Citation Nr: 21020771 Decision Date: 04/08/21 Archive Date: 04/08/21 DOCKET NO. 16-20 243 DATE: April 8, 2021 REMAND Entitlement to service connection for a psychiatric disability, to include depression, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from February 2004 to February 2008. The Veteran submitted a timely substantive appeal (VA Form 9) in this claim in May 2016 in which the Veteran requested a Board hearing before a Veteran’s Law Judge (VLJ). In March 2019, the Veteran was notified that she was scheduled for that hearing in April 2019, the Veteran did not appear at the scheduled hearing and did not provide any good cause with regards to her absence. As such, the Board finds that the VA has fulfills its duty in affording the Veteran an opportunity to appear at a hearing before a VLJ and present testimony. 1. Entitlement to service connection for a psychiatric disability, to include depression With regard to the claim for service connection for a psychiatric disability, the Board finds that the most recently obtained VA examination and nexus opinion in March 2015 is inadequate, and remand is required to obtain additional opinion for the VA to fulfill the duty to assist the Veteran. The Board notes that the VA’s statutory duty to assist the Veteran includes the duty to conduct a thorough and contemporaneous examination so that the evaluation of the claimed disability will be a fully informed one. Green v. Derwinski, 1 Vet. App. 121 (1991); Snuffer v. Gober, 10 Vet. App. 400 (1997). Assistance by VA includes providing a medical examination or obtaining a medical opinion when such an examination or opinion is necessary to make a decision on a claim. 38 U.S.C. § 5103A(d); 38 C.F.R. § 3.159(c)(4); McLendon v. Nicholson, 20 Vet. App. 79 (2006). When the medical evidence is inadequate, as it is here, VA must supplement the record by seeking an advisory opinion or ordering another medical examination. Colvin v. Derwinski, 1 Vet. App. 171 (1991); Hatlestad v. Derwinski, 3 Vet. App. 213 (1992). The Board finds that the March 2015 VA examination and nexus opinion fail in providing an adequate rationale with regards to addressing in-service aggravation of the Veteran’s preexisting psychiatric disability. Specifically, the examiner’s opinion, while adequately establishing that the Veteran entered service with some level of psychiatric distress, and/or condition, failed to explain how such condition was not aggravated beyond its natural progression during service. While the examiner ultimately concluded that the Veteran’s condition was “clearly” not aggravated by service, the examiner based such finding that the Veteran entered service with a level of impairment and function. To this end, however, in the examiner own notes during the examination/interview of the Veteran, the examiner noted that much of the more severe symptoms did not arise until 2004, after the Veteran entered service. Specifically, the Veteran explicitly noted that she did not start cutting herself until after she entered service, or start her severe substance abuse until after her entry into active service; neither of these specific events were addressed or reconciled by the VA examiner’s opinion. The Board finds that the examiner’s failure to address and reconcile these notations regarding reported aggravations of the Veteran’s condition during service renders the opinion to be inadequate. While the Board is not competent to speak to the medical/psychiatric implications of such actions and reported manifestations of the Veteran’s condition during service, the Board may find that the lack of discussion regarding these inservice symptoms to render the opinion incomplete. Consequently, such addendum is also considered to be inadequate. As such, remand is required for the VA to fulfill its duty to the Veteran. The matters are REMANDED for the following action: 1. The Agency of Original Jurisdiction should obtain copies of VA treatment records for the Veteran’s disabilities. 2. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s claimed psychiatric disabilities, which has been conceded by the VA, to have preexisted the Veteran’s service, was aggravated beyond its’ natural progression by any aspect of her active service, or during her active service. The examiner must address all the relevant evidence of record, to explicitly include reconciling any opinion with that already of record. The examiner must also speak directly to any symptoms and manifestations that arose during service, that was not noted upon entry to service, or on medical/treatment records prior to service. The examiner must consider and discuss the Veteran’s lay statements. The rationale for all opinions must be provided. DELYVONNE M. WHITEHEAD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Ziheng Zhu, 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.