Citation Nr: 21069107 Decision Date: 11/17/21 Archive Date: 11/17/21 DOCKET NO. 15-20 229 DATE: November 17, 2021 REMANDED The service connection claim for an acquired psychiatric disability is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from October 1951 to February 1954. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a January 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office in Guaynabo, Commonwealth of Puerto Rico. In June 2017 and November 2018, the Board remanded the case to the Regional Office for further evidentiary development. After the matter returned to the Board, a January 2021 decision denied the claim. Thereafter, the Veteran appealed this January 2021 Board decision with the United States Court of Appeals for Veterans Claims (Court). In an August 2021 joint motion for partial remand, the parties stipulated that the Board erred when: (1) it failed to ensure compliance with VA's duty to assist after a prior, June 2017 remand; and (2) it failed to provide an adequate statement of reasons and bases for rejecting a May 2014 private opinion that was materially favorable to the Veteran's claim. In an August 2021 Order, the Court adopted the parties' stipulations, and remanded the part of the January 2021 Board decision that denied the service connection claim for an acquired psychiatric disability. As the Veteran did not challenge or appeal the portion of the January 2021 Board decision that denied the service connection claim for bilateral hearing loss, this issue is not subject to reconsideration. In this regard, the Board regrets further delay, as an additional development is required before it may render a fully-informed decision on the sole issue on appeal. In June 2017, the Board remanded the service connection claim for an acquired psychiatric disability for a VA examiner to (1) determine whether it is at least as likely as not that any current psychiatric disability is related to the Veteran's combat service; (2) address a May 2014 private opinion which linked generalized anxiety disorder, major depressive disorder, and PTSD to service; and (3) opine whether it is at least as likely as not that any current psychiatric disability is caused by or aggravated by the Veteran's service-connected traumatic brain injury. After the Veteran was afforded VA examinations in September 2017 and March 2020, both corresponding, September 2017 and March 2017 VA opinions indicated that the Veteran was not diagnosed with traumatic brain injury. However, these findings are inconsistent with other medical evidence of a traumatic brain injury diagnosis. Therefore, these opinions are based on an inaccurate factual premise, and accordingly, they are entirely discounted and cannot be considered in the adjudication of this service connection claim for an acquired psychiatric disability. See Reonal v. Brown, 5 Vet. App. 458, 460 61 (1993) (finding that an opinion that is based on an inaccurate factual premise has no probative value). The matters are REMANDED for the following action: 1. Obtain a new medical opinion on the nexus between the Veteran's acquired psychiatric disability and his active service. The VA examiner must review a complete claims file and must note that review in the report. A copy of this REMAND must also be provided to the VA examiner. The VA examiner must undertake the following: a. For each psychiatric disability that has been diagnosed since the Veteran filed this claim, opine whether it is at least as likely as not (more than 50 percent probability) the pertinent psychiatric disability is the result of an in-service injury, illness or event, especially including his combat service. b. For the post-traumatic stress disorder (PTSD) diagnosis, the VA examiner is advised that the record contains current documentation of PTSD. Therefore, the VA examiner must render an opinion on a link between the current symptomatology and the Veteran's verified combat in service, and/or a fear of hostile military terrorist activity. c. In rendering an opinion, the VA examiner must address the May 2014 private opinion from Dr. Q, which linked generalized anxiety disorder, major depression disease, and PTSD to the Veteran's service. i. If there are any discrepancies with findings or diagnoses in Dr. Q's medical opinion, please identify each discrepancy, and with a clear rationale, explain the reason or reasons for each discrepancy. ii. Also, for each diagnosed psychiatric disability, opine whether it is at least as likely as not that the pertinent psychiatric disability was caused by the Veteran's service-connected traumatic brain injury. iii. Then, for each diagnosed psychiatric disability, also opine whether it is at least as likely as not that the pertinent psychiatric disability was aggravated by the Veteran's service-connected traumatic brain injury. "Aggravation" means an increase in severity of the disorder beyond any medically established baseline. d. A detailed explanation is requested for all opinions provided. M. Tenner Veterans Law Judge Board of Veterans' Appeals Attorney for the Board V-N. Pratt 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.