Citation Nr: 21068760 Decision Date: 11/12/21 Archive Date: 11/12/21 DOCKET NO. 14-33 132 DATE: November 12, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disorder to include posttraumatic stress disorder (PTSD), anxiety, and depression and to include as secondary to a service-connected disability to include a total abdominal hysterectomy, and right knee degenerative joint disease, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from May 1980 to June 1984 and from August 1990 to July 1991. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 2014 rating decision issued by the Department of Veteran Affairs (VA) Regional Office (RO). In October 2018, the Board remanded this issue in order to obtain further development to include a VA examination. In July 2020, the Board denied the Veteran's claim for entitlement to service connection for an acquired psychiatric disorder. The Veteran appealed the Board's decision to the United States Court of Appeals for Veterans Claims (Court). In a May 2021 Joint Motion for Remand (JMR), the Court set aside the Board's July 2020 decision and remanded the matters for additional development and adjudication. Entitlement to service connection for an acquired psychiatric disorder to include PTSD, anxiety, and depression and to include as secondary to a service-connected disability to include a total abdominal hysterectomy, and right knee degenerative joint disease, is remanded. The Veteran contends her current psychiatric disorder is related to active-duty service or alternatively as secondary to one of her service-connected disabilities. As noted in the May 2021 JMR, in October 2018, the Board remanded the case in part to obtain a new VA medical examination which included a directive to discuss the August 2001 letter from S.P. stating that the Veteran was significantly inhibited psychologically by chronic pain and whether a hormonal imbalance due to residuals of a hysterectomy could be aggravating her psychiatric diagnoses. A VA examination was obtained in October 2019, however, the examiner failed to discuss the August 2001 letter as directed by the October 2018 remand order. Accordingly, as per the JMR, a new VA examination is warranted to fully comply the with October 2018 remand directives. Stegall v. West, 11 Vet. App. 268, 271 (1998). The matter is REMANDED for the following action: 1. Schedule the Veteran for a VA psychiatric examination with a psychiatrist or psychologist to determine the nature and etiology of any diagnosed acquired psychiatric disorder. The examiner must specify in the report that the records have been reviewed. The examiner is to provide a detailed review of the Veteran's pertinent medical history, current complaints, and the nature and etiology of any diagnosed psychiatric disability. The examiner should then address: (a.) What are the Veteran's current psychiatric diagnoses? If posttraumatic stress disorder is not diagnosed, please discuss why the diagnosis of posttraumatic stress disorder the Veteran has received from her treating VA psychiatrist is rejected. (b.) For every psychiatric disorder diagnosed at any time since 2014, address whether it is at least as likely as not that the disorder is related to the Veteran's active military service. Please specifically address the Veteran's assertions that she has posttraumatic stress disorder or other psychiatric disorder due to being harassed, disrespected, and reduced in rank in service. (c.) For every psychiatric disorder diagnosed, address whether it is at least as likely as not that the disorder was (i) caused or (ii) is aggravated (worsened beyond the natural progression) by the Veteran's service-connected disabilities, which include residuals of a total abdominal hysterectomy with bilateral salpingo-oophorectomy, right and left knee degenerative joint disease, hemorrhoids, and scarring. Please specifically discuss the August 2001 letter from S.P. stating that the Veteran was significantly inhibited psychologically by chronic pain, and whether a hormonal imbalance due to residuals of a hysterectomy could be aggravating her psychiatric diagnoses. A complete and fully explanatory rationale must be provided for any opinion offered. If any opinion cannot be rendered without resorting to speculation, the examiner must state whether the need to speculate is caused by a deficiency in the state of general medical knowledge, i.e., no one could respond given medical science and the known facts, or by a deficiency in the record or the examiner, i.e., additional facts are required, or the examiner does not have the needed knowledge or training. A. S. CARACCIOLO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Laura C. Owens 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.