Citation Nr: 21074670 Decision Date: 12/16/21 Archive Date: 12/16/21 DOCKET NO. 18-52 656 DATE: December 16, 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 Army from April 1999 to September 2006, with additional subsequent service in the Army National Guard. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a rating decision issued in April 2016 by the Department of Veterans Affairs (VA) Regional Office in Providence, Rhode Island. In January 2021, the Veteran testified before the undersigned at a Board hearing. A transcript of that hearing has been associated with the record. Finally, the Board notes that the Veteran initially characterized his claim as one for service connection for posttraumatic stress disorder (PTSD). However, he has also been diagnosed with adjustment disorder and anxiety disorder. Therefore, in light of Clemons v. Shinseki, 23 Vet. App. 1 (2009), the Board finds that it is appropriate to recharacterize the claim as entitlement to service connection for an acquired psychiatric disorder. Service connection In July 2016, the Veteran underwent a VA examination in relation to his claim. At that time, a VA psychologist ruled out PTSD and diagnosed adjustment disorder with mixed anxiety and depressed mood. On the question of etiology, the examiner concluded that the Veteran's military service was the cause of some of the Veteran's symptoms, but that it was less likely than not the reason he developed the diagnosed disorders. Rather, the examiner explained that the Veteran's disorder was due to concurrent legal and familial issues concerning custody of his son and time recently spent in jail in relation to a domestic violence incident. The Board finds that this examination report is inadequate for purposes of deciding the Veteran's claim. By determining that some of the Veteran's symptomology is due to service, the examiner suggests the possibility that service connection could be warranted. He then concluded that the Veteran's recent legal trouble was the reason for his psychiatric concerns, without taking into account the Veteran's detailed and consistent descriptions of his combat experiences while serving in the Army. The examiner also disregarded the fact that the Veteran was experiencing symptomology prior to the legal issues described during the July 2016 examination. Further, VA treatment records support a finding that the Veteran's psychiatric symptomology could have a basis in his military service. For example, a November 2016 note indicated that the Veteran was experiencing "trauma-related symptoms manifesting as intrusive recollections" and flashbacks. In addition, VA treatment notes from 2018 show that the Veteran's legal and custody issues had resolved, but he continued to experience symptoms. Lastly, at his January 2021 hearing, the Veteran testified as to multiple incidents in service in which his unit was under attack, and that he saw multiple dead and bloated bodies while on patrol. The Veteran's exposure to such incidents was not discussed in the July 2016 examination report. For these reasons, the Board must find that the July 2016 examination report is inadequate, and a new examination is warranted. See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007) (holding that when VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate). In ordering a new examination, the Board is aware that the Veteran has been diagnosed with, inter alia, a personality disorder. Under VA regulations, certain conditions including personality disorders, even if first noted during service, are recognized as having existed prior to service. 38 C.F.R. § 3.303 (c). Personality disorders are characterized by developmental defects or pathological trends in the personality structure manifested by a lifelong pattern of action or behavior. Id. As a matter of law, VA cannot grant service connection for a personality disorder, or for aggravation of a personality disorder while in military service. Morris v. Shinseki, 678 F.3d 1346, 1356 (Fed. Cir. 2012); see also 38 C.F.R. §§ 3.303 (c); 3.310 (a), 4.127. Rather, VA may grant service connection under such conditions only when another mental disorder is "superimposed" upon a personality disorder. Superimposed is not defined in the regulations, but a common definition is that one thing is placed over another, typically so that both are still evident. See Carpenter v. Brown, 8 Vet. App. 240 (1995) (personality disorders are not considered disabilities for rating purposes, but properly diagnosed superimposed psychotic disorders developing after enlistment, are to be considered disabilities rated analogous to schizophrenia). Upon remand, the selected examiner will be asked to proffer an opinion concerning any diagnosed personality disorder. This matter is REMANDED for the following action: Afford the Veteran an appropriate VA examination so as to determine the nature and etiology of his claimed acquired psychiatric disorder. Following a review of the record and conducting all indicated testing, the examiner is asked to identify all current acquired psychiatric disorders that meet DSM-5 criteria. Then, for each disorder, please offer an opinion as to whether it is at least as likely as not (i.e., a 50 percent or greater probability) that such disorder had its onset in, or is otherwise related to, the Veteran's military service. The examiner is asked to specifically discuss the Veteran's lay testimony as to the onset and origins of his symptoms, to include in-service exposure to gunfire, violent ambushes, and dead bodies. In addition, if a diagnosis of a personality disorder is diagnosed, the examiner should offer an opinion as to whether is it at least as likely as not that the personality disorder was subject to a superimposed disease or injury in service (e.g. psychiatric disorder) resulting in additional disability. If so, identify any additional disability that the Veteran experienced as a result of an injury, that was superimposed on the Veteran's personality disorder. A rationale for any opinion offered should be provided. R. FEINBERG Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Jeremy J. Olsen, 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.