Citation Nr: 21014233 Decision Date: 03/11/21 Archive Date: 03/11/21 DOCKET NO. 18-15 580 DATE: March 11, 2021 REMANDED Entitlement to an initial evaluation in excess of 50 percent for posttraumatic stress disorder (PTSD) is remanded. REASONS FOR REMAND The Veteran served on active duty from March 2000 to May 2005. This matter is before the Board of Veterans’ Appeals (Board) on appeal of a November 2017 rating decision of the Department of Veterans Affairs (VA). The Veteran appeared at a hearing before the undersigned Veterans Law Judge in July 2020. A review of the entire claims file shows that the Veteran’s last VA examination was in March 2017, four years ago. At his July 2020 Board hearing, he noted having a problem with anxiety, which was sometimes severe. He reported having problems sleeping, which then caused him to be exhausted the next day. He noted being hypervigilant, especially at night, irritable, and experiencing angry outburst once or twice a month. He noted being separated from his wife, living with a girlfriend and her children, having a good relationship with his own children and having a few close friends. He also noted working in a hospital and having a side business making custom knives. He stated that within the past 2 years, his home life had changed, which impacted his service-connected PTSD. The record suggests that the Veteran’s disability may have worsened since he was last examined. See Caffrey v. Brown, 6 Vet. App. 377 (1994). While the Board regrets the delay, a new examination is needed. Id. The matter is REMANDED for the following action: Schedule the Veteran for a VA mental health examination, with a psychiatrist or psychologist, to determine the symptoms and severity of his service-connected PTSD. The claims file must be reviewed by the examiner. (The Board recognizes the practical difficulties of scheduling an examination in view of the COVID-19 epidemic, and requests flexibility and understanding in affording the Veteran an opportunity to report for an examination). All necessary tests and studies must be conducted in order to identify the degree of social and occupational impairment attributable to the Veteran’s PTSD. The report of examination must contain a detailed account of all manifestations present, including all subjective complaints and objective findings. The examiner must also discuss the impact PTSD has on the Veteran’s ability to secure and follow substantially gainful employment without regard to age and nonservice-connected conditions, and with consideration of his education and vocational background. All opinions must be supported by a rationale. A. C. MACKENZIE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A-L Evans, 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.