Citation Nr: 21010680 Decision Date: 02/25/21 Archive Date: 02/25/21 DOCKET NO. 14-35 108A DATE: February 25, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disorder (other than other trauma and stressor related disorder), to include bipolar disorder, major depressive disorder, and posttraumatic stress disorder (PTSD), to include bipolar disorder as secondary to service-connected other trauma and stressor related disorder, is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1990 to December 1991. This matter returns to the Board of Veterans’ Appeals (Board) on appeal from an August 2013 rating decision issued by the Department of Veterans’ Affairs (VA) Regional Office (RO) in Columbia, South Carolina. By way of background, the RO denied service connection for PTSD and bipolar II disorder in the August 2013 rating decision from which the Veteran timely appealed. Following a Decision Review Officer (DRO) hearing, the RO issued a January 2017 Supplemental Statement of the Case (SSOC) continuing the denial of both claims. The matters were brought to the Board who issued an August 2018 decision granting service connection for other trauma and stressor related disorder and remanding entitlement to service connection for an acquired psychiatric disorder (other than other trauma and stressor related disorder) to include bipolar disorder for additional development. As will be discussed in more detail below, the Board finds substantial compliance with the Board’s August 2018 remand directives has not been met. See Stegall v. West, 11 Vet. App. 268, 271 (1998) (holding when a remand is issued, the Veteran is entitled, as a matter of law, the right to compliance with the remanded order). The Board notes the Veteran currently has other claims pending on appeal under multiple VA Form 10182s for which a separate Board decision under a different docket will be forthcoming. Entitlement to service connection for an acquired psychiatric disorder (other than other trauma and stressor related disorder), to include bipolar disorder, major depressive disorder, and PTSD, to include bipolar disorder as secondary to service-connected other trauma and stressor related disorder, is remanded. Upon review, the Board finds the record reasonably raises an additional theory of entitlement for service connection for bipolar disorder as secondarily aggravated by service-connected other trauma and stressor related disorder based on the October 2016 VA examiner’s opinion. The Board is required to address all issues reasonably raised by the Veteran or the evidence of record. Robinson v. Peake, 21 Vet. App. 545, 552-56 (2008), aff’d sub nom. Robinson v. Shinseki, 557 F.3d 1355 (Fed. Cir. 2009). To date, the only opinion addressing secondary service connection based on aggravation is from the October 2016 VA examiner where he opined that the Veteran’s nightmares are attributable to other stressor and trauma related disorder but also contribute to disrupted sleep “which exacerbates other symptoms attributable to bipolar disorder.” Clarification is necessary to determine whether the Veteran’s service-connected stressor disorder aggravated his non-service-connected bipolar disorder in light of this ambiguous opinion. See Bowling v. Principi, 15 Vet. App. 1, 12 (2001). The Board recognizes the additional delay this causes in resolving the Veteran’s claim but finds remand is necessary to ensure the Veteran receives any and all benefits to which he is entitled. As such, remand is necessary to obtain an addendum opinion addressing specifically whether the Veteran’s bipolar disorder is aggravated by his service-connected other than other trauma and stressor related disorder. The matters are REMANDED for the following action: 1. Return the entire claims file and this remand to an appropriate examiner for review. The necessity of an in-person examination is left to the discretion of the examiner. The examiner shall provide an opinion, including rationale, as to whether the Veteran’s bipolar disorder is aggravated by his service-connected other than other trauma and stressor related disorder. The VA examiner is cautioned that the term “aggravated,” as used in 38 C.F.R. § 3.310(b), does not require that there be “permanent worsening” of the nonservice-connected disability. Instead, secondary service connection is warranted for “any incremental increase in disability and any additional impairment of earning capacity in nonservice-connected disabilities resulting from service-connected conditions, above the degree of disability existing before the increase regardless of its permanence.” See Ward v. Wilkie, 31 Vet. App. 233, 239 (2019). The examiner is directed to address the October 2016 VA examiner’s opinion that the Veteran’s nightmares which are attributable to other stressor and trauma related disorder do contribute to disrupted sleep “which exacerbates other symptoms attributable to bipolar disorder including moodiness and fatigue.” The examiner must provide a complete rationale for any opinion expressed, based on the examiner’s clinical and medical expertise; established medical principles; and references to the evidence of record, as appropriate. If any opinion cannot be expressed without resort to speculation, ensure that the examiner so indicates and discusses why an opinion is not possible, to include whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. 2. After the above development, and any other development deemed necessary, readjudicate the claims. Shereen M. Marcus Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A.C. Allen, 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.