Citation Nr: 21031562 Decision Date: 05/24/21 Archive Date: 05/24/21 DOCKET NO. 19-30 539 DATE: May 24, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD) is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1985 to December 1989. These matters come before the Board of Veterans' Appeals (Board) on appeal from a rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). This matter was before the Board in April 2020, at which time the Board denied entitlement to service connection for an acquired psychiatric disorder. The Veteran appealed that decision to the Court of Appeals for Veterans' Claims (Court), which, pursuant to a Joint Motion for Remand, vacated the Board's judgment and returned the matter to the Board. 1. Entitlement to service connection for an acquired psychiatric disorder, to include PTSD, is remanded. This matter must be remanded in order to afford the Veteran an adequate VA medical opinion as to etiology. The Veteran carries a current diagnosis of PTSD, furnished by VA treating providers and confirmed by the VA examiner with whom she met in December 2018. That examiner also acknowledged the in-service incidents to which the Veteran has attributed the condition, including several instances of sexual harassment, and a sexual assault occurring during the delivery of her child. However, the examiner indicated that the Veteran's PTSD was unrelated to these incidents, linking the condition instead to childhood trauma, and explaining that the condition was present on entry into service and during service, and has persisted since separation. The Board notes that no psychiatric condition was noted on the Veteran's entry into service, and service records do not reflect complaints of psychiatric symptoms. Veterans are presumed to be medically sound on entry into service unless a condition is explicitly noted at the time of entry. In cases where subsequent evidence indicates a medical condition clearly and unmistakably predated service, the evidence must also show by that that condition was clearly and unmistakably not aggravated by any aspect of active duty service. The examiner in this case did not offer any assessment with respect to aggravation and did not make explicit whether the evidence in this case rises to the clear and unmistakable level as the law requires. On remand, an addendum medical opinion as to etiology must be obtained, to include a thorough and reasoned assessment of whether a pre-existing mental condition was aggravated by any aspect of service. The matters are REMANDED for the following action: 1. Obtain an addendum opinion regarding the etiology of the Veteran's psychiatric condition. The entire claims file must be made available to and be reviewed by the examiner in conjunction with this request, including a copy of this remand. The need for an in-person examination is left to the discretion of the examiner. a. The examiner should state whether, by clear and unmistakable evidence, any psychiatric condition predated the Veteran's entry into active duty service, and if so, whether that condition was clearly and unmistakably not aggravated by any aspect of active duty service. b. If the examiner finds either that the Veteran did not have pre-existing psychiatric condition or that a pre-existing psychiatric condition was aggravated by service, the examiner should provide an opinion as to whether it is at least as likely as not (fifty percent or greater probability) that any diagnosed psychiatric disability is related to the Veteran's active service or aggravation of his pre-existing psychiatric disability during service. The examiner is directed to consider as credible the Veteran's lay statements with respect to both in-service sexual harassment, and the incident that occurred during the birth of her son, as she describes it, and to which she attributes psychiatric sequelae. A thorough and reasoned explanation must accompany all opinions expressed. GAYLE STROMMEN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Z. Sahraie, 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.