Citation Nr: 21011562 Decision Date: 03/02/21 Archive Date: 03/02/21 DOCKET NO. 15-01 689 DATE: March 2, 2021 REMAND Entitlement to service connection for an acquired psychiatric disorder to include posttraumatic stress disorder (PTSD), major depressive disorder (MDD), depression, anxiety disorder, bipolar disorder and schizoaffective disorder is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Army from May 1968 to May 1970, including service in the Republic of Vietnam. In May 2018 and June 2020, the Board remanded the matter for further development. The Board regrets further delay, but finds that additional development is necessary before a decision may be rendered in this appeal. Entitlement to service connection for an acquired psychiatric disorder. The Veteran asserts entitlement to service connection for an acquired psychiatric disorder. Under 38 C.F.R. § 3.655, when entitlement to a benefit cannot be established without a current VA examination or reexamination and a claimant, without good cause, fails to report for such examination or reexamination scheduled in connection with an original or supplemental compensation claim, the claim shall be rated based on the evidence of record. Examples of good cause include, but are not limited to, the illness or hospitalization of the claimant, or the death of an immediate family member. Review of the record shows that the Veteran was schedule for a VA examination in October 2020. The Veteran requested that his post-remand VA examination be delayed for one year because of the ongoing COVID-19 pandemic. See, e.g., October 2020 Report of General Information. The Veteran also indicated that he did not want a telehealth examination in lieu of an in-person examination because of difficulty hearing. The Board notes that review of VA treatment records shows that the Veteran has cancelled in-person health appointments and personal activities during the same period because of a high risk of illness during the pandemic. Further, VA treatment records show that the Veteran has had only one telephonic appointment during the period, for which a family member had to help the Veteran understand the provider because of the Veteran’s hearing loss. See September 2020 VA Treatment Records. A March 2020 VA examination report notes that the Veteran had a severe hearing deficit. The Board finds that good cause has been shown for the Veterans failure to report to the VA examination. As detailed above, the Veteran is at heightened risk of illness due to the COVID-19 pandemic, and he has severe hearing loss that impedes his ability to participate in telehealth appointments. As explained in the June 2020 remand, it is unclear whether the March 2020 VA examiner reviewed the claims file, and the examiner was unable to implement testing for several psychiatric disorders indicated by the Veteran’s medical records. Moreover, the March 2020 VA examiner stated that his overall assessment of the Veteran’s social and occupational function was “speculative and impressionistic to an almost unacceptable degree” because of his lack of expertise in the matter. As such, the Board will remand the matter for the purpose of obtaining another medical opinion as to the nature and etiology of any current acquired psychiatric disorder of record. The matters are REMANDED for the following action: Provide access to the Veteran’s claims folder to an appropriate clinician who has not yet participated in this matter for the purposes of obtaining a medical opinion on the nature and etiology of any current acquired psychiatric disorders, to include PTSD, major depressive disorder, depression, anxiety disorder, bipolar disorder, and schizoaffective disorder. The clinician should note that the record as been reviewed. After reviewing the record, the clinician should provide separate opinions for each diagnosed psychiatric disorder, with supporting rationale. Specifically, the clinician should note if it is at least as likely as not (50 percent or greater probability) that the Veteran’s psychiatric disorder(s) began during the Veteran’s active service or is otherwise causally related to his service, to include combat service in Vietnam. If the examiner is unable to provide any required opinion, he or she should explain why. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation as to why this is so. If the inability to provide a more definitive opinion is the result of a need for additional information, the examiner should identify the additional information that is needed. A. J. Spector Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Hillan Sosa, 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.