Citation Nr: 21077195 Decision Date: 12/28/21 Archive Date: 12/28/21 DOCKET NO. 16-21 547 DATE: December 28, 2021 ORDER Entitlement to service connection for bipolar disorder is granted. FINDING OF FACT The evidence of record is in equipoise that the Veteran's bipolar disorder is related to his service. CONCLUSION OF LAW The criteria for service connection for bipolar disorder have been met. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served in the United States Navy from June 1997 to June 2007. These matters come before the Board of Veterans' Affairs (Board) on appeal of a June 2013 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In June 2017, the Veteran testified at a Board hearing before a Veterans Law Judge (VLJ) who is no longer available to participate in the Veteran's appeal. A transcript of that hearing is associated with the claims file. In March 2020, the Veteran was sent a letter offering him the opportunity to testify at a new hearing before a VLJ who would participate in the decision. 38 U.S.C. § 7107(c); 38 C.F.R. § 20.707. The Veteran was provided 30 days to respond but did not do so. Accordingly, the Board will consider the appeal based on the evidence of record. Id. These matters were previously before the Board in November 2018 and September 2020, and both times the Board remanded these matters for additional development. It has since returned to the Board for further appellate review. 1. Entitlement to service connection for bipolar disorder is granted. Service connection will be granted if the evidence demonstrates that current disability resulted from an injury suffered or disease contracted in active military, naval, or air service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Establishing service connection generally requires competent evidence of three things: (1) a current disability; (2) in-service injury or disease; and (3) a relationship between the two. Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018). Consistent with this framework, service connection is warranted for a disease first diagnosed after service when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). The Veteran was afforded VA examinations in August 2015, August 2019, and April 2020. However, the August 2015 and August 2019 examinations were previously determined to be inadequate. In the February 2021 addendum opinion, the examiner found that the Veteran failed to fulfill all of the required DSM-5 criteria for a diagnosis of PTSD. Additionally, the examiner found that the Veteran's reported depression during service is more likely related to his now-diagnosed bipolar disorder. In the April 2021 addendum opinion, the same examiner noted that although the Veteran indicated he had a traumatic upbringing, there was no evidence of a mental health diagnosis prior to service. Additionally, the examiner pointed out that although his service treatment records are silent regarding a formal diagnosis during service, his separation examination notes nervous trouble, such as anxiety or panic attacks. The examiner also found that depression and excessive worry are evidence of the Veteran's subjective experience during service. Additionally, the buddy statement from K.W. expressed that he felt the Veteran immersed himself into his work as a way to cope with his anxiety and depression. The examiner also noted the Veteran attempted suicide via overdose in 2006. The examiner opined that while this was subjective evidence, it supports the Veteran's claim of in-service anxiety and depression, which the examiner found to be related to his now-diagnosed bipolar disorder. Therefore, the examiner found it to be at least as likely as not that the Veteran's bipolar disorder was related to his service. The Veteran has a current diagnosis of bipolar disorder, and thus the first element of service connection has been met. The Veteran's service treatment records and lay statements indicate the Veteran experienced symptoms of depression and anxiety during service, and therefore the second element of service connection has been met. Finally, the April 2021 examiner provided a positive nexus opinion regarding the Veteran's bipolar disorder and his service, satisfying the third element of service connection. As such, the Board finds that service connection for bipolar disorder is warranted. Caroline B. Fleming Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Gabrielle Ongies, 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.