Citation Nr: 21023830 Decision Date: 04/21/21 Archive Date: 04/21/21 DOCKET NO. 17-22 653 DATE: April 21, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disorder is remanded. REASONS FOR REMAND The Veteran had active service in the United States Marine Corps from January 1979 to January 1983. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a June 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge (VLJ) at a videoconference Board hearing in January 2020; a transcript of that hearing is of record. This matter was most recently before the Board in May 2020 when it was remanded for additional development. The Veteran’s prior attorney representative is no longer accredited by VA. As such, he can no longer represent the Veteran in this appeal. An April 15, 2021 correspondence notified the Veteran of this and that he could submit a VA Form 21-22 or 21-22a appointing a new representative.   Entitlement to service connection for an acquired psychiatric disorder is remanded. The Veteran asserts service connection for an acquired psychiatric disorder. He has a current diagnosis of substance induced bipolar disorder as reported at the September 2020 examination. As such, the first element of service connection is met. The Veteran testified at a Board hearing in January 2020. He asserted that he has an acquired psychiatric disorder that is related to his time in service. Specifically, he experienced a motor vehicle accident during service as well as his experiences in Beirut and Iran. The Board notes that his service treatment records document a motor vehicle accident in December 1980. Moreover, he has contended that his acquired psychiatric disorder is secondary to his service-connected traumatic brain injury (TBI). He also testified that following his service, his spouse told him that he acts different. He has had nightmares and poor sleep since he exited service. The Board finds the Veteran competent and credible to describe his in-service experiences. Jandreau v. Nicholson, 492 F.3d1372, 1377, 1377 n.4 (Fed. Cir. 2007). However, he is not competent to provide an etiology opinion for his acquired psychiatric disorder as the issue is medically complex and requires a thorough understanding of the psychiatry and/or psychology. A negative nexus opinion was provided in September 2020. The examiner explained that as the Veteran did not have mental health treatment or an Article 15 while in service, that his disorder did not have its onset in service. The Board finds that the examiner only partially addressed the direct service connection claim. While the Board finds some probative value in the disorder not manifesting in service, the examiner did not further address whether the disorder was caused by his service, to include his motor vehicle accident, and did not initially manifest during service. The Board has found the Veteran competent and credible to describe his symptoms which arose after service, in addition to reporting his experiences during service. As such, the Board finds that an addendum opinion is warranted to fully discuss the Veteran’s reported symptoms that developed after service, his experiences during service, and whether his disability was caused by service rather than only manifesting during service. This matter is REMANDED for the following actions: 1. Obtain any outstanding VA treatment records. All requests and responses for the records must be documented. If any identified records cannot be obtained, notify the Veteran of the missing records, the efforts taken, and any further efforts that will be made by VA to obtain such evidence, and allow him an opportunity to provide the missing records. 2. After completing #1, obtain an addendum (or an examination if necessary). Send the file to an appropriate mental health examiner (licensed psychologist and/or psychiatrist) and ask the clinician to review the claims file. If the mental health specialist needs an in-person examination, then schedule one. --Identify any acquired psychiatric disability, to include, PTSD, bipolar disorder, substance abuse disorder, or any other psychiatric disorder since March 2015. Then, the mental health specialist is to address the following (a.) For each current psychiatric disability, the examiner is to provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that any of the Veteran’s current (present at any time since March 2015) psychiatric disabilities, in whole or part, had their onset in service, or are otherwise the result of a disease or injury in service, to include an in-service motor vehicle accident tin December 1980. See 4/13/2015, STR – Medical – MVA. (b.) If not, is it at least as likely as not (50 percent or greater) that the Veteran’s psychiatric disability is either 1) proximately due to OR 2) aggravated by the Veteran’s service-connected disabilities (such as TBI)? **The Board has found the Veteran competent and credible to report developing symptoms (sleep impairment, social isolation, among others) soon after service. Additionally, the examiner may not rely solely on the absence of medical treatment to provide a negative nexus opinion.** See 1/14/2020, Hearing Transcript, at p. 7-9. The term “aggravated” refers to a worsening of the underlying condition beyond the natural progression of the disease, as opposed to temporary or intermittent flare-ups or symptoms that resolve with return to the baseline level of disability. If aggravation is found, please state, to the extent possible, the baseline level of disability prior to aggravation. A comprehensive rationale for all opinions must be provided. All pertinent evidence, including both lay and medical, should be considered. (Continued on the next page)   If an opinion cannot be provided without resorting to speculation, the examiner must explain why this is so and state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), the record (additional facts are required), or the examiner (does not have the knowledge or training). Paul Sorisio Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board G. Morales, Associate 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.