Citation Nr: 21070305 Decision Date: 11/23/21 Archive Date: 11/23/21 DOCKET NO. 17-04 608 DATE: November 23, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disorder is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from August 1976 to August 1977. This case comes before the Board of Veterans' Appeals (Board) on appeal of a March 2014 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). In August 2019, the Board reopened the claim, noting that new and material evidence was received after the final June 1995 rating decision. Also, in August 2019, the Board remanded the claim for further development. Again, in August 2021, the Board remanded the claim for further development. Specifically, in the August 2021 Remand, the Board directed the RO to obtain an addendum opinion as to the nature and etiology of the Veteran's claimed acquired psychiatric disorder. In connection with the claim, an addendum opinion, dated August 2021, was obtained. The Board finds that the opinion is inadequate as there was not substantial compliance with the Board's August 2021 Remand directives. Thus, the Board must again remand the claim. 1. Entitlement to service connection for an acquired psychiatric disorder is remanded. The Veteran has stated that while in high school, she "had difficulties in the areas of mental breakdown." See December 1994 Statement in Support of Claim. The Veteran further contended that her mental condition was caused or aggravated by her military service and that she was referred to mental health counseling while on active duty. See January 2017 VA Form 9. As an initial matter, the Board notes that the Veteran's August 1976 Report of Medical Examination, conducted at enlistment, reveals a normal psychiatric assessment. In the August 2019 Remand, the Board found that the presumption of soundness was not rebutted and sought an addendum opinion regarding the etiology of each of the Veteran's diagnosed psychiatric disorders. The December 2019 examiner opined that the Veteran's unspecified personality, anxiety, and depressive disorders were not related to or aggravated by her military service, concluding that the Veteran's disorder is consistent with the natural progression of the disorders under similar circumstances, whether she was active duty or not. However, the examiner's rationale as to the etiology of each disorder did not consider the Veteran's statements included on her VA Form 9, the Veteran's report of multiple sexual assaults while in the military, or her statement that while at the military base she would wake up naked surrounded by alcohol bottles. As such, the Board remanded the claim. In the August 2021 Remand, the Board directed the RO to obtain an addendum opinion as to the nature and etiology of the Veteran's claimed acquired psychiatric disorders from a qualified examiner. The examiner was directed to opine as to whether it was at least as likely as not that such disorder was incurred in or aggravated by military service. In doing so, the examiner was also directed to consider the Veteran's various lay statements. An August 2021 examiner opined that it was less likely than not that the Veteran's psychiatric disorders were incurred in or caused by the claimed in-service injury, event, or illness. Additionally, the examiner opined that the claimed conditions, which clearly and unmistakably existed prior to service, were clearly and unmistakably not aggravated beyond its natural progression by an in-service injury, event, or illness The examiner reasoned that as to the diagnosis of unspecified personality disorder, the Veteran had a borderline personality disorder prior to service and, thus, the disorder was not caused by or incurred in service. As to the Veteran's diagnosis of unspecified anxiety disorder, the examiner noted that it was due to an "unstable childhood home with abuse and safety concerns with exposure to 'violence'" and, therefore, it was not caused by service or reported military sexual trauma. As to unspecified depressive disorder, the examiner noted that, according to the 2019 mental disorder examination, this condition was resolved and not an active diagnosis. The examiner further noted that depression should not have been diagnosed and was "considered to have been diagnosed in error" and therefore, it is not considered to have been caused by service or reported military sexual trauma. The Board finds that the August 2021 opinion is inadequate for several reasons. Here, the August 2021 opinion is mainly a reiteration of the August 2019 opinion, which the Board deemed to be inadequate. Also, the examiner failed to address the Veteran's lay statements, to include that her mental disorder was aggravated by her military service. Additionally, the examiner failed to address the Veteran's lay statements that she experienced sexual assaults while in the military and while at the military base she would wake up naked surrounded by alcohol bottles. Further, the examiner failed to include an opinion as to aggravation. Additionally, the opinion is flawed because the examiner did not adequately explain why the diagnosis of depression made in a February 2014 VA treatment record was in error. McClain v. Nicholson, 21 Vet. App. 319 (2007). The matters are REMANDED for the following action: 1. Obtain an addendum opinion as to the nature and etiology of the Veteran's claimed acquired psychiatric disorders from a psychologist or another appropriate examiner (who has never examined the Veteran). The examiner must review the claims file, including this remand, and if necessary, schedule the Veteran for an in-person examination. After reviewing the relevant evidence, the examiner must address the following: With respect to each psychiatric disorder identified, is it at least as likely as not (50 percent or greater probability) that such disorder was incurred in or aggravated by her military service? As noted above, the examiner is reminded that the presence of a disability at the time of filing of a claim or during its pendency warrants a finding that the current disability requirement has been met, even if the disability resolves prior to the Board's adjudication of the claim unless the examiner determines that the original diagnosis was in error, in which case the examiner should provide a thorough rationale as to why the diagnosis was in error. McClain v. Nicholson, 21 Vet. App. 319 (2007). Also, in providing the above opinion, the examiner must consider each of the Veteran's statements, to include that her mental disorder was aggravated by her military service; that she experienced multiple sexual assaults while in the military; and that she woke up naked surrounded by alcohol bottles while at the military base. 2. Readjudicate the issues on appeal. GAYLE STROMMEN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Hanson 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.