Citation Nr: 21026660 Decision Date: 05/03/21 Archive Date: 05/03/21 DOCKET NO. 17-59 006A DATE: May 3, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD) is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1985 to December 1985. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2015 rating decision. The Veteran was afforded a hearing before the undersigned Veterans Law Judge in March 2021. VA treatment records and the August 2015 and November 2020 VA examinations reflect the Veteran has diagnoses of unspecified depressive disorder, major depressive disorder, anxiety, and depression. The Board notes that the Veteran claimed entitlement to service connection for posttraumatic stress disorder (PTSD); this claim has been expanded from the Veteran's original claim to include all acquired psychiatric disorders. See Clemons v. Shinseki, 23 Vet. App. 1 (2009) (finding a claimant without medical expertise cannot be expected to precisely delineate the diagnosis of his mental illness). 1. Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD) is remanded. The Veteran contends that service connection is warranted for PTSD resulting from a personal assault during service. Claimed stressors must generally be verified, but VA has acknowledged that stressors related to military sexual trauma (MST) may be more difficult to corroborate than other claimed stressors. Accordingly, in such cases, stressors may be verified via alternate means, including through behavior changes, records from law enforcement authorities, and statements from fellow soldiers, family members, or friends. Although STRs do not document any reported assault allegations, the Board finds sufficient corroborating evidence to conclude that the Veteran's reported in-service stressor due to personal assault occurred. The regulation relating to personal assault reflects VA's judgment that unreported personal assaults occur frequently in the military. The record does not include any contemporaneous corroborating evidence, such as police reports or medical examinations; however, the Veteran provided an explanation as to why she did not report an assault by an unknown male because she did not see who attacked her. She told her mother and sister about the incident. The Board further notes that the fact that mental health professionals treating the Veteran post-service have accepted that the stressors occurred can be considered corroborating evidence. See Menegassi v. Shinseki, 638 F.3d 1379, 1381 (Fed. Cir. 2011); Patton v. West, 12 Vet. App. 272, 282 (1999). Accordingly, the Board resolves all reasonable doubt in favor of the Veteran to find that there is sufficient evidence in the record to establish that she experienced a personal assault during service. VA treatment records include recognition of a history of MST and diagnoses of major depressive disorder with psychotic features, generalized anxiety disorder, panic disorder w/agoraphobia, and "other specified trauma related disorder--hx MST not meeting criteria for PTSD" by VA staff psychiatrist P.S. The Veteran was afforded a VA examination in August 2015. The August 2015 VA examiner opined that the Veteran's unspecified depressive disorder was not at least as likely as not related to an MST in 1985. The examiner reasoned that the Veteran's depression appears to be recent and the result of disruptions in personal relationships with her children and economic stressors related to unemployment. The examiner found the Veteran's psychological testing administered was invalidated by overreporting. This occurs when someone attempts to exaggerate or feign symptoms, but it may also occur when an individual genuinely believes they have symptoms that are not based in objective medical reality. The Veteran was afforded another examination in November 2020. The VA examiner opined the Veteran's unspecified depressive disorder was less likely than not related to an MST. The examiner reasoned the Veteran's military records do not have any markers and that due to lack of markers, the unspecified depressive disorder was not at least as likely as not due to the claimed MST. Because the examiner based the conclusion on the lack of markers in service and the Board has found the Veteran experienced a personal assault during service, an addendum opinion is needed. The matters are REMANDED for the following action: 1. Obtain VA treatment records dated from October 2019 to the present. 2. Obtain an addendum opinion by an appropriate medical professional to determine the nature and etiology of any diagnosed psychiatric disability, to include major depressive disorder with psychotic features, generalized anxiety disorder, panic disorder w/agoraphobia, and other specified trauma related disorder. The entire file must be made available to the examiner, and the report of examination should include discussion of the Veteran's documented history and assertions. The examiner must opine whether each diagnosed disorder including major depressive disorder with psychotic features, generalized anxiety disorder, panic disorder w/agoraphobia, and other specified trauma related disorder, is at least as likely as not related to the Veteran's report of an in-service personal assault. The examiner is to accept as fact that the Veteran experienced military sexual trauma. See March and October 2015 statements from the Veteran's mother and sister and March 2021 transcript of Board hearing. The examiner is requested to provide a clear rationale and explain in detail the underlying reasoning for any opinions expressed. A discussion of the facts and medical principles involved would be of considerable assistance to the Board. If an examiner cannot provide the requested opinion without resorting to speculation, he or she should expressly indicate this and provide a supporting rationale as to why an opinion cannot be made without resorting to speculation. TANYA SMITH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Alexia E. Palacios-Peters, 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.