Citation Nr: 21028879 Decision Date: 05/12/21 Archive Date: 05/12/21 DOCKET NO. 15-43 496 DATE: May 12, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD), impulse control disorder, and unspecified anxiety disorder, is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Army from December 1967 to July 1969, to include service in Vietnam. His decorations include the National Defense Service Medal and the Vietnam Campaign Medal. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a September 2012 rating decision issued by the Department of Veterans Affairs (VA) Regional Office in North Little Rock, Arkansas. This case was previously before the Board in August 2018 and September 2020, when it was remanded to the agency of original jurisdiction (AOJ) for additional development. On both occasions, after taking further action, the AOJ confirmed and continued the prior denial and returned the case to the Board. Although the Board sincerely regrets the additional delay, a remand is necessary to ensure compliance with the prior remand directives. See Stegall v. West, 11 Vet. App. 268 (1998). Entitlement to service connection for an acquired psychiatric disorder, to include PTSD, impulse control disorder, and unspecified anxiety disorder, is remanded. In September 2020, the Board remanded this case, in part, to obtain a medical opinion as to whether it was at least as likely as not that the Veteran had an acquired psychiatric disorder that had its onset in, or was otherwise attributable to, his period of active service. The Veteran was provided a VA examination in December 2020. The examiner found that the Veteran did not meet the criteria for a diagnosis of PTSD but confirmed a diagnosis of unspecified anxiety disorder. In so doing, the examiner did not offer an opinion as to whether the unspecified anxiety disorder was related to service. Nor did she provide any substantive discussion of the significance, if any, of the Veteran's February 2020 VA cognitive screen assessing a mild neurocognitive disorder, or the August 2012 diagnosis of impulse control disorder NOS (not otherwise specified), as referenced in the remand. In addition, the examiner indicated that a comprehensive neuropsychological evaluation would be beneficial for purposes of assessing the Veteran for any memory deficits. Because the opinion provided is not entirely responsive to the Board's remand directives, and because the examiner has indicated that additional testing would be beneficial to a further understanding of the Veteran's debility, additional development is necessary. See, e.g., Barr v. Nicholson, 21 Vet. App. 303, 311 (2007) (once VA has provided an examination, it is required to provide an adequate one, regardless of whether it was legally obligated to provide an examination in the first place). This matter is REMANDED for the following action: 1. Ask the Veteran to identify, and provide appropriate releases for, any care providers who may possess new or additional evidence pertinent to the issue on appeal. If he provides the necessary release(s), assist him in obtaining the records identified, following the procedures set forth in 38 C.F.R. § 3.159. Any new or additional (i.e., non-duplicative) evidence received should be associated with the record. If any of the records sought are not available, the record should be annotated to reflect that fact and the Veteran, and his representative should be notified. 2. Obtain copies of records pertaining to any VA treatment the Veteran has received since the time that such records were last procured, following the procedures set forth in 38 C.F.R. § 3.159. The evidence obtained, if any, should be associated with the record. 3. Arrange to have the Veteran scheduled for neuropsychological evaluation for purposes of assessing him for any memory deficits. The report of the evaluation should be associated with the record. 4. After the foregoing development has been completed to the extent possible, make arrangements to have a properly qualified VA clinician (either a psychiatrist or a psychologist) review the record and provide a supplemental opinion as to whether it is at least as likely as not (i.e., whether it is 50 percent or more probable) that any of the psychiatric disorders that have been diagnosed since July 2011 (when the Veteran filed his claim for service connection), to include PTSD, impulse control disorder, and unspecified anxiety disorder, had their onset in, or are otherwise attributable to, the Veteran's period of active service. In so doing, the examiner should consider that the Veteran is competent to attest to factual matters of which he has first-hand knowledge, such as observable symptomatology. The examiner should also address, as necessary, a February 2020 VA cognitive screen assessing the Veteran with a mild neurocognitive disorder. The need for another examination and/or telephonic or video interview of the Veteran is left to the discretion of the examiner selected to offer the requested opinions. A complete medical rationale for all opinions expressed must be provided. 5. After completing the above, and any other development as may be indicated by any response received as a consequence of the actions taken in the preceding paragraphs, the issue on appeal should be readjudicated based on the entirety of the evidence. If the benefit sought remains denied, the Veteran and his representative should be issued a supplemental statement of the case. An appropriate period of time should be allowed for response. DAVID A. BRENNINGMEYER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Joseph T. Leonard, 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.