Citation Nr: 21075924 Decision Date: 12/21/21 Archive Date: 12/21/21 DOCKET NO. 16-11 489 DATE: December 21, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disorder, to include bipolar disorder, major depressive disorder, and posttraumatic stress disorder (PTSD), is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1987 to June 1989. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a September 2013 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In January 2019, the Veteran testified at a Board videoconference hearing before the undersigned Veterans Law Judge. A transcript of the hearing is of record. In May 2019 and November 2020, the Board remanded the claim for further evidentiary development. Service Connection The Veteran is seeking service connection for an acquired psychiatric disorder, to include PTSD, major depressive disorder, and bipolar disorder. Specifically, the Veteran contends that he has an acquired psychiatric disorder related to five in-service events: (1) late 1988 or early 1989 two soldiers were accidentally killed by M60 machine guns that went off at the armory; (2) March 1989 20 plus soldiers were killed and/or injured during Operation Team Spirit in Korea; (3) June 1988 a helicopter went down at Camp Futenma, Okinawa and the crew was killed; (4) August 1988 the death of a soldier who was left in the desert (at 29 Palms California) and passed away from dehydration; and (5) December 1988 a grenade went off in a dance club in Okinawa resulting in panic and trampling of a large number of people. The Veteran testified during the January 2019 Board hearing that since the aforementioned in-service events he has received multiple psychiatric disorder diagnoses, experienced flashbacks, and noticed a change in the relationships with his friends and family. The Veteran further testified that he did not seek in-service treatment for his psychiatric disorder because he was self-medicating with alcohol. He contends that he was diagnosed with bipolar disorder by a private doctor in 2005. Pursuant to the November 2020 remand, the RO attempted to verify the Veteran's stressor. An April 2021 Records Research Response and VA Memorandum determined that there was a newspaper article from United Press International (UPI) dated December 24, 1988 confirming the Veteran's December 1988 stressor. The article noted that teargas canisters were released by US servicemen in nightclub in Okinawa City causing a stampede that injured 23 people and the resulting investigation required cooperation by the US military. The aforementioned documents also noted that there was a Los Angeles Times newspaper article confirming the June 1988 helicopter crash, a Wikipedia article confirming the Veteran's stressor of the August 1988 death of a soldier who was left in the desert and died from dehydration, and a UPI article confirming the accidental killing of two Marines stationed in Japan by accidental charge of M-60 machine guns. The Veteran was afforded a VA examination in July 2021. The VA examiner determined that the Veteran's diagnosis of bipolar disorder was inaccurate, that he did not meet the criteria for PTSD, but instead had other specified personality disorder. In rendering a negative nexus opinion, the VA examiner did not reconcile the prior diagnoses of major depressive disorder and bipolar disorder by treating VA clinicians, as documented in VA treatment records. The VA examiner did not discuss why these diagnoses were invalid or whether they were related to the Veteran's corroborated in-service stressors. As the July 2021 VA examiner's diagnosis and medical opinion are inconsistent with the findings of the prior VA examiner and VA treatment records documenting diagnoses of major depressive disorder, the Board must remand for a new VA examination to assess the nature and etiology of the Veteran's psychiatric disability. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007) (once VA undertakes the effort to provide an examination when developing a service-connection claim, even if not statutorily obligated to do so, it must provide an adequate one or, at a minimum, notify the claimant why one will not or cannot be provided). The matter is REMANDED for the following actions: 1. Schedule the Veteran for a VA examination to determine the nature and etiology of his claimed acquired psychiatric disorders. The Veteran's claims file, including a copy of this remand, must be made available to an appropriate clinician, other than the July 2021 VA examiner. All diagnostic testing deemed to be necessary by the examiner should be accomplished. The examiner should address the following: (a.) Identify by diagnosis each current acquired psychiatric disorders. For the purposes of your opinion, "current" means all diagnoses made during the period on appeal and proximate to the filing of the claim for service connection. Note that VA psychiatrists diagnosed the Veteran with bipolar disorder and major depressive disorder as documented in VA medical treatment records. Also note that a July 2021 VA psychologist determined that the Veteran had other specified personality disorder and no other mental disorders. Please address any and all inconsistencies with these diagnoses. (b.) Is it at least as likely as not that an acquired psychiatric disorder arose during the Veteran's service or is otherwise related to any incident of his service? Please explain why or why not. In providing this opinion, please comment on the significance, if any, of the Veteran's in-service stressors, which have already been conceded. (c.) Is it at least as likely as not that any personality disorder was aggravated by the Veteran's service? Please explain why or why not. In providing this opinion, please comment on the significance, if any, of the Veteran's in-service stressors, which have already been conceded. (d.) A rationale for any opinions expressed should be set forth. If the examiner cannot provide an above opinion without resorting to speculation, he/she should explain why an opinion cannot be provided (e.g. lack of sufficient information/evidence, the limits of medical knowledge, etc.). S.C. Krembs Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Bilstein, 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.