Citation Nr: 21010310 Decision Date: 02/24/21 Archive Date: 02/24/21 DOCKET NO. 17-24 693 DATE: February 24, 2021 REMANDED Entitlement to service connection for the cause of the Veteran's death is remanded. REASONS FOR REMAND The Veteran had several periods of active service in the Marine Corps and Army. This matter is before the Board of Veterans’ Appeals (Board) on appeal from an August 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The appellant testified before the undersigned Veterans Law Judge (VLJ) at a videoconference Board hearing in July 2019. A transcript is of record. This matter was subsequently remanded by the Board in November 2019. Entitlement to service connection for the cause of the Veteran's death is remanded. The Veteran died in February 2014 due to acute peritonitis and perforated bowel. His death was ruled an accident. The Board notes that at the time of his death, the Veteran was not service connected for any acquired psychiatric disorder. Based on testimony at the Board hearing, this matter was remanded for an opinion to determine whether the Veteran had an acquired psychiatric disorder related to his military service; and if so, whether the disability contributed substantially or materially to the cause of the Veteran’s death. A July 2020 psychiatrist determined that it was less likely than not that the Veteran had an acquired psychiatric disorder due to service. She explained that the Veteran’s service treatment records, and VA notes were conflicting. She also stated that if the Veteran had a documented mental disorder, the claim should be revisited. The Board finds this opinion to be insufficient to determine whether the Veteran had an acquired psychiatric disorder related to service, and if so, whether such a disorder substantially or materially contributed to his death. Since the above opinion, the appellant has submitted additional evidence. A letter from a licensed clinical social worker, from the Vet Center in Boise, Idaho, states that the Veteran was treated for PTSD symptoms, and had a PTSD diagnosis on March 19, 2012 and January 29, 2013. See 9/15/2020, Medical Treatment Record – Non-Government Facility. The appellant has also submitted lay written testimony that explains the multitude of personality, behavior, and physical changes the Veteran experienced after he returned from Iraq. See 9/18/2020, NOD. Additional reports have been submitted that documented the Veteran’s experiences during service in Iraq to include gunfire and explosions, and improvised explosive devices. See 9/21/2020, Military Personnel Record. As such, the Board finds that an additional medical opinion is necessary to address whether the Veteran had a psychiatric disorder that was incurred in service, and if so, whether it contributed substantially or materially to the Veteran’s death. 38 U.S.C. §5103A(a). This matter is REMANDED for the following actions: 1. Obtain any outstanding records and associate them with the claims file. Request the appellant submit any relevant records in their possession or authorize VA to obtain them. 2. After associating any records, forward the claims file, including a copy of this Remand, to an appropriate clinician to provide a medical opinion. Review of the claims file is to be noted in the examiner’s report. --Identify all acquired psychiatric disorders during the Veteran’s lifetime. **In identifying all psychiatric disorders, please review and acknowledge review of the following: • 9/21/2020, Military Personnel Record (detailing the Veteran’s experiences in Iraq with hostile forces and improvised explosive devices); • 9/21/2020, Medical Treatment Record – Government Facility (reporting dates the Veteran was diagnosed with PTSD); • 3/22/2016, Medical Treatment Record – Government Facility – PTSD Symptoms (endorsing PTSD symptoms); • 3/22/2016, Medical Treatment Record – Government Facility – Anxiety (reported adjustment disorder with anxiety and depressed mood); • 1/7/2016, Medical Treatment Record – Government Facility – History (reporting symptoms in 2006; a mental hold in October 2013; depression medication prescription; and meeting PTSD criteria in December 2013).** Then, the examiner is to address whether: (a.) For any PTSD diagnosis, is it at least as likely as not (50 percent or greater probability) that PTSD manifested during or is otherwise related to the Veteran’s active service, to include due to the reported in-service stressors and/or fear of hostile military or terrorist activity? See 9/21/2020, Military Personnel Record. (b.) Other than PTSD, is it at least as likely as not (50 percent probability or greater) that the Veteran had an acquired psychiatric disorder during his lifetime, to include anxiety and/or depression, that was related to his military service? (c.) If yes to a) or b), is it at least as likely as not (50 percent or greater probability) that such acquired psychiatric disorder contributed substantially or materially to the cause of the Veteran’s death? **The appellant has asserted that the Veteran’s death was by suicide, rather than an accident, and was caused by his acquired psychiatric disorders.** See 7/29/2019, Hearing Transcript. The examiner is to address this contention in opining on the above questions and document his/her review of the hearing transcript. A comprehensive rationale for all opinions is to be provided. All pertinent evidence, including both lay and medical, should be considered. If an opinion cannot be given without resorting to speculation, the examiner should explain why and state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), the record (additional facts are required), or the examiner (does not have the knowledge or training). Paul Sorisio Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board G. Morales, 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.