Citation Nr: 21028847 Decision Date: 05/12/21 Archive Date: 05/12/21 DOCKET NO. 14-09 713 DATE: May 12, 2021 REMANDED Entitlement to a disability rating in excess of 50 percent for posttraumatic stress disorder (PTSD) is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1974 to January 1978. He died in March 2017. The Veteran's spouse filed a timely request for substitution in May 2017 and is the appellant. By way of background, this appeal was most recently remanded by the Board of Veterans' Appeals (Board) in November 2018 following a remand from the Court of Appeals for Veterans Claims ("the Court") in February 2018. The Board issued a decision on this matter in March 2020 and denied the Veteran's claim of entitlement to a disability rating in excess of 50 percent for PTSD. Subsequently, through a Joint Motion for Remand, the Court issued an order vacating the Board's March 2020 decision and the case has since been remanded to the Board for further proceedings consistent with the motion. Entitlement to a disability rating in excess of 50 percent for posttraumatic stress disorder (PTSD). The Appellant asserts that the Veteran is entitled to a disability rating in excess of 50 percent for his service-connected PTSD. The Appellant through her representative re-iterated the directives in the November 2020 Joint Motion for Remand and asserts that the Board should provide appropriate reasons or bases in addressing the September 2019 PTSD Compensation and Pension medical opinion of record and if not, obtain an examination that does. See Appellate Brief Received May 2021. In the November 2020 Joint Motion for Remand issued by the Court, the Board erred in failing to provide adequate reasons or bases in addressing whether the September 2019 Compensation and Pension Examiner substantially complied with the Board's November 2018 remand instructions. The Court highlighted the fact that the November 2018 Board remand decision stated that it was not clear to the Board that all the symptoms looked to by the Court, including in particular tension headaches, are attributable to the Veteran's PTSD and therefore, a records-based medical opinion was warranted to distinguish, to the extent feasible, the symptoms attributable to the Veteran's PTSD from those due to other causes. Further, the Court stated that the November 2018 Board remand instructed the examiner to address the impact of the Veteran's PTSD on social and occupational functioning and provide adequate explanation for the findings and conclusions. Additionally, the Court stated that the Board's November 2018 remand instructed that "[i]f it is not possible to provide any specific opinion regarding symptoms or functional impairment without speculation, the examiner must explain why this is so. The Court noted that the September 2019 examiner's opinion stated that "[b]ased on a review of the record and literature it cannot be conclusively determined that tension headaches were distinguishable in their symptoms and effects from the psychiatric disability." The examiner further opined that "[i]t is impossible to retroactively determine the impact on functioning" in reference to tension headaches. Further, the parties noted that although the September 2019 examiner did note that "Appellant" [sic] (should be Veteran) experienced other symptoms than tension headaches, he failed to address whether those symptoms were attributable to his PTSD, and if so, what functional effects, if any, they had upon it. The Board finds that the 2019 examiner's opinion is inadequate as it did not fully address the November 2018 Board remand directives. Because VA may only consider independent medical evidence to support its findings and is not permitted to base decisions on its own unsubstantiated medical conclusions, remand is required. See Colvin v. Derwinski, 1 Vet. App. 171, 175 (1991). The Board is obligated by law to ensure that the RO complies with its directives. Stegall v. West, 11 Vet. App. 268, 271 (1998). RO compliance with remand directives is not optional or discretionary, and the Board errs as a matter of law when it fails to ensure remand compliance. Stegall, 11 Vet. App. at 271. As such, an addendum opinion is necessary to help assess the severity of the Veteran's PTSD prior to his death, the symptoms associated with the disorder, and the functional effects it had on the Veteran prior to his death. This matter is REMANDED for the following action: 1. Obtain an addendum opinion from the examiner who provided the September 2019 opinion, or a qualified substitute if unavailable, to address the nature and severity of the Veteran's psychiatric disability over the appeal period prior to his death. In so doing, the examiner should distinguish, to the extent feasible, symptoms and impairments and their effects on functioning which were due to the Veteran's psychiatric disability from those which were due to other causes. In particular, the examiner should clearly articulate what symptoms the Veteran experienced that were directly attributed to PTSD (other than tension headaches) and address what functional effects (to include social and occupational effects), if any, these symptoms caused. The examiner must specifically address the impact of symptoms other than tension headaches on functioning, and whether there was any such impact, of any past suicidal attempt or suicidal ideation. The examiner should provide an adequate explanation for these findings and conclusions. If it is not possible to provide any specific opinion regarding symptoms or functional impairment without speculation, the examiner must explain why this is so. Tiffany Dawson Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Dorsey-Kwansa, 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.