Citation Nr: 21011132
Decision Date: 03/01/21	Archive Date: 03/01/21

DOCKET NO. 15-21 015
DATE: March 1, 2021

REMANDED

Entitlement to service connection for an acquired psychiatric disorder, claimed as dementia, is remanded.  

REASONS FOR REMAND

The Veteran served on active duty from October 1954 to January 1979.  He passed away in January 2014.  The appellant is his surviving spouse.  

This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a December 2012 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO).  The Board remanded this case in July 2018 for further development.

In a September 2020 rating decision, entitlement to service connection for erectile dysfunction as related to the service-connected disability of prostate cancer was granted.  As this issue has been resolved by a full grant of benefits, it is no longer in appellate status.  AB v. Brown, 6 Vet. App. 35 (1993).

1. Entitlement to service connection for an acquired psychiatric disorder, claimed as dementia, is remanded.  

The Board finds that the April 2019 VA opinions addressing the etiology of the Veteran’s acquired psychiatric disorder is incomplete.  Secondary service connection is a two-part issue that involves an analysis of both causation and aggravation.  See Allen v. Brown, 7 Vet. App. 439, 448 (1995); 38 C.F.R. § 3.310.  As the VA examinations of record did not address whether the Veteran’s service-connected disabilities, to include his service-connected prostate cancer with urinary tract infections, aggravated his acquired psychiatric disorder, a supplemental VA opinion is required that address aggravation.  El-Amin v. Shinseki, 26 Vet. App. 136 (2013) (when proximate causation and aggravation are at issue, the Board must ensure that the medical opinion addresses each).  Additionally, the VA opinions did not address the May 1958 examination noting mild nervousness.  As such, a supplemental VA opinion addressing this is warranted.

The matters are REMANDED for the following action:

1. Obtain a supplemental VA opinion from an appropriately qualified examiner.  Provide the claims file, including a copy of this REMAND, to the examiner for review.

After reviewing the claims file, the examiner should respond to the following:

a. Is it at least as likely as not (50 percent probability or greater) that the Veteran’s acquired psychiatric disorder, to include dementia and Alzheimer’s disease, was incurred in or due to his active duty service?  The examiner should address the May 1958 examination noting mild nervousness.

b. Is it at least as likely as not (50 percent probability or more) that the Veteran’s acquired psychiatric disorder, to include dementia and Alzheimer’s disease, was proximately due to, or the result of, his service-connected disabilities, to include any medications used to treat them?

c. Or, is it at least as likely as not (50 percent probability or more) that the Veteran’s acquired psychiatric disorder, to include dementia and Alzheimer’s disease, was aggravated (increased beyond the natural progression of the disability) by his service-connected disabilities, to include any medications used to treat them?

A complete rationale for any opinion expressed must be provided.

 

 

LESLEY A. REIN

Veterans Law Judge

Board of Veterans’ Appeals

Attorney for the Board	E. Ko, 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.