Citation Nr: 21073082 Decision Date: 12/07/21 Archive Date: 12/07/21 DOCKET NO. 18-35 893 DATE: December 7, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disorder, to include bipolar disorder, unspecified trauma and stressor related disorder, and posttraumatic stress disorder (PTSD), is remanded. Entitlement to an effective date prior to September 28, 2016, for the award of a total disability rating based on individual unemployability (TDIU) due to service-connected disabilities is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1992 to August 1992, from October 1992 to May 1993, and from March 2007 to November 2007. In December 2019, the Board issued a decision denying the Veteran's service connection claim for an acquired psychiatric disorder and an earlier effective date for TDIU. The Veteran appealed the Board's denial decision to the United States Court of Appeals for Veterans Claims (CAVC), resulting in an October 2020 Joint Motion for Partial Remand (JMPR), which vacated the December 2019 Board decision as it pertained to the service connection claim for an acquired psychiatric disorder and an earlier effective date for TDIU, and remanded for re-adjudication consistent with its decision. In March 2021, the claim was remanded for further development. 1. Entitlement to service connection for an acquired psychiatric disorder In its March 2021 decision, the Board directed the agency of original jurisdiction (AOJ) to obtain an addendum VA medical opinion to adequately address the theory of presumption of soundness prior to readjudication of the claim. Specifically, community mental health records associated with the claims file suggested that the onset of the Veteran's bipolar disorder dated back to 1989. Additionally, in a July 2017 VA medical opinion, the VA examiner suggested that the Veteran's psychiatric disorders had onset before he joined the service and were attributable to his childhood abuse and/or were a genetic/organic condition. Furthermore, in an April 2018 medical opinion, Dr. F.N., a private examiner, opined that the Veteran's mental problems preexisted his military service and were aggravated more than normal by his military service. After the Board's March 2021 decision, the Veteran submitted correspondence from the community mental health provider referred to in the March 2021 Board decision that identified a discrepancy in the Veteran's medical records regarding the date of onset of his mental health disorder. Dr. V.K. confirmed that the date of onset as reported by the Veteran had been transposed in the Veteran's medical records as 1989 when, in fact, onset was reported to have begun in 1998. The April 2021 letter indicated that it was to serve as evidence that the clinician transposed numbers and that the Veteran's medical record had been amended to reflect a reported date of 1998 rather than 1989. The Veteran underwent VA examination in July 2021. However, the Board finds that the obtained addendum opinion is inadequate for claims purposes. Initially, it is noted that the VA examiner used the incorrect standard equipoise when providing her opinion as to whether the Veteran's acquired psychiatric disorder preexisted the Veteran's service. The opinion was also partially based on an inaccurate factual premise as the examiner referenced the 1989 onset date when supporting her conclusions without acknowledging that the claims file contained evidence that this date had been corrected to 1998. Further, the VA examiner noted that she had neither the July 2017 VA opinion nor the April 2018 private medical opinion to review although she referenced the July 2017 VA opinion to support her rationale. Thus, to ensure an adequate record upon which to adjudicate the Veteran's claims, he should be afforded a new examination that addresses the issues raised. 2. Entitlement to an effective date prior to September 28, 2016 for the award of a TDIU is remanded. As development of the Veteran's disability claim before the Board may have an impact on his TDIU claim, the Board finds these issues are inextricably intertwined. Harris v. Derwinski, 1 Vet. App. 180 (1991). Accordingly, the Board will defer adjudication of the inextricably intertwined TDIU claim at this time. The matters are REMANDED for the following action: 1. The Veteran should be afforded a VA psychiatric examination that addresses the nature and etiology of his acquired psychiatric disorders. The entire claims file, including a copy of this remand, must be made available to the examiner, and note review of the record in the examination report. Any indicated tests or studies should be performed, and all material relevant evidence should be discussed. All pertinent medical complaints, symptoms, and clinical findings must be reported in detail. Following a review of the entire record, the examiner should address the following questions: a) Identify and clearly describe all diagnoses related to the Veteran's acquired psychiatric disorder, to include bipolar disorder, unspecified trauma and stressor related disorder, and PTSD. If PTSD is diagnosed, the stressor(s) to support such diagnosis must be identified. If a diagnosis of PTSD is not found, the examiner must explicitly state so and provide discussion/opinion on the determination in change of diagnosis from that reflected in the April 2018 private examination. b) For all disabilities identified, is it clear and unmistakable (obvious/undebatable) that such existed prior to his entrance into any period of active duty service? Please note that the examiner must opine as to all active duty periods, and must discuss the July 2017 VA medical opinion and the April 2018 private medical opinion suggesting/noting a preexisting condition. The examiner is reminded that the Veteran's medical records have been corrected to reflect a reported date of onset of 1998. c) If it is clear and unmistakable that the Veteran's psychiatric disorder existed prior to any period of service, is it clear and unmistakable (obvious/undebatable) that the preexisting psychiatric disorder(s) did NOT undergo an increase in severity beyond the natural scope of the disability during any period of his active duty service. d) If the answer to either question b) or c) is "NO," then assume as true that the disability did not pre-exist service. With this understanding, is it at least as likely as not (i.e., a 50 percent or greater probability) that the disability had its onset in, or is otherwise related to any period of active duty service? The examiner is asked to consider and reconcile any conflicting medical evidence or opinions of record. In offering any opinion, the examiner must consider the full record, to include the lay statements regarding in-service and continuity of symptomatology. A clearly-stated rationale for any opinion offered should be provided. The examiner is advised that the Veteran is competent to report symptoms, and that his reports must be considered in formulating the requested opinion. 2. After the above development, and any additionally indicated development, has been completed, readjudicate the issues on appeal. James Springer Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board L. Bristow Williams, 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.