Citation Nr: 21028951 Decision Date: 05/12/21 Archive Date: 05/12/21 DOCKET NO. 12-23 213 DATE: May 12, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disorder is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Army from June 1976 to November 1977. The issue was remanded by the Board of Veterans' Appeals (Board) in December 2013, April 2017, August 2017, April 2019, October 2019, and October 2020 for further development. The most recent remand in October 2020 specifically instructed the regional office (RO) to obtain a medical opinion pertaining to the Veteran's claim. Upon review of the record, the Board finds that the claim must be remanded. The Board sincerely regrets the additional delay caused by this remand, particularly as this matter has been the subject of many prior remands, but wishes to assure the Veteran that it is necessary for a full and fair adjudication of his claim. Entitlement to service connection for an acquired psychiatric disorder is remanded. The Board finds that a new examination and etiological opinion is warranted for the Veteran's claim. The Veteran contends that his acquired psychiatric disorder is related to his service. Specifically, in July 1977, while waiting in the chow line for his food, his sergeant called him a racially sensitive term, to which he responded by knocking him to the floor. He underwent a Court Martial and was transferred out of the company. He reported that the incident caused acquired psychiatric symptoms, drinking, drugging, and stints in and out of prison, which have continued. The Veteran underwent a VA examination via video telehealth in March 2021, in which the examiner opined that the Veteran's unspecified depressive disorder, unspecified anxiety disorder, and alcohol use disorder were less likely than not related to service. As to rationale, she stated only that "the Veteran continues to present as an unreliable historian. Without clear details of the onset and progression of his current symptoms, I am unable to determine service connection without resorting to mere speculation." A medical opinion must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions. Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007); see also Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008) (noting that "most of the probative value of a medical opinion comes from its reasoning" and concluding that a medical opinion is not entitled to any weight "if it contains only data and conclusions"). The Board finds the March 2021 VA examination conclusory and therefore inadequate for adjudication purposes. The Board notes that the RO conceded the Veteran's reported stressor based on a review of service personnel records that showed that in October 1977, he had been reprimanded for a physical altercation with two individuals that had taken place in July 1977. See September 2012 Initial Federal 3rd Party Letter PTSD diagnosed, confirm stressor, to MC. However, it is not clear whether the March 2021 examiner found that certain reports by the Veteran was unreliable or that the Veteran was wholly not credible. Moreover, she did not specify what additional information is needed in order to be able to render an opinion. Accordingly, an additional VA examination that addresses the Veteran's contentions should be obtained on remand. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007) (once VA undertakes to provide a medical examination or opinion, it must ensure that the examination or opinion is adequate). The matters are REMANDED for the following action: 1. Assist the Veteran in associating with the claims folder updated treatment records. 2. Schedule the Veteran for a VA examination with an appropriate examiner to obtain a medical opinion concerning the etiology of his acquired psychiatric disorder. A complete history from the Veteran should be obtained and recorded. The Veteran's electronic claims file must be accessible for review by the VA examiner in conjunction with the examination and this review should be acknowledged in the report. Following the review of the claims file and examination of the Veteran, the examiner is then requested to respond to the following: (a.) Determine whether the Veteran may be diagnosed with a condition conforming to DSM-5 criteria. (b.) If the examiner diagnoses the Veteran with PTSD in accordance with DSM-5, the examiner should indicate whether it is at least as likely as not (i.e., at least a 50 percent probability) that the Veteran's PTSD was due to the reported in-service stressor. The examiner is advised that the Veteran's reported stressor is CONCEDED. See September 2012 Initial Federal 3rd Party Letter PTSD diagnosed, confirm stressor, to MC (c.) If the examiner concludes that the Veteran has an acquired psychiatric disorder(s) other than PTSD, the examiner should opine as to whether it is at least as likely as not (i.e., at least a 50 percent probability) that the current psychiatric disorder(s) had its(their) onset during military service or is(are) causally related to such service, to include his CONCEDED military stressor. See September 2012 Initial Federal 3rd Party Letter PTSD diagnosed, confirm stressor, to MC The examiner is advised that the Veteran is competent to report symptoms, treatment, and injuries, and that his reports must be taken into account in formulating the requested opinions. THE EXAMINER IS ADVISED THAT IF THERE IS REASON TO DOUBT THE CREDIBILITY OF THE VETERAN'S STATEMENTS, THE BASIS FOR THAT DETERMINATION MUST BE SET FORTH IN DETAIL. The examiner must provide the rationale for all proffered opinions. If the examiner is unable to provide any required opinion, he or she should explain why. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation as to why this is so. If the inability to provide a more definitive opinion is the result of a need for additional information, the examiner should identify the additional information that is needed. A. S. CARACCIOLO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. L. Park, 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.