Citation Nr: 21012316 Decision Date: 03/04/21 Archive Date: 03/04/21 DOCKET NO. 16-53 775 DATE: March 4, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disorder, to include anxiety and depression, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from June 1973 to June 1977. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a January 2016 rating decision issued by the Department of Veterans Affairs (VA) Regional Office in St. Paul, Minnesota. In November 2019, the Veteran testified at a Board video-conference hearing before the undersigned Veterans Law Judge. A transcript of that hearing has been associated with the record. In March 2020, the Board remanded the case to the agency of original jurisdiction (AOJ) for additional development. After taking further action, the AOJ confirmed and continued the prior denial and returned the case to the Board. Although the Board sincerely regrets the additional delay, a remand is necessary to ensure compliance with the prior remand directives. See Stegall v. West, 11 Vet. App. 268 (1998). Entitlement to service connection for an acquired psychiatric disorder, to include anxiety and depression, is remanded. In March 2020, the Board remanded this case, in part, to obtain a medical opinion as to whether it was at least as likely as not that the Veteran had a psychiatric disorder that had its onset in, or was otherwise attributable to, his period of active service, to include as a result of his exposure to carbon tetrachloride. The Veteran was provided a VA examination in May 2020. The examiner confirmed a diagnosis of an anxiety disorder and opined that it was less likely than not that the Veteran’s disorder was incurred in, or caused by, the claimed in-service injury, event, or illness. In so doing, however, the examiner did not provide a substantive rationale. Although the examiner cited a 15-year gap between the Veteran’s alleged exposure and the time he obtained psychiatric treatment, the examiner did not explain how that evidence related to his opinion; nor did he provide any discussion of the significance, if any, of the Veteran’s documented in-service complaints of sleepiness, upset stomach, and emotional stress, or the symptoms he reported having experienced during service such as sweating, nervousness, and panic attacks, as set out in the remand. As such, the matter must again be remanded. Stegall v. West, 11 Vet. App. 268, 271 (1998). This matter is REMANDED for the following action: 1. Ask the Veteran to identify, and provide appropriate releases for, any care providers who may possess new or additional evidence pertinent to the issue on appeal. If he provides the necessary release(s), assist him in obtaining the records identified, following the procedures set forth in 38 C.F.R. § 3.159. Any new or additional (i.e., non-duplicative) evidence received should be associated with the record. If any of the records sought are not available, the record should be annotated to reflect that fact, and the Veteran and his representative should be notified. 2. Obtain copies of records pertaining to any VA treatment the Veteran has received since the time that such records were last procured, following the procedures set forth in 38 C.F.R. § 3.159. The evidence obtained, if any, should be associated with the record. 3. After the foregoing development has been completed to the extent possible, make arrangements to have the VA examiner who previously evaluated the Veteran in May 2020 review the record and provide a supplemental report on the matter of whether it is at least as likely as not (i.e., whether it is 50 percent or more probable) that the anxiety disorder noted in the May 2020 report had its onset in, or is otherwise attributable to, the Veteran’s period of active service. In so doing, the examiner must discuss the medical significance, if any, of a November 1974 service treatment record reflecting that the Veteran presented for treatment with reports of being tired for two weeks and sleeping all day; an April 1976 service treatment record wherein it was noted in the margin that it was probable that most or all of the Veteran’s then-reported symptoms, including upset stomach, were aggravated and/or caused by emotion/stress; and the Veteran’s assertions to the effect that he felt “jittery” after being exposed to carbon tetrachloride during service and that he developed psychiatric symptoms in service, such as sweating, nervousness, and panic attacks. If the May 2020 examiner is unable to provide the opinion requested, arrange to obtain the requested information from another qualified examiner. The need for another examination and/or telephonic or video interview of the Veteran is left to the discretion of the examiner selected to offer the requested opinions. A complete medical rationale for all opinions expressed must be provided. 4. After completing the above, and any other development as may be indicated by any response received as a consequence of the actions taken in the preceding paragraphs, the Veteran’s claim should be readjudicated based on the entirety of the evidence. If the benefit sought remains denied, the Veteran and his representative should be issued a supplemental statement of the case. An appropriate period of time should be allowed for response. DAVID A. BRENNINGMEYER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Joseph T. Leonard, Law Clerk 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.