Citation Nr: 21022845 Decision Date: 04/19/21 Archive Date: 04/19/21 DOCKET NO. 18-34 263A DATE: April 19, 2021 REMANDED Entitlement to an initial compensable rating for bilateral hearing loss is remanded. Entitlement to service connection for an acquired psychiatric disorder, to include insomnia and unspecified depressive disorder, is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1958 to February 1962. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a November 2017 rating decision of the Department of Veterans Affairs (VA) agency of original jurisdiction (AOJ). These matters were previously before the Board in September 2020. Because a veteran without medical expertise is not competent to diagnose his particular condition, the Board has broadened the Veteran’s claim for entitlement to service connection for personality structure to incorporate any acquired psychiatric disorder diagnosed during the claims period, including insomnia and unspecified depressive disorder. See Clemons v. Shinseki, 23 Vet. App. 1 (2009). 1. Entitlement to an initial compensable rating for bilateral hearing loss is remanded. As directed in the prior remand, the AOJ obtained March 2017 and March 2018 VA audiology evaluations that had been noted in VA medical center (VAMC) records but were not associated with the claims file. Unfortunately, both audiology evaluations indicate in the comments section that the results are “Not adequate for rating purposes” without stating why. The AOJ must attempt to obtain further information regarding both the March 2017 and March 2018 VA audiology records to explain why the records are inadequate for rating purposes and identify, if possible, the word recognition test used. 2. Entitlement to service connection for an acquired psychiatric disorder, to include insomnia and unspecified depressive disorder, is remanded. An additional VA medical opinion is required on remand. While the prior Board remand requested that an examiner provide an opinion as to whether the Veteran’s depressive disorder clearly and unmistakably preexisted service, there is no evidence of a psychiatric disorder prior to service, and remand for another opinion would serve no useful purpose. However, an opinion regarding the Veteran’s personality disorder is required. Service treatment records show assessments of a personality disorder. The entrance examination report was normal, and the entrance report of medical history does not reflect any reported psychiatric symptoms. Personality disorders are considered congenital or developmental defects and not diseases or injuries within the meaning of applicable legislation and, therefore do not constitute disabilities for VA compensation purposes. See 38 C.F.R. §§ 3.303(c), 4.9. Service connection, however, can be granted for additional disability resulting from a mental disorder that is superimposed upon the personality disorder. 38 C.F.R. §§ 3.303(c), 4.9, 4.127; see also VAOPGCPREC 82- 90, 55 Fed Reg. 45,711 (July 18, 1990). Because the VA examiners’ opinions have not adequately addressed whether any psychiatric disorder was superimposed on the Veteran’s personality disorder resulting in additional disability, an opinion is required. In addition, while the October 2017 VA examiner provided an opinion as to direct service connection, the examiner limited that opinion to depressive disorder and did not address the other current diagnosis of insomnia and a new opinion is required. Finally, the Veteran claimed in July 2020 that his depression was secondary to his service-connected tinnitus. This must be addressed on remand. The matters are REMANDED for the following action: 1. Request that the VA audiologists who performed the March 2017 and March 2018 audiology evaluations explain why the records are inadequate for rating purposes and identify the word recognition test used, if possible. If one or both of the audiologists are unavailable, ask a similarly qualified clinician to provide the responses. 2. Obtain an addendum opinion from an appropriate clinician answering the following questions regarding any acquired psychiatric disorder diagnosed from September 2017 to the present, including insomnia and unspecified depressive disorder. (a.) The examiner must opine whether it is at least as likely as not (50 percent probability or higher) that any psychiatric disability, to include insomnia and depressive disorder, is related to service. (b.) The examiner must also opine whether it is at least as likely as not (50 percent probability or higher) that any psychiatric disability superimposed on a personality disorder resulting in additional disability. If so, identify the additional disability. (c.) Is it at least as likely as not (50 percent probability or higher) that any acquired psychiatric disorder is proximately due to or aggravated beyond its natural progression by service-connected tinnitus? A full and complete rationale must be provided for any opinion reached. 3. Upon completion of the above, and any additional development deemed appropriate, readjudicate the remanded issues. If any issue remains denied, return the matter(s) to the Board for appellate review if otherwise in order. JESSICA SEAY Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board W. Ripplinger, 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.