Citation Nr: 21074568 Decision Date: 12/15/21 Archive Date: 12/15/21 DOCKET NO. 17-51 352 DATE: December 15, 2021 ORDER Entitlement to a depressive disorder due to service-connected torn right meniscus (knee disability) and service-connected lumbar moderate endplate spurring (back disability) is granted. FINDING OF FACT The depressive disorder is related to the service-connected knee and back disabilities. CONCLUSION OF LAW The criteria for service connection for a depressive disorder, to include as secondary to service-connected back and knee disabilities, have been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from September 1988 to February 1990. This case comes before the Board of Veterans' Appeals (Board) on appeal from a September 2016 rating decision of the Department of Veteran Affairs (VA) Regional Office (RO). This issue was previously before the Board in March 2019, when it was remanded for further development. That development was completed, and the case has since been returned to the Board for appellate review. Entitlement to service connection for a depressive disorder is granted. The Veteran alleges that his depressive disorder is related to his service-connected back and knee disabilities. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Service connection may also be granted on a secondary basis for disability which is proximately due to or the result of service-connected disease or injury, or for additional disability resulting from the aggravation of a nonservice-connected disability by a service-connected disability. 38 C.F.R. § 3.310 (2018); Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc). First, the Board finds that there is a current disability. See Holton, 557 F.3d at 1366; 38 C.F.R. § 3.303(d). The Veteran submitted a May 2016 private disability benefits questionnaire (DBQ) that identified a diagnosis of a depressive disorder due to chronic pain syndrome with major depressive episodes. The Veteran underwent a VA examination in July 2016 where a diagnosis of unspecified anxiety disorder was noted. And a February 2020 VA DBQ provided diagnoses of generalized anxiety disorder and panic disorder with agoraphobia. Accordingly, the first element of service connection is met. Second, the Board finds that the record is at least in equipoise as to whether the Veteran's diagnosed depressive disorder was caused or aggravated by his service-connected torn right meniscus and lumbar moderate endplate spurring. In this regard, the May 2016 examiner opined that it is more likely than not that the depressive disorder is a continuation of the service-connected back and right knee disabilities. The examiner explained that the Veteran has a symptomatology consistent with a depressive disorder and a chronic pain disorder which is secondary to the service-connected conditions. The examiner noted that she relied on the interview with the Veteran, as well as a review of the medical record, a recent mental health evaluation, chronic pain assessments, the Veterans Health Administration (VHA) pain primer literature, other contemporaneous chronic pain medical literature, and a diagnostic and statistical manual of mental disorders. The Board notes that there are negative etiological opinions of record. However, these opinions only addressed other diagnoses of anxiety disorder and agoraphobia. To the extent they did not provide an opinion regarding the diagnosed depressive disorder, they are afforded lesser probative value. The Board notes that the requirement for service connection that there be a current disability is satisfied when the disability is shown at the time of the claim or during the pendency of the claim, even though the disability subsequently resolves. McClain v. Nicholson, 21 Vet. App. 319 (2007). The May 2016 DBQ provided a current diagnosis of a depressive disorder. May 2017 VA treatment records note that the Veteran takes antidepressants. July 2017 VA treatment records, as well as others, note depression on the Veteran's active problem list. October 2017 VA treatment records indicate a positive PHQ screening for mild depressive symptoms. Further, although a July 2016 examiner stated that the May 2016 examination lacked specifics related to the criteria such as duration and impact on functioning, these actually were listed on the examination, including, but not limited to, depressed mood, weekly panic attacks, diminished activities of daily living, behavioral and verbal regrets, and avoidance of certain movements or activities due to fear re-injury or re-experiencing pain. Relatedly, the July 2016 examiner also noted that the Veteran will often avoid events that are recognized to cause pain, but then in a contradictory statement claimed that the Veteran only identified financial stressors. See Nieves-Rodriguez, 22 Vet. App. at 301. In contrast, the Board affords the May 2016 private medical opinion significant probative value as it reflects a consideration of the Veteran's medical history and lay assertions, and is supported by well-reasoned rationale and relevant medical literature, including from VHA. Factors for assessing the probative value of a medical opinion include the thoroughness and detail of the opinion. Prejean v. West, 13 Vet. App. 444, 448-9 (2000). A medical examination report must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008). As the evidence is at least in equipoise, service connection for depressive disorder secondary to back and knee disabilities is granted. Roya Bahrami Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Rogos 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.