Citation Nr: 21014614 Decision Date: 03/15/21 Archive Date: 03/15/21 DOCKET NO. 17-42 498 DATE: March 15, 2021 ORDER Entitlement to service connection for an acquired psychiatric disability is granted. REMANDED Entitlement to a total disability rating based upon individual unemployability due to service-connected disabilities (TDIU) is remanded. FINDING OF FACT The Veteran’s has a psychiatric disability that developed during her active service as a result of her bilateral stress fractures of the lower extremities. CONCLUSION OF LAW The criteria for service connection for an acquired psychiatric disability have been met. 38 U.S.C. §§ 1110, 1131, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303, 3.310 (2019). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January to May 1997. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a March 2013 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). Service Connection – Acquired Psychiatric Disability The Veteran has asserted that her diagnosed depressive disorder was directly caused by her active military service, or alternatively, is secondary to her service-connected bilateral stress fractures of the lower extremities. The Veteran was afforded a VA examination in February 2020. The examiner noted a diagnosis of an unspecified depressive disorder but indicated that the Veteran made no mention of her service-connected disabilities being a precipitating factor for the onset of her mental health symptoms. It was noted that the Veteran first sought mental health treatment in 2013-2014 and that treatment since that time has included prescription medication as well as brief periods of mental health counseling and therapy. Additional personal circumstances influencing the progression of the Veteran’s mental health disability were also noted. The examiner overall opined that the Veteran’s mental health disability is less likely than not related to active military service, or secondary to service-connected disabilities because of the absence of incidents in service and the Veteran’s failure to mention service-connected medical conditions as influencing or causing her mental health symptoms. Private treatment records include a 2014 mental health treatment noting a diagnosis of unspecified depressive disorder, and relating that diagnosis to the Veteran’s service-connected bilateral stress fractures of the lower extremities. An addendum report from the same mental health treatment provider, based upon review of the entirety of the Veteran’s claims file as well as referencing a prior in-person examination and updated records, was submitted in September 2020. That report confirmed an opinion that the Veteran’s unspecified depressive disorder is more likely than not due to active military service, but this opinion, unlike the 2014 report, directly relates it to the Veteran’s period of service, finding that it began in service as a result of bilateral shin splints (service-connected as bilateral stress fractures of the lower extremities) and has continued ever since. This opinion includes a thorough rationale that no mental health symptoms were present prior to service, and statements provided by close family members and friends confirm the onset of symptoms upon the Veteran’s return from active service. Service treatment records confirm that X-rays from the Moncrief Army Hospital in March 1997 demonstrated stress fractures in both tibias and in the left femur. The following month, in April 1997, service personnel records depict that the Veteran began having difficulty with the pain in her legs, and as a result, began having issues with motivation and following instructions. The Veteran later reported to mental health treatment providers that these incidents caused trouble sleeping and difficulty in dealing with stress, self-esteem, and symptoms of depression. Accordingly, the Board finds that the evidence for and against the claim is at least in equipoise. Therefore, the benefit of the doubt must be resolved in favor of the Veteran, and entitlement to service connection for an acquired psychiatric disability is warranted. 38 U.S.C. § 5107 (b) (2018); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). REASONS FOR REMAND Entitlement to a TDIU At this time, the Veteran does not currently meet the schedular criteria for entitlement to a TDIU. However, because the grant of service connection for an acquired psychiatric disability may impact the Veteran’s overall disability rating, the Board finds that the issue of entitlement to a TDIU must be deferred to take into consideration the disability rating assigned for service connection for depression, as granted herein. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991). This matter is REMANDED for the following action: 1. Implement the Board’s grant of entitlement to service connection for an acquired psychiatric disability and assign an appropriate rating. 2. Identify and obtain any pertinent, outstanding VA and private treatment records and associate them with the claims file, and conduct any other development determined to be warranted. 3. Then, adjudicate the issue of entitlement to a TDIU. If a decision is adverse to the Veteran, issue a supplemental statement of the case and allow appropriate time for response. Then, return the case to the Board. Kristin Haddock Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E. Sutherell, 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.