Citation Nr: 21015422 Decision Date: 03/17/21 Archive Date: 03/17/21 DOCKET NO. 10-34 234 DATE: March 17, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disability is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1967 to December 1969, to include service in Vietnam. 1. Entitlement to service connection for an acquired psychiatric disability is remanded. Unfortunately, there has not been substantial compliance with the Board’s previous remand directives regarding the issue of entitlement to service connection for an acquired psychiatric disability. Another remand is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). The Board’s February 2020 remand specifically requested a medical examiner’s opinion addressing both direct and secondary service connection theories of entitlement. In June 2020, a VA examiner opined that the Veteran’s diagnosed unspecified depressive disorder was less likely than not due to his combat exposure in Vietnam. The examiner stated that the condition was likely due to medical procedures associated with non-service-connected disabilities. However, in reaching this conclusion, the examiner did not provide any rationale explaining why the Veteran’s combat experience could not be the source of his depressive disorder, or alternatively why the cited medical procedures were more likely the source of this condition. The examiner used the same conclusory rationale to find that the depressive disorder was not due to his service-connected disabilities. The examiner also failed to address whether the Veteran’s depressive disorder was aggravated by his service-connected disabilities. Instead, the examiner concluded without explanation that the Veteran’s psychiatric disability “clearly and unmistakably existed prior to service”. Remand is needed for a more responsive opinion on the etiology of the Veteran’s diagnosed depressive disorder. 2. Entitlement to a TDIU is remanded. Finally, because a decision on the remanded issue of entitlement to service connection for an acquired psychiatric disability could significantly impact a decision on the issue of entitlement to a TDIU, the issues are inextricably intertwined. Therefore, further consideration of the TDIU claim must be deferred. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s depressive disorder is at least as likely as not related to the Veteran’s combat experience in Vietnam. If the examiner finds that the depressive disorder is more likely related to another event or source, he or she should provide a detailed explanation for why the Veteran’s depressive disorder is not related to his combat experience. The examiner must also opine whether the Veteran’s depressive disorder is at least as likely as not caused or aggravated by service-connected back and/or knee disabilities. A complete rationale must be provided for all opinions offered. 2. Confirm that the VA medical opinion provided comports with this remand, specifically that the standard for the secondary aggravation opinion is any increase in disability, not the standard of beyond the natural progression as noted on the examination form itself. 3. After the above development, and any additionally indicated development, has been completed, readjudicate the issues on appeal, including the inextricably intertwined issue of entitlement to TDIU. If the benefit sought is not granted to the Veteran’s satisfaction, send the Veteran and his representative a Supplemental Statement of the Case and provide an opportunity to respond. If necessary, return the case to the Board for further appellate review. Jack S. Komperda Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board P.S. McLeod 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.