Citation Nr: 21028067 Decision Date: 05/10/21 Archive Date: 05/10/21 DOCKET NO. 16-30 882 DATE: May 10, 2021 REMANDED Entitlement to an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD) is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1966 to December 1969. This appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c). 38 U.S.C. § 7107(a)(2). The Board most recently remanded the claim in November 2020 for further development. There has not been substantial compliance with the remand directives and the claim must be remanded again. Stegall v. West, 11 Vet. App. 268 (1998). The Veteran seeks entitlement to service connection for an acquired psychiatric disorder, to include PTSD. He contends that he experienced a traumatic incident while serving aboard the USS Agerholm. His service personnel records confirm the Veteran was onboard the USS Agerholm when the ship fired upon enemy positions. The claim must be remanded again because the December 2020 medical opinion is inadequate. While the examiner ultimately provided a negative nexus opinion, the opinion appears to be based on a review and analysis of prior medical opinions only, rather than on pertinent evidence related to the Veteran. The opinion does not appear to include this examiner's own analysis of the evidence. The Board had previously determined the prior opinions were inadequate in some respects and the most recent examiner's reliance on them is inappropriate. The opinion on remand must not be limited to a review of the record, but must include an examination (in person or via telehealth) of the Veteran. The matters are REMANDED for the following action: Schedule the Veteran for a psychiatric examination (or telehealth interview, if an in-person examination is not feasible) to determine the nature and etiology of any acquired psychiatric disability, including PTSD, found to be present. Copies of all pertinent records must be made available to the examiner for review. (a) The examiner should conduct the examination with consideration of the current diagnostic criteria for PTSD. The examination report should include a detailed account of all pathology present. Any further indicated special studies, including psychological studies, should be accomplished. (b) If a diagnosis of PTSD is appropriate, the examiner should specify what stressors support the diagnosis and (i) whether the stressor was sufficient to produce PTSD; (2) whether the remaining diagnostic criteria to support the diagnosis of PTSD have been satisfied; and (3) whether there is a link between the current symptomatology and one or more of the in-service stressors. The Veteran's service personnel records confirm he was aboard the USS Agerholm when the ship fired upon enemy positions. The examiner must specifically comment on whether the stressor involved "fear of hostile military or terrorist activity." (c) If the examination results in a psychiatric diagnosis other than PTSD, the examiner should offer an opinion as to the etiology of the non-PTSD psychiatric disorder, to include whether it is at least as likely as not that any currently demonstrated psychiatric disorder, other than PTSD, is related to the Veteran's military service, including any stressors in service. A complete rationale must be provided for all opinions. If the examiner cannot provide an opinion without resort to speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge; the examiner's own expertise, or; whether additional facts are required and note what, if any, additional evidence would permit such an opinion to be made. M.E. Larkin Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S.E. Bresler, 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.