Citation Nr: 21020981 Decision Date: 04/08/21 Archive Date: 04/08/21 DOCKET NO. 15-35 936 DATE: April 8, 2021 REMANDED Entitlement to service connection for a psychiatric disorder, to include posttraumatic stress disorder (PTSD), dysthymic disorder, and unspecified anxiety disorder, to include as secondary to service-connected disability or disabilities, is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1972 to July 1975. The Department of Veterans Affairs (VA) is grateful for his service. The Board of Veterans’ Appeals (Board) had issued a decision in May 2019 in pertinent part reopening but denying the claim for service connection for a psychiatric disorder, to include PTSD, dysthymic disorder, and an unspecified anxiety disorder. However, at the time of the May 2019 decision, VA was in constructive possession of a May 2019 request by the Veteran’s authorized representative for a 90-day extension to submit additional evidence (which request had not been available for review at the time of the May 2019 decision). After the issuance of the Board decision, the Veteran requested that the Board vacate its May 2019 decision as to this issue. Accordingly, in September 2020, the Board vacated that portion of the May 2019 decision that denied service connection for a psychiatric disorder. The issue thus remains reopened and is now before the Board for further review, to include review of additional submitted evidence.   Entitlement to service connection for a psychiatric disorder, to include PTSD, dysthymic disorder, and unspecified anxiety disorder, to include as secondary to service-connected disability or disabilities, is remanded. In a submitted Disability Benefits Questionnaire (DBQ), dated in July 2017, a private psychologist, Heather Henderson-Galligan reviewed the Veteran’s claims file, examined the Veteran, and diagnosed an unspecified anxiety disorder. She then opined that the disorder more likely than not originated in service and had continued uninterrupted up to the present. She added that the Veteran had a history of self-medication with alcohol in the past. The psychologist additionally opined that the Veteran’s service-connected sinusitis had aggravated his anxiety disorder. Submitted into the record in September 2019 is an additional psychological evaluation and opinion by Dr. Henderson-Galligan, dated in May 2019. Dr. Henderson-Galligan reviewed additional records within the claims file and reiterated her opinion that the Veteran had an unspecified anxiety disorder which more likely than not began in service and continued “uninterrupted” to the present. She then additionally opined that the Veteran’s anxiety disorder was aggravated by his service-connected disabilities of sleep apnea, migraine headaches, and sinusitis. However, she failed to provide a rationale to support these additional opinions of aggravation. The Board finds a remand is warranted to obtain an opinion as to whether the Veteran’s psychiatric disorder is caused or aggravated by a service-connected disability or disabilities. Due to multiple documentations by medical professionals questioning the Veteran’s credibility, the Board finds psychological testing with validity testing should be conducted to better ascertain the nature of the present psychiatric disorder. The matter is REMANDED for the following action: Obtain a new VA psychiatric examination to address the nature and etiology of any psychiatric disability present during the claim period on a secondary basis. The claims file must be reviewed, and examination and psychiatric testing should be conducted with validity testing, with the results reported in detail. Validity testing is required in this case due to the Veteran’s past inconsistent and contradictory reporting, resulting in impaired credibility of self-reported symptoms and history. See May 2013, April 2014, and January 2019 VA examination reports. To assist in a review of the claims file, the examiner is informed of the following facts: • The Veteran is service connected for obstructive sleep apnea, chronic sinusitis, and migraine headaches. • The Veteran claims that he has a psychiatric disorder that is caused or aggravated by the service-connected obstructive sleep apnea, chronic sinusitis, and/or migraine headaches. The examiner is asked to provide the following opinions: 1. Is it at least as likely as not (50 percent probability or greater) that the psychiatric disorder is caused by obstructive sleep apnea, chronic sinusitis, and/or migraine headaches? Please state upon what facts and medical principles you base the opinion. 2. If the answer to (1) is negative, is it at least as likely as not (50 percent probability or greater) that the psychiatric disorder is aggravated by obstructive sleep apnea, chronic sinusitis, and/or migraine headaches? Aggravation is different from causation in that it did not cause the disability but that it aggravated the disability. Please state upon what facts and medical principles you base the opinion. 3. If the examiner finds that obstructive sleep apnea, chronic sinusitis, and/or migraine headaches aggravates the psychiatric disorder, the examiner is asked to state whether there is medical evidence created prior to the aggravation or at any time between the time of aggravation and the current level of disability that shows a baseline for the lumbar spine disability prior to aggravation. If the examiner is unable to establish a baseline for the lumbar spine disability prior to the aggravation, he or she should state such and explain why a baseline cannot be determined. The examiner is asked to provide a rationale for each opinion given, including providing the medical principles and evidence relied upon for each opinion. If the examiner is unable to provide an opinion without resorting to speculation, he or she should explain why this is so and what, if any, additional evidence would be necessary before an opinion could be rendered. A. P. SIMPSON Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Schechter 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.