Citation Nr: 21026258 Decision Date: 04/30/21 Archive Date: 04/30/21 DOCKET NO. 14-18 217 DATE: April 30, 2021 REMANDED Entitlement to service connection for hepatitis C is remanded. Entitlement to service connection for acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD), is remanded. Entitlement to service connection for substance abuse is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1972 to February 1975. These matters come before the Board of Veterans’ Appeals (Board) from a November 2009 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge in August 2017, and a transcript of that hearing is of record. In November 2019, the Board denied these claims, and the Veteran appealed to the United States Court of Appeals for Veterans Claims (CAVC). With regards to the part of the Board decision that denied service connection for an acquired psychiatric disorder, to include PTSD, pursuant to a joint motion for remand (JMR) granted by the CAVC in December 2020, the November 2019 Board decision was vacated and remanded to obtain an adequate nexus opinion consistent with the February 2018 Board remand instructions. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Specifically, the parties to the JMR agreed that the October 2018 VA examiner’s opinion (the Veteran “has been clean for 15 years and has not required any additional mental health treatment…”) appears to be based on an inaccurate factual basis as the Veteran has received mental health treatment as recently as August 2015. As for the part of the Board decision that denied service connection for substance abuse and hepatitis C, the parties to the JMR also agreed it should be vacated and remanded as these claims are inextricably intertwined with the Veteran’s claim for service connection for an acquired psychiatric disorder. The matters are REMANDED for the following action: 1. Obtain any VA medical records for treatment from July 2019 to present. 2. DO NOT SCHEDULE THE FOLLOWING until the above VA records are obtained, to the extent they exist. 3. Then, return the file to the to the October 2018 VA examiner (or if unavailable, with another appropriate VA examiner). An in-person examination is not needed, unless the examiner deems otherwise. The examiner is requested to review the Veteran’s entire electronic claims file, including this REMAND, prior to examination. Such review must be noted in the examination report. The examiner is then requested to: (a.) Opine on whether the Veteran’s acquired psychiatric diagnoses diagnosed during the appeal period (see below) are at least as likely as not (probability of at least 50 percent) etiologically related to active duty military service, to include his credible reports of in-service personal assault. While the October 2018 VA examiner opined that the Veteran “has been clean for 15 years and has not required any additional mental health treatment,” the evidence of record shows he received mental health treatment as recently as August 2015 with diagnoses including psychosis, depression and unspecified anxiety state. Even if the examiner concludes no current diagnosis is warranted, an opinion must still be given as to the prior diagnoses and their relationship to service. (b) Opine on whether the Veteran has experienced a current substance abuse disability at any time since his disability application was received in March 2009. (c) If so, is it at least as likely as not (probability of at least 50 percent) that the Veteran’s current substance abuse disability is caused by or aggravated by any of his diagnosed acquired psychiatric disabilities? The examiner must provide a complete rationale for any opinion expressed that is based on the examiner’s clinical experience, medical expertise, and established medical principles. If an opinion cannot be made without resort to speculation, the examiner must explain why this is so and note what, if any, additional evidence would permit an opinion to be made. 4. Then, readjudicate the claims on appeal. If the benefits sought on appeal are not granted, the Veteran and his representative should be provided a supplemental statement of the case and an appropriate time period for response. MICHELLE L. KANE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Lee 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.