Citation Nr: 21015012 Decision Date: 03/16/21 Archive Date: 03/16/21 DOCKET NO. 17-04 140 DATE: March 16, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disorder, to include as due to service-connected disabilities, is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Navy from March 1993 to March 1995. This matter comes before the Board of Veterans Appeals (Board) on appeal from an August 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In August 2019, the Veteran testified at a hearing before the undersigned. A transcript of the hearing has been associated with the claims file. This matter was remanded by the Board in December 2019 for an opinion to address secondary service connection. In the December 2019 Board remand the examiner was directed to provide an opinion as to direct service connection for the Veteran’s acquired psychiatric disorder, and whether the psychiatric conditions were secondary to the Veteran’s service-connected right fifth finger injury. The Veteran received a VA examination in March 2020. While, the examiner provided a negative opinion as to direct service connection, he did not address secondary service connection. In a secondary service connection claim, a medical opinion that a disorder is not the result of an already service-connected disability does not address the issue of aggravation. El-Amin v. Shinseki, 26 Vet. App. 136, 140-41 (2013). Generally, a medical opinion should address the appropriate theories of entitlement. Stefl v. Nicholson, 21 Vet. App. 120, 123-24 (2007). The Board sincerely regrets the additional delay occasioned by multiple remands. However, the Board errs when it fails to ensure substantial compliance with a Board remand. Stegall v. West, 11 Vet. App. 268, 271 (1998) (Board remand confers a right on a claimant to compliance with the remand order). Where the Board fails to ensure substantial compliance, remand is appropriate. Stegall, 11 Vet. App. at 271. The matters are REMANDED for the following action: 1. Obtain an addendum opinion to determine the nature and etiology of the Veteran’s acquired psychiatric disorder. Any and all studies, tests, and evaluations deemed necessary by the examiner should be performed. The examiner is requested to review all pertinent records associated with the claims file, including a copy of this remand, the Veteran’s service treatment records, post-service medical records, and statements. It should be noted that the Veteran is competent to attest to factual matters of which he had first-hand knowledge. If there is a medical basis to support or doubt the history provided by the appellant, the examiner should provide a fully reasoned explanation. After examining the Veteran—if deemed necessary by the examiner—and considering his pertinent medical history and lay statements regarding his reported symptoms, the examiner should opine as to: (a) Whether it is at least as likely as not (a 50 percent probability or greater) that his acquired psychiatric disorder was incurred in, aggravated by, or etiologically related to his military service. (b) Whether it is at least as likely as not (a 50 percent probability or greater) that his acquired psychiatric disorder was caused or aggravated by his service-connected right fifth finger injury. Aggravation is defined as any increase in severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice-connected disease. The examiner is advised that a finding that a disability was aggravated beyond the normal progression due to a service-connected disability does not require evidence of permanent worsening and may encompass any additional impairment in earning capacity resulting from an already service-connected condition. (Continued on the next page) A clear rationale for all opinions must be provided and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. ANTHONY C. SCIRÉ, JR Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Javed 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.