Citation Nr: 21076682 Decision Date: 12/27/21 Archive Date: 12/27/21 DOCKET NO. 19-25 356 DATE: December 27, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disorder is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1979 to July 1992. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a December 2018 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In April 2021, the Veteran testified at a hearing before the undersigned. Entitlement to service connection for an acquired psychiatric disorder is remanded. As an initial matter, the Board notes that personality disorders are not considered diseases or injury for which service connection may be granted, 38 C.F.R. §§ 3.303(c), 4.9, 4.127, but service connection may be granted for additional disability superimposed on top of a personality disorder resulting from a disease or injury during service. See VAOPGCPREC 82-90 (July 18, 1990). The Veteran was afforded a VA examination in October 2018 in which he was diagnosed with generalized anxiety disorder and unspecified personality disorder. The Board finds this VA examination to be inadequate for the following reasons. First, the VA examiner did not sufficiently address whether any additional disability was superimposed on the personality disorder in service. Second, the VA examiner did not address all of the Veteran's diagnoses of acquired psychiatric disorders as reflected in the Veteran's treatment records, including a March 2018 diagnosis of major depressive disorder and an August 2018 VA treatment record reflecting that the Veteran's prior medical history includes posttraumatic stress disorder and major depression. Finally, the VA examiner did not provide a sufficient rationale as to whether it is at least as likely as not that the Veteran's generalized anxiety disorder is related to his service. For these reasons, remand is warranted for a new VA opinion. The Board finds that remand is also warranted because it is unclear if all of the Veteran's relevant treatment records have been associated with the claims file. First, a December 2012 VA treatment record notes that the Veteran was treated for mental health related issues and that an examination was performed that it is viewable by VISTA users, however, the Board does not have access to VISTA, and therefore, cannot view the examination. The December 2012 examination does not appear to have otherwise been associated with the claims file. Second, a January 2019 VA treatment record notes that the Veteran was approved for referral to the therapy orientation group at the Fairview Mental Health Clinic. It is unclear if the Veteran attended such group therapy, however, if he did, it does not appear as though these treatment records have been associated with the claims file. Accordingly, remand is warranted to associate all relevant treatment records with the claims file. This matter is REMANDED for the following action: 1. Obtain any outstanding VA treatment records and associate them with the claims file. In this regard, obtain records for all treatment provided to the Veteran through the VA Choice program and/or any referral from VA. In doing so, secure any necessary releases from the Veteran. If any identified records cannot be obtained and further attempts would be futile, such should be noted in the claims file and the Veteran should be notified so that he can make an attempt to obtain those records on his own behalf. 2. Schedule the Veteran for a psychiatric examination to determine the nature and etiology of any psychiatric disorder diagnosed. The examiner must first determine whether it is at least as likely as not that the Veteran has a personality disorder. The examiner must then determine if the Veteran has had any acquired psychiatric disability at any point in time during the appeal period. If the Veteran is NOT diagnosed with a personality disorder but IS diagnosed with an acquired psychiatric disability, then the examiner is asked to address the etiology of any acquired psychiatric disability. Specifically, for each acquired psychiatric disability diagnosed, the examiner must opine whether it is at least as likely as not that the disability is related to the Veteran's military service. If PTSD is diagnosed, the examiner must identify the stressor or stressors upon which the diagnosis is made. If the Veteran IS diagnosed with a personality disorder AND is diagnosed with an acquired psychiatric disorder, the examiner must opine whether the acquired psychiatric disorder was at least as likely as not superimposed on the personality disorder during active service and resulted in additional disability. If so, the examiner must describe the resulting additional disability. If the examiner finds that any disability noted in the record is in remission or is not an accurate diagnosis for the Veteran at any point during the appeal, the examiner should explain in detail why this is so. The examiner is advised that the Veteran is competent to report his symptoms and history, and such reports must be specifically acknowledged and considered in formulating any opinion. If the examiner rejects the Veteran's reports, he or she must provide a reason for doing so; however, the Veteran's history of symptoms capable of lay observation cannot be dismissed solely on the basis that they are not recorded in contemporaneous treatment records. All findings must be reported in detail and all opinions must be accompanied by a clear rationale. If any of the above issues cannot be resolved without resorting to speculation, then a detailed medical explanation as to why this is so must be provided. M. HYLAND Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Elias, 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.