Citation Nr: 21021032 Decision Date: 04/09/21 Archive Date: 04/09/21 DOCKET NO. 12-00 873 DATE: April 9, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disorder is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1965 to January 1967. The claim has a complicated procedural history that has been addressed by the Board in previous decisions. Most recently, the Board denied the claim in a March 2017 decision which the Veteran appealed to the United States Court of Appeals for Veterans Claims (Court). In a September 2017 order, the Court granted the parties Joint Motion for Remand (JMR). Thereafter, the Board remanded the claim in February 2018. There has not been substantial compliance with the remand directives and the claim must be remanded again. Stegall v. West, 11 Vet. App. 268 (1998). Entitlement to service connection for an acquired psychiatric disorder is remanded. The claim must be remanded again because the March 2019 VA medical opinion is inadequate. Barr v. Nicholson, 21 Vet. App. 303 (2007). The examiner provided a negative opinion as to direct and secondary service connection but considered the improper burden of proof: “beyond a reasonable doubt.” The matters are REMANDED for the following action: 1. Forward the copies of all pertinent records to an appropriate VA examiner to obtain a medical opinion as to the likely etiology of any diagnosed psychiatric disability. If the examiner determines that an opinion cannot be provided without an examination, one should be scheduled (or telehealth interview, review of the record, etc., if an in-person examination is not feasible). After reviewing the claims file, the examiner is asked to answer the following questions: (a) Identify all psychiatric disabilities diagnosed since September 2010. (b) Is it at least as likely as not (50 percent probability) that any diagnosed psychiatric disability identified is proximately due to (caused by) the Veteran’s service-connected disabilities? (c) If the answer to (b) is no, is it at least as likely as not that any diagnosed psychiatric disability identified is aggravated by the Veteran’s service-connected disabilities? Aggravation here is defined as any increase in disability. If aggravation is present, the clinician should indicate, to the extent possible, the approximate level of disability (baseline) before the onset of the aggravation. The examiner is also informed that the proper standard of proof is whether it is “at least as likely as not (50 percent probability)” and NOT the higher standard of beyond a reasonable doubt. A complete rationale must be provided for all opinions. If the examiner cannot provide an opinion without resort to speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge; the examiner’s own expertise, or; whether additional facts are required and note what, if any, additional evidence would permit such an opinion to be made. 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. If not, get an addendum. M.E. Larkin Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. G. Perkins, 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.