Citation Nr: 21008012 Decision Date: 02/11/21 Archive Date: 02/11/21 DOCKET NO. 15-06 508 DATE: February 11, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disorder, claimed as posttraumatic stress disorder (PTSD), is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from November 1978 to November 1981. This case comes before the Board of Veterans’ Appeals (Board) on appeal of a September 2011 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). By way of background, in June 2018, the Board remanded this case for additional development. The case was remanded again in July 2020 for additional development. Unfortunately, the RO has not fully complied with the instructions from the July 2020 remand. The Board is obligated by law to ensure that the RO complies with its directives. Stegall v. West, 11 Vet. App. 268, 271 (1998). RO compliance with remand directives is not optional or discretionary, and the Board errs as a matter of law when it fails to ensure remand compliance. Stegall, 11 Vet. App. at 271. Accordingly, remand is required to obtain an adequate medical opinion that complies with the Board remand directives. Entitlement to service connection for an acquired psychiatric disorder, claimed as posttraumatic stress disorder (PTSD), is remanded. The Veteran asserts that the preponderance of the evidence establishes that he is entitled to service-connection for a psychiatric disability that he contends is related to service. See Appellant Brief Received November 2020. The Veteran further asserts that since 1989 he has been having nightmares about being hit by the vehicle that struck him and also states that he has been suffering from pain on his right side. Additionally, the Veteran asserts that he could not play with his children or grandchildren and was been battling depression because of this. See Statement in Support of Claim Received September 2020. The Veteran’s service treatment records state that while on duty in June 1981 the Veteran sustained injuries after being struck by a car during night call. An informal conference report of record states that during an August 2013 hearing, the Veteran indicated that he was injured in 1981 in Landstuhl, Germany when he was crossing a street and hit by a car. It was further noted that the car driver drove off and it was considered a hit and run accident. The report also noted that the Veteran’s girlfriend SR testified that the Veteran wakes up from nightmares and night sweats, re-living the accident. SR also stated that she was in a relationship with the Veteran at the time of the accident and his mother informed her that Red Cross contacted her to let her know that the Veteran was involved in the accident. See Informal Conference Report Received August 2013. Pursuant to the Board’s July 2020 remand decision an addendum opinion was requested. In addition to identifying all acquired psychiatric disorders present during the period of the claim, the examiner was requested to state whether it is at least as likely as not (50 percent probability or greater) that the Veteran had a psychiatric disorder that had its onset during service or is otherwise etiologically related to the Veteran’s military service. In providing his or her opinion, the examiner was asked to address the Veteran’s contention that his psychiatric symptomatology is related to being struck by an automobile while stationed in Germany in 1981(the Board has conceded the occurrence of this incident). An addendum medical opinion was provided in July 2020. The examiner failed to address the Veteran’s contention that his psychiatric symptomatology is related to being struck by an automobile while stationed in Germany. Unfortunately, the Board finds the July 2020 VA addendum opinion is inadequate as it does not fully address the remand directives detailed in the Board’s July 2020 remand decision. When VA undertakes to provide a VA examination or obtain a VA opinion it must ensure that the examination or opinion is adequate. Barr v. Nicholson, 21 Vet. App. 303 (2007). Therefore, additional medical comment is necessary before the Board can adjudicate this claim. The claim is being remanded for a medical opinion to determine whether the documented in-service incident of being struck by an automobile while stationed in Germany in 1981 has resulted in any type of psychiatric disability. The matters are REMANDED for the following action: 1. Obtain updated VA treatment records. 2. Forward the Veteran’s claims file to the July 2020 psychiatric examiner (or if she is unavailable, to another qualified examiner) for an opinion regarding the nature and etiology of all acquired psychiatric disorders present during the period of the claim. If the examiner determines an additional examination is warranted, schedule the additional examination. Following a review of the relevant records and lay statements, and an additional examination if indicated, the examiner should state: Whether it is at least as likely as not (50 percent probability or greater) that the disorder had its onset during or is otherwise etiologically related to the Veteran’s military service. In providing his or her opinion, the examiner must address the Veteran’s contention that his psychiatric symptomatology is related to being struck by an automobile while stationed in Germany in 1981 (the Board has conceded the occurrence of this incident). The examiner must also address the Veteran and SR’s assertions that he has been having nightmares about being hit by the vehicle that struck him and experiencing pain and depression. The examiner must provide a rationale for all proffered opinions. In providing this opinion, the examiner is reminded that the Veteran is competent to report continuous symptoms since service, and such reports must be specifically acknowledged and considered in formulating any opinion. If the examiner rejects the Veteran’s reports regarding current or past symptoms, the examiner must provide a reason for doing so. (Continued on the next page)   Rationale for all requested opinions shall be provided. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation stating why this is so. In so doing, the examiner shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question(s). Tiffany Dawson Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Dorsey-Kwansa, 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.