Citation Nr: 21027295 Decision Date: 05/05/21 Archive Date: 05/05/21 DOCKET NO. 18-15 145 DATE: May 5, 2021 REMANDED Entitlement to service connection for a psychiatric disability, including posttraumatic stress disorder (PTSD) and schizophrenia, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from September 1993 to July 1997. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida. The Veteran and his spouse testified at a hearing before the undersigned in January 2021. The Board notes the Agency of Original Jurisdiction (AOJ) developed the Veteran's claims seeking service connection for PTSD and schizophrenia as separate appeals, but the Board has recharacterized the issues into a single appeal seeking service connection for a psychiatric disability. See Clemons v. Shinseki, 23 Vet. App. 1 (2009) (holding that claims for service connection for PTSD also encompass claims for service connection for all psychiatric disabilities afflicting a Veteran based on a review of the medical evidence). Entitlement to service connection for a psychiatric disability is remanded. The Veteran contends he has PTSD related to a stressor involving being physically attacked and thrown down a set of stairs abord a ship during active duty service. The Veteran was provided a VA psychiatric examination in June 2015. The examiner found the Veteran's symptoms did not meet the criteria for a PTSD diagnosis but diagnosed schizophrenia and major depressive disorder. She concluded she was unable to provide an opinion regarding the etiology of the schizophrenia. She explained that there "is some possibility" that the claimed stressor triggered the onset of the schizophrenia during service, but that the Veteran also reported being abused as a child, and she therefore could not state whether the schizophrenia was due to his active duty service. She opined the depression was likely caused by the schizophrenia. The Board finds the opinion concerning the etiology of the schizophrenia is inadequate. While the examiner considered the Veteran's background, it does not appear she considered his statements that the symptoms manifested during service. In addition, if the schizophrenia was found to preexist service, service connection would still be warranted if the condition was aggravated therein. The Board notes a February 1995 service treatment record indicates the Veteran reported he had a paranoia of small spaces and worried he would have a panic attack. A December 1996 service treatment record notes the Veteran sought treatment for back pain and reported he had fallen flat on his back three weeks earlier. Accordingly, a remand to schedule an examination and obtain an adequate etiology opinion is required. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007) (holding that when VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate). The matters are REMANDED for the following action: 1. Obtain and associate with the claims file any outstanding VA treatment records. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any psychiatric disorder. The claims file should be made available and reviewed by the examiner. Following consideration of the evidence of record (both lay and medical), the examiner is asked to address the following: For each psychiatric disorder diagnosed, provide an opinion as to whether it is at least as likely as not (a 50 percent or greater probability) any such disability originated during active service or is otherwise etiologically related to active service. In providing an answer to the above question, the examiner should consider and discuss, among other things, the February 1995 service treatment record that indicates the Veteran was worried about having anxiety attacks; the December 1996 service treatment record that shows the Veteran complained of back pain resulting from falling flat on his back; and a May 2016 VA treatment record that notes he reported having panic attacks in service. (Continued on the next page) The examiner should note that the Veteran is entitled to a legal presumption of soundness on entry to service with respect to a psychiatric disability, and that any opinion indicting the disability preexisted service must be supported by clear and unmistakable evidence of pre-existence. If a diagnosed psychiatric disability is found to have clearly and unmistakably preexisted the Veteran's service (and was manifested in service), opine further whether there is clear and unmistakable evidence that the disability was NOT aggravated during service (as the Veteran is entitled to a further presumption of aggravation in such circumstances). The examiner must include in the medical report the rationale for any opinion expressed. John J. Crowley Veterans Law Judge Board of Veterans' Appeals Attorney for the Board William A. Skowronski, 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.