Citation Nr: 21016239 Decision Date: 03/22/21 Archive Date: 03/22/21 DOCKET NO. 17-45 045 DATE: March 22, 2021 REMANDED Service connection for a psychiatric disorder, to include anxiety and depression, is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1953 to March 1955. The case is on appeal from a February 2017 rating decision. The Veteran has been adjudicated as not competent to handle disbursement of payments of VA compensation benefits, and his spouse has been appointed as his fiduciary with respect to matters before the Department of Veterans Affairs (VA). She has pursued this appeal on his behalf and is the appellant in this case. This matter was previously before the Board in October 2018, and the Board denied the claim. The appellant appealed the matter to the Court of Appeals for Veteran’s Claims (Court). In a July 2019 order, the Court granted a Joint Motion for Remand (JMR), vacated the Board’s October 2018 denial, and remanded the matter to the Board for action consistent with the JMR. Thereafter, in January 2020, the Board remanded the claim of service connection for a psychiatric disability for a VA examination with a psychiatrist or psychologist to determine the etiology of any diagnosed psychiatric disability. In November 2020, the Board remanded the claim of service connection for anxiety and depression for an additional examination and opinion to determine whether the anxiety and depression disorders were present at the time of claim filing or any time thereafter and, if so, whether any such disorder is related to service. In December 2020, the VA Regional Office issued a supplemental statement of the case denying service connection for anxiety and depression. Service connection for a psychiatric disorder, including anxiety and depression is remanded. Remand is required for an addendum medical opinion. As noted above, in November 2020, the Board remanded the claim of service connection for anxiety and depression for an additional examination and opinion to determine whether the anxiety and depression disorders were present at the time of claim filing or any time thereafter and, if so, whether any such disorder is related to service. The Veteran subsequently underwent a VA examination in December 2020. The examiner diagnosed a neurocognitive disorder but did not diagnose anxiety or depression. In the medical opinion, the examiner noted that by review of the record he could see that several mental diagnoses had been documented since July 2016, to include generalized anxiety disorder, moderate depression-recurrent, and depression, nos. However, the examiner explained that he could not provided the requested medical opinion without resort to mere speculation; it was implied that the reason for this was because they were not diagnosed on examination at the present. When an examiner states that he or she cannot offer an opinion without resort to speculation, that opinion is adequate only when it is clear that it is predicated on a lack of knowledge among the medical community at large and not the insufficient knowledge of the specific examiner. Jones v. Shinseki, 23 Vet. App. 382, 390 (2010). Here, the Board finds the examiner’s opinion inadequate to this limited extent because he did not provide sufficient rationale for why an opinion could not be provided without resort to mere speculation. Accordingly, an addendum opinion should be obtained on remand. The matter is REMANDED for the following action: 1. Obtain an addendum opinion concerning the etiology of the Veteran’s anxiety and depression. The examiner must review the entire claims file in conjunction with authoring this opinion. A December 2020 VA examiner noted that diagnoses of anxiety and depression were documented since July 2016; however, it was determined that a nexus opinion could not be provided without mere speculation, implicitly because such diagnoses were not found at the time of the examination. The Board has found that explanation inadequate and requires a new opinion and rationale. Is it at least as likely as not (a 50 percent or greater probability) the Veteran’s depression and/or anxiety were incurred in, or are otherwise related to, his active service? The examiner should consider all relevant evidence of record in authoring this opinion. When an examiner states that he or she cannot offer an opinion without resort to speculation, that opinion is adequate only when it is clear that it is predicated on a lack of knowledge among the medical community at large and not the insufficient knowledge of the specific examiner. Jones v. Shinseki, 23 Vet. App. 382, 390 (2010). (Continued on the next page)   A complete rationale must be provided for all opinions expressed. Mike Sobiecki Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M.L. Thomas 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.