Citation Nr: A21018158 Decision Date: 11/12/21 Archive Date: 11/12/21 DOCKET NO. 191002-35673 DATE: November 12, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disability is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1983 to October 1983. A rating decision was issued under the legacy system in October 2014. In May 2018, the Veteran opted into the modernized review system, also known as the Appeals Modernization Act (AMA), by submitting a Rapid Appeals Modernization Program (RAMP) election form and selecting the supplemental claim lane. The agency of original jurisdiction (AOJ) issued a RAMP supplemental claim decision in January 2019. In January 2019, the Veteran submitted a VA Form 21-4138, RAMP Selection and requested a Higher-Level Review (HLR) of the January 2019 RAMP supplemental claim decision. In May 2019, the agency of original jurisdiction (AOJ) issued the HLR decision on appeal, which considered the evidence of record at the time of the prior January 2019 RAMP supplemental claim decision. In the August 2019 VA Form 10182, Decision Review Request: Board Appeal, the Veteran elected the Hearing docket. The Veteran testified before the undersigned Veterans Law Judge (VLJ) at a Board virtual hearing in June 2021. Therefore, the Board may only consider the evidence of record at the time of the January 2019 RAMP supplemental claim decision on appeal, as well as any evidence submitted by the Veteran or his representative at the hearing or within 90 days following the June 2021 hearing. 38 C.F.R. § 20.302(a). Entitlement to service connection for an acquired psychiatric disability is remanded. The issue of entitlement to service connection for an acquired psychiatric disability is remanded to correct a duty to assist error that occurred prior to the January 2019 decision. The AOJ obtained an October 2013 medical opinion prior to the January 2019 decision. However, this medical opinion does not provide an adequate rationale regarding whether the Veteran's acquired psychiatric disability had its onset during service or is otherwise related to service as it used the wrong legal standard. Specifically, the October 2013 VA examiner opined that it was less likely than not that the Veteran's schizoaffective disorder was incurred in or caused by service, as it was preexisting condition, and there was no evidence that the preexisting condition was aggravated by service. However, the Veteran's January 1983 psychiatric examination upon entrance to service was normal. As such, the presumption of soundness attaches and the correct legal standard is whether it is clear and unmistakable that the condition preexisted service, and if so, whether it is clear and unmistakable that such was not aggravated by service. The Board notes that in February 2014, the Veteran submitted a letter dated in January 2014 from his treating VA clinician in which the clinician indicated that the Veteran's symptoms prior to service were more consistent with attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder and that it was possible that the Veteran's schizoaffective disorder was a result of service or possibly aggravated by service. However, similar to the October 2013 VA opinion, this opinion also did not use the correct legal standard and also used speculative language. Therefore, the Board finds that the February 2014 letter is not sufficient to establish service connection. A remand to obtain an addendum opinion as to the nature and etiology of the Veteran's acquired psychiatric disorder is required. The matter is REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician as to the Veteran's acquired psychiatric disability, diagnosed as schizoaffective disorder. The examiner must review the claims file. An in-person examination is not necessary unless deemed so by the examiner. The examiner is asked to provide a response to the following: Did the Veteran's schizoaffective disorder clearly and unmistakably (undebatable) preexist the Veteran's service? If the examiner finds that the Veteran's schizoaffective disorder did clearly and unmistakably preexist service, was it clearly and unmistakably not aggravated by service? If the examiner finds that the Veteran's schizoaffective disorder either did not clearly and unmistakably preexist service or was not clearly and unmistakably not aggravated by service, is the Veteran's schizoaffective disorder at least as likely as not related to service? Provide a rationale to support the opinion(s). Although a complete review of the claims file is required, the examiner's attention is drawn to a January 2014 letter from the Veteran's treating VA clinician that the Veteran's symptoms prior to service were more consistent with attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder rather than schizoaffective disorder. K. Parakkal Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Owen, 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.