Citation Nr: 21031308 Decision Date: 05/21/21 Archive Date: 05/21/21 DOCKET NO. 18-21 854 DATE: May 21, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disorder, to include as secondary to service-connected mesothelioma status post chemotherapy and extended pleurectomy decortication, is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Coast Guard from October 1971 to October 1975. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a February 2017 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The case was initially brought before the Board in May 2019, at which time the Board denied the Veteran's claim for service connection for a psychiatric disability, to include chronic mental health and posttraumatic stress disorder (PTSD). The Veteran appealed the May 2019 decision to the U.S. Court of Appeals for Veterans Claims (Court). In a January 2021 Order of the Court granting a December 2020 Joint Motion for Remand (JMR), the parties agreed to vacate the May 2019 Board decision and remand the matter for compliance with the terms of the JMR. The case has been returned to the Board. In April 2021, the Veteran submitted additional evidence in support of his appeal along with a signed waiver of RO consideration of evidence. The Board accepts this evidence for inclusion in the record. See 38 C.F.R. § 20.1305. 1. Entitlement to service connection for an acquired psychiatric disorder, to include as secondary to service-connected mesothelioma status post chemotherapy and extended pleurectomy decortication, is remanded. As discussed above, in the December 2020 JMR, the parties agreed to vacate the May 2019 Board decision, which denied service connection for a psychiatric disability. The December 2020 JMR noted that a November 2016 VA examiner found that the Veteran's symptoms did not warrant a mental health diagnosis. Private treatment records in November 2016 reflected diagnoses for PTSD and generalized anxiety disorder. However, the Board afforded more probative weight to the November 2016 VA examiner's findings than the diagnoses provided by the private provider. The JMR found that the Board did not provide an adequate reasons and bases for its determination that the November 2016 private treatment records should be afforded less probative weight. Subsequent to the JMR, the Veteran submitted a September 2020 opinion from a private physician. Although the private physician diagnosed the Veteran with adjustment disorder with mixed anxiety and depressed mood, that diagnosis was not provided by a mental health professional. To make a fully informed decision, the Board must remand the appeal to seek a supplemental VA opinion to clarify the Veteran's diagnosis and to provide an etiological opinion. The matter is REMANDED for the following actions: 1. Obtain all the outstanding treatment records for the Veteran's mental health disorder that are not currently of record. 2. Obtain an addendum opinion from an appropriately qualified clinician (psychologist/psychiatrist) to determine the nature and etiology of any mental health disorder. The examiner must respond to the following: (a.) Confirm/identify any mental health diagnosis. (b.) Is it at least as likely as not that any current mental health disorder was caused by the Veteran's service-connected mesothelioma status post chemotherapy and extended pleurectomy decortication? (c.) Is it at least as likely as not that any current mental health disorder was aggravated beyond its natural progression by the Veteran's service-connected mesothelioma status post chemotherapy and extended pleurectomy decortication? In providing the above opinions, the examiner should address the mental health diagnoses of record, to include PTSD, generalized anxiety disorder, and adjustment disorder with mixed anxiety and depressed mood. The examiner should also address the September 2020 private opinion. (Continued on the next page) A complete rationale with discussion of medical literature for any opinion expressed must be provided. If an opinion cannot be expressed without resort to speculation, discuss why this is the case. 3. Then, readjudicate the issue on appeal. If the benefits are not granted to the Veteran's satisfaction, then send the Veteran and his representative a supplemental statement of the case and provide an opportunity to respond. If necessary, return the case to the Board for further appellate review. LESLEY A. REIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Journet Shaw, 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.