Citation Nr: 21009660 Decision Date: 02/23/21 Archive Date: 02/23/21 DOCKET NO. 11-06 735 DATE: February 23, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disorder to include posttraumatic stress disorder (PTSD), depressive disorder, and generalized anxiety disorder, and to include as secondary to a service-connected disability is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1983 to March 1986. This case has been before the Board multiple times, most recently in July 2020 when it was remanded for additional developments. There has not been substantial compliance with the remand directives and the claim must be remanded again. Stegall v. West, 11 Vet. App. 268 (1998). After the July 2020 remand, service connection for a right ankle disability was granted. See September 2020 rating decision. Accordingly, that issue is no longer on appeal. Entitlement to service connection for an acquired psychiatric disorder to include PTSD, major depressive disorder, and generalized anxiety disorder, and to include as secondary to a service-connected disability is remanded. While the August 2020 VA examiner opined that the Veteran’s diagnosed acquired psychiatric disorders were less likely than not related to service, to include his in-service head injury, the VA examiner did not offer an opinion as to whether any of his other psychiatric disorders are secondary to his service-connected post-concussive headaches, his service-connected residuals of that head injury. Additionally, the September 2017 VA examiner noted that some of the Veteran’s depression may be related to his medical issues. Accordingly, all theories of entitlement should be addressed on remand. On remand, updated treatment records should be obtained. See 38 C.F.R. § 3.159. See also Bell v. Derwinski, 2 Vet. App. 611 (1992). The matters are REMANDED for the following action: 1. Obtain the names and addresses of all medical care providers who treated the Veteran for any psychiatric complaints since service not already associated with the record.  After securing the necessary release, take all appropriate action to obtain these records, including any updated VA treatment since July 2020. 2. After completion of the above, obtain an addendum opinion (with examination or telehealth interview, review of the record, etc., if needed) from the August 2020 VA  examiner (or from another appropriate examiner if the August 2020 VA examiner is unavailable) on the likely etiology of the Veteran’s any and all diagnosed acquired psychiatric disorders.  Copies of all pertinent records should be made available to the examiner for review. The examiner should answer the following:   (a.) Identify all acquired psychiatric disorders diagnosed since April 2007, to include a depressive disorder and generalized anxiety disorder. The examiner should specifically identify whether PTSD has been diagnosed under the DSM-IV or DSM-5 criteria at any point since April 2007. (b.) If the Veteran is diagnosed with PTSD, the examiner must explain how the diagnostic criteria are met and opine whether it is at least as likely as not related to a verified in-service stressor. (c.) For any acquired psychiatric disorder other than PTSD diagnosed during the period on appeal, to include depressive disorder and generalized anxiety disorder, it is at least as likely as not related to an in-service injury event, or disease to include his in-service surfing accident that resulted in a head injury and concussion. Why or why not?  (d.) For any acquired psychiatric disorder other than PTSD diagnosed during the period on appeal, to include depressive disorder and generalized anxiety disorder, is it at least as likely as not (i) caused or (ii) aggravated by (defined as any increase in disability) a service-connected disability? Why or why not? The Veteran is service-connected for post-concussive headaches, residuals of a closed head injury; tinnitus; and a right ankle condition. The examiner must explain the rationale for all opinions in detail, citing to supporting clinical data and/or medical literature, as appropriate. If an opinion cannot be provided, the examiner should indicate why. M.E. Larkin Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Eric Struening 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.