Citation Nr: 21009122 Decision Date: 02/19/21 Archive Date: 02/19/21 DOCKET NO. 14-36 772 DATE: February 19, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD) and Major Depressive Disorder (MDD), is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1978 to September 1978. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from September 2011 and September 2015 rating decisions issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned at a hearing in April 2017. The Board remanded this matter in December 2017 and September 2020 for additional development. The matter is now returned to the Board for further appellate review. This appeal is advanced on the Board's docket pursuant to 38 C.F.R. § 20.902(c) (2019); 38 U.S.C. § 7107 (a)(2) (2012). Entitlement to service connection for an acquired psychiatric disorder, to include PTSD and Major Depressive Disorder, is remanded. The Veteran contends his psychiatric condition, to include PTSD and MDD, is due to his military service, to include a training exercise in a gas chamber and being mistreated during service because of his race. In September 2018, VA provided the Veteran an examination to determine the nature and etiology of his psychiatric condition. The examiner opined the Veteran’s claimed PTSD and MDD were less likely than not incurred in or caused by an in-service injury, event or illness, to include both the training in the gas chamber, and his allegations of mistreatment because of his race. Unfortunately, the September 2018 examination is inadequate to adjudicate the Veteran’s claim. The September 2018 examiner determined that the Veteran did not meet the criteria for a diagnosis of PTSD, noting that the Veteran’s gas chamber training exercise “is not considered a traumatic situation” and was not adequate to constitute a PTSD stressor. The examiner did not, however, explain why the Veteran’s training experience in the gas chamber was not an adequate stressor to support a PTSD diagnosis, especially in light of his consistent allegation that he found it very traumatic and that his family commented that his behaviour had changed after the gas chamber training exercise. She concluded by stating that gas exposure is typical for soldiers in training and that the experience had no bearing on the Veteran’s psychiatric diagnoses whatsoever. She provided no rationale for this conclusion. The September 2018 examiner found the Veteran did meet the diagnostic criteria for MDD; however, she indicated that it was unclear if the MDD is related to service events, poor adaptive skills to manage stress, or the result of other events in his life, including those related to service. The same examiner provided a May 2019 addendum addressing the etiology of MDD. She again opined the Veteran’s MDD was less likely than not related to his active duty service, noting that no depression symptoms were documented in the Veteran’s service treatment records. She also stated that the Veteran denied any symptoms associated with depression during service, but she did not reference any records that reflected the Veteran denying symptoms of depression. Finally, she indicated that the onset of MDD was after military service in the 1980s and is associated with the Veteran’s legal problems, substance abuse, and subsequent incarceration. The September 2018 and May 2019 opinions are inadequate for several reasons. With respect to PTSD, the examiner provided no explanation for why the Veteran’s gas chamber training exercise did not meet the criteria for a PTSD stressor. She also failed to provide a rationale for why she found that the gas chamber training incident had no bearing on his psychiatric diagnoses whatsoever. With respect to MDD, the examiner initially indicates in September 2018 that it is unclear if the Veteran’s MDD is related to service or post-service factors. She then provides a second opinion in May 2019 where she concludes that it is not due to service but is instead due to post-service factors such as legal problems and incarceration. She does not, however, provide a rationale to explain how she concluded the MDD was more likely due to the post-service factors rather than military service. Accordingly, a remand is necessary to obtain a new etiology opinion regarding the Veteran’s psychiatric claim. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007); see also Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008) (probative value of a medical opinion is derived from it being factually accurate, fully articulated, and soundly reasoned). The matter is REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician (other than the clinician who provided the September 2018 opinion and May 2019 addendum) to determine whether the Veteran’s psychiatric disorder, to include PTSD and MDD, is related to his military service. If the clinician determines that an additional in-person examination is required, one should be scheduled. Please note, if the clinician deems it reasonable, an alternate format such as a telehealth interview is acceptable. Following review of the claims file and, if indicated, examination of the Veteran, the clinician should opine whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s psychiatric disorder, to include PTSD and MDD, began in or is otherwise related to the Veteran's active service, to include his allegations regarding his gas chamber training exercise experience and his treatment while on active duty due to his race. If the examiner determines that the Veteran has not met the criteria for a diagnosis of PTSD at any point during the appeal period, the examiner must explain how the Veteran does not meet the criteria for a diagnosis of PTSD. (Continued on the next page)   The clinician 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 clinician rejects the Veteran's reports, he or she must provide a reason for doing so. The fact that his report of symptoms is not corroborated by contemporaneous medical treatment records is not, by itself, a sufficient reason to reject the Veteran's report of symptoms capable of lay observation. 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 Zachery S.C. Luce, 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.