychiatric disorder remains the only issue on appeal. Following the memorandum decision, the Board remanded this issue in a June 2021 remand. The issue has now returned to the Board. 1. Entitlement to service connection for a psychiatric disorder, to include posttraumatic stress disorder (PTSD) and bipolar disorder (claimed also as manic depression) is remanded. The Veteran asserts that he is entitled to service connection for a psychiatric disorder. Essentially, the Veteran contends that he currently suffers from a psychiatric disorder related to his witnessing an explosion while stationed in Germany. The Veteran contends that he was teased after this explosion for losing control of his bladder, and that the combined effects of these incidents resulted in his claimed psychiatric disorder. In the previous June 2021 Board remand, the issue of entitlement to service connection for a psychiatric disorder was remanded to obtain a new VA examination. In July 2021, the Veteran appeared for his VA examination and the examiner opined that the Veteran's bipolar disorder was less likely than not related to his military service, to include witnessing a bomb explosion. The examiner explained that the Veteran's in-service emotional issues (specifically him getting into fights and receiving Article 15s) stemmed from being teased by other soldiers for involuntarily losing control of his bladder when he witnessed a bomb explosion. The examiner concluded by stating that the Veteran's bipolar disorder is more likely due to post-military stressors and excessive Stimulant Use Disorder which has been in remission in recent years. The opinion obtained, though fairly comprehensive, gives the Board pause. In essence, the VA examiner attributed the Veteran's current disorder to his post-service drug use and other stressors rather than the Veteran's claimed in-service incidents. However, when answering whether the Veteran's current disorder is related to his active service, the examiner stated that the Veteran's currently diagnosed "disorders are not more likely than not mostly due to in-service stressors." While there is no "reasons and bases" requirements for examiners as there is for the Board, the use of this language presents a question as to whether the examiner applied the proper legal framework. The question is ultimately whether the Veteran's current disability is "at least as likely as not" related to his active service, rather than whether it is more likely or mostly as likely. Further, though the examiner attributed the Veteran's current diagnosed disorders to his post-service drug use, the examiner stated that the Veteran's "development of a serious problem with stimulant use (crack cocaine) can also be best viewed as willful misconduct and not mostly due to in-service stressors." Again, the language employed here makes it unclear as to whether the examiner made this determination consistent with the framework guiding veterans benefits. For these reasons, the Board finds the opinion to be inadequate. As the examination itself appears to be complete and based on an adequate review of the Veteran's history and the in-person examination, the Board is not concerned with the underlying results of that examination. Accordingly, the Board must remand this matter in order that a new, adequate examination be obtained. The matters are REMANDED for the following action: Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's psychiatric disorder is at least as likely as not related to his military service. Only schedule the Veteran for an examination if the examiner deems it necessary to address the questions posed by the Board. Whether or not an examination is performed, the examiner is to answer the following questions: (a) Is it at least as likely as not (a 50 percent or greater probability) that the Veteran's currently diagnosed psychiatric disorders had their onset during or are otherwise related to the Veteran's active service, to include his claimed witnessing of an explosion and his claimed conflicts with other soldiers? (b) If the examiner finds that the Veteran's current psychiatric disorders are more likely due to his post-service drug use, then state whether the Veteran's drug use was attributable to any psychiatric disorder or symptoms stemming from his active service? To put it another way, did the Veteran use drugs as a result of a psychiatric disorder incurred during his active service, or because of symptoms related to any incident from his active service. In answering these questions, the examiner is asked to use the language governing veterans benefits, specifically as to whether "it is at least as likely as not" that the Veteran's psychiatric disorders are related to his active service. The examiner must consider and discuss the Veteran's statements regarding his psychiatric history, and provide a complete rationale for any findings made. Evan M. Deichert Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. K. Hall, 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.