Citation Nr: 21071752 Decision Date: 12/01/21 Archive Date: 12/01/21 DOCKET NO. 11-13 052 DATE: December 1, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD) and major depressive disorder, is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1964 to December 1968. The matter comes before the Board of Veterans' Appeals (Board) on appeal from an April 2010 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). In March 2017, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A copy of the proceeding is associated with the claims file. Subsequently, the Board remanded the matter for further development in August 2017, March 2020, February 2021, April 2021, and July 2021. Service Connection for an Acquired Psychiatric Disorder The Veteran contends that his acquired psychiatric disorder is related to service. Alternatively, he contends that his acquired psychiatric disorder is secondary to his service-connected tinnitus. See December 2020 VA examination. The Board regrets further delay, but additional development is necessary before the matter can be adjudicated. Specifically, the Board finds that remand is required in order to obtain an adequate VA medical opinion that addresses secondary service connection. Where VA provides a veteran with an examination in a service connection claim, the examination and medical opinion must be adequate. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). The Board has previously found that the February 2021 and May 2021 VA medical opinions regarding secondary service connection are inadequate as the examiner improperly based his conclusions on the Veteran's assertions that his depression may have multiple causes. Additionally, the Board noted that the examiner appeared to dismiss the current diagnosis of depression on the basis that the Veteran previously denied depression while seeking medical treatment in 2018, 2019, and 2020. Pursuant to the Board's July 2021 remand directives, the Veteran was afforded a VA examination in August 2021, in which he was diagnosed with major depressive disorder with anxious distress. The examiner opined that the Veteran's acquired psychiatric disorder was less likely than not proximately due to or aggravated by his service-connected tinnitus. He reasoned that the Veteran's tinnitus had its onset in the 1960s and his psychiatric symptoms began in the early 2000s. He concluded that there is no relationship between the Veteran's psychiatric presentation and tinnitus as there is a lack of plausibility of explanation, temporal association, or dose response curve. The Board finds that the August 2021 examiner failed to provide adequate rationale for his conclusion that the Veteran's acquired psychiatric disorder is not secondary to his service-connected tinnitus. As there is no adequate medical opinion regarding secondary service connection on which to adjudicate the matter, the Board finds that remand is necessary to obtain an addendum medical opinion. The matter is REMANDED for the following action: 1. Obtain updated VA treatment records. 2. Thereafter, forward the claims file to a qualified medical professional to obtain a medical opinion regarding the nature and etiology of the Veteran's major depressive disorder. If the examiner determines that another physical examination is necessary, such an examination should be scheduled. Following a review of the claims file, the examiner is asked to opine as to the following: a) Is it at least as likely as not (a 50 percent or greater probability) that the Veteran's major depressive disorder is proximately due to, the result of, his service-connected tinnitus? b) Is it at least as likely as not (a 50 percent or greater probability) that the Veteran's major depressive disorder has been aggravated beyond normal progression by his service-connected tinnitus? A complete rationale must be provided for all opinions expressed. Nathaniel J. Doan Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Robinson, 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.