Citation Nr: 21023827 Decision Date: 04/21/21 Archive Date: 04/21/21 DOCKET NO. 16-08 329 DATE: April 21, 2021 ORDER Entitlement to an acquired psychiatric disorder, to include mood disorder and adjustment disorder with mixed anxiety and depressed mood, including as secondary to service-connected low back disability, is granted. FINDING OF FACT The Veteran’s acquired psychiatric disorder, to include mood disorder and adjustment disorder with mixed anxiety and depressed mood, is secondary to his service-connected low back disability. CONCLUSION OF LAW The criteria for service connection for acquired psychiatric disorder, to include mood disorder and adjustment disorder with mixed anxiety and depressed mood, as secondary to service-connected low back disability are met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from September 2008 to January 2012. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2013 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Board notes that the Veteran elected to appear before the Board for an optional hearing on his February 2016 VA Form-9. However, in August 2019, the Veteran withdrew the hearing request. Accordingly, the Board considers the Veteran’s request for a hearing to be withdrawn. 38 C.F.R. § 20.704(e). As the medical evidence contains multiple psychiatric diagnoses, the Board has recharacterized the claim on appeal accordingly. Clemons v. Shinseki, 23 Vet. App. 1 (2009). Entitlement to an acquired psychiatric disorder, to include mood disorder and adjustment disorder with mixed anxiety and depressed mood, including as secondary to service-connected low back disability The Veteran contends that he first began experiencing symptoms of an acquired psychiatric disorder in service. In the alternative, the Veteran claims that his acquired psychiatric disorder is secondary to his service-connected low back disability. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). Service connection may also be established on a secondary basis for: (1) a disability that is proximately due to or the result of a service-connected disease or injury; or, (2) any increase in the severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice-connected disease or injury. 38 C.F.R. § 3.310(a)-(b). In order to establish service connection for a disability on a secondary basis, there must be (1) medical evidence a current disability; (2) evidence of a service-connected disability; and (3) medical nexus evidence establishing a connection, or link between, the current disability and the service-connected disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998). The Veteran’s service treatment records show that he was diagnosed with adjustment disorder in October 2011. The Veteran post-service treatment records include VA treatment records from February 2012 showing a diagnosis for mood disorder. The Veteran was provided with a mental disorders examination in December 2016 where he was noted to have a diagnosis for generalized anxiety disorder and major depressive disorder. The examiner opined that the Veteran’s psychiatric disability was at least as likely as not aggravated beyond its natural progression by his serv-connected low back disability because the Veteran’ “feels angry and irritable when people and things in his surroundings are not what he thinks they should be.” The examiner added that the Veteran “feels anxious when he does not feel in control,” and “having to cope with chronic pain adds to his irritability and feelings of hopelessness but is not the sole cause of it.” The Veteran was provided with another mental disorders examination in May 2019 where he was noted to have a diagnosis for adjustment disorder with mixed anxiety and depressed mood. The examiner found that the Veteran did not have a diagnosis for generalized anxiety disorder because there were no “findings, signs and or symptoms to support a diagnosis.” The examiner also noted that the Veteran did not have major depressive disorder because the Veteran’s depression “appears to be connected to an adjustment disorder- to his medical conditions.” The May 2019 examiner found that the Veteran’s “adjustment disorder with mixed anxiety and depressed mood is at least as likely as not, the result of his service connected conditions.” Although the examiner checked the box noting that the Veteran’s condition is less likely than not proximately due to a service-connected disability, the examiner explained that the Veteran did not have a diagnosis for generalized anxiety disorder, but his adjustment disorder was due to his service-connected conditions. As such, it appears that the examiner checked the wrong box in providing her conclusion and based on the written opinion, the examiner found that the Veteran’s adjustment disorder was related to his service-connected conditions. In addition to causation, the May 2019 examiner also found that the Veteran’s adjustment disorder with mixed anxiety and depressed mood was at least as likely as not aggravated beyond its natural progression by his service connected disabilities. The examiner noted that the Veteran did not have any mental health issues prior to service. The examiner provided the rationale that the Veteran is not able “to do heavy labor jobs due to his back,” and he has “feelings of worthlessness due to not being able to hold down a job long enough.” The Board finds that the December 2016 and May 2019 medical opinions are probative medical evidence showing that the Veteran’s acquired psychiatric disorder, to include mood disorder and adjustment disorder with mixed anxiety and depressed mood is aggravated by his service-connected disabilities, to specifically include his low back disability. Accordingly, the Board finds that service connection for an acquired psychiatric disorder is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. M. Donohue Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Morrad, 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.