Citation Nr: 21023783 Decision Date: 04/21/21 Archive Date: 04/21/21 DOCKET NO. 13-23 126 DATE: April 21, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disorder (other than posttraumatic stress disorder (PTSD)), to include bipolar disorder (previously claimed as cyclothymic disorder), to include as secondary to service-connected PTSD, is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) due to service-connected disabilities is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1965 to January 1968. This case comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2012 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Denver, Colorado. These matters were previously before the Board in July 2017, March 2019, and October 2020, where they were remanded for further development. The Board notes that there was again not substantial compliance with its October 2020 remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998); D’Aries v. Peake, 22 Vet. App. 97, 105 (2008). 1. Acquired Psychiatric Disorder (Other Than PTSD) In October 2020, the Board remanded the Veteran’s claim for additional development, requesting that the Veteran be provided an addendum VA medical opinion to determine the current nature and etiology of the Veteran’s acquired psychiatric disorder(s) (other than PTSD). In particular, the RO was directed to have an examiner opine as to whether it was at least as likely as not that the Veteran had a personality disorder in service and, if so, whether any current psychiatric disability is due to the aggravation of the Veteran's personality disorder by superimposed disease or injury related to military service. The law states that personality disorders are not diseases within the meaning of applicable legislation providing compensation benefits. 38 C.F.R. § 3.303 (c). However, service connection may be granted, in limited circumstances, for another disability due to aggravation of a constitutional or developmental abnormality (to include personality disorder), by superimposed disease or injury. Here, the Veteran was examined remotely by a VA examiner in February 2021. In pertinent part, the examiner opined that the Veteran’s personality disorder at least as likely as not pre-existed military service and was, therefore, present during military service. He further opined that the personality disorder was not aggravated by the Veteran’s military service. However, he did not specifically opine whether the Veteran’s personality disorder in service caused or aggravated a superimposed disability (other than PTSD, but to include major depressive disorder and bipolar disorder). Accordingly, a remand is necessary to address the matters discussed above. 2. TDIU As development of the Veteran’s disability claim before the Board may have an impact on the Veteran’s TDIU claim, the Board finds these issues to be inextricably intertwined. Harris v. Derwinski, 1 Vet. App. 180 (1991). Accordingly, the Board will defer adjudication of the inextricably intertwined TDIU claim at this time. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination. The entire claims file, including a copy of this remand, must be made available to the examiner, and note review of the record in the examination report. Any indicated tests or studies should be performed, and all material relevant evidence should be discussed. All pertinent medical complaints, symptoms, and clinical findings must be reported in detail. Following complete review of the record, the examiner must address the following: a) What are the Veteran’s psychiatric disorders, other than PTSD? Has he suffered from a mood disorder, bipolar disorder, or other psychiatric disorder during the appeal period? b) Opine whether it is at least as likely as not that any current psychiatric disability (other than the already service-connected PTSD) was superimposed on top of the Veteran’s diagnosed personality disorder while in service. Note: VA may not grant service connection for a personality disorder but may grant service connection when another mental disorder is “superimposed” upon a personality disorder. Superimposed is not defined in the regulations, but a common definition is that one thing is placed over another, typically so that both are still evident. c) Provide an opinion as to the effects of the Veteran’s psychiatric disorders on his ability to obtain and maintain gainful employment. Any opinion should include a detailed rationale. The examiner should consider the entire claims file, and discuss the Veteran's lay statements regarding the nature, onset, and chronicity of symptoms. The examiner is advised that the Veteran is competent to report symptoms, and that his reports must be considered in formulating the requested opinion. R. Erdheim Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Dodd, Ryan 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.