Citation Nr: 21032447 Decision Date: 05/27/21 Archive Date: 05/27/21 DOCKET NO. 15-42 000 DATE: May 27, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disability, to include major depressive disorder and generalized anxiety disorder, to include as due to service-connected neck and left eyebrow scars, is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1969 to January 1970 This matter was previously before the Board in February 2020, at which time it denied the above-captioned issues. The Veteran appealed those denials to the Court of Appeals for Veterans Claims (Court). In November 2020, the Court granted a Joint Motion for Remand (JMR), reversing the Board's prior decision and remanding that claim for further development. Specifically, the Court found the Board's reasons and bases for denying the above-captioned claims inadequate. The Court noted that favorable evidence, to include complaints of neck pain causing functional limitation was not addressed. Further, the Veteran's lay statements of depression since active duty, contained in a March 2014 record, were also not discussed. The Board has expanded the Veteran's claim to encompass all acquired psychiatric disorders, which in this case includes major depressive disorder and generalized anxiety disorder. See Clemons v. Shinseki, 23 Vet. App. 1 (2009) (the scope of a disability claim includes any disability that may reasonably be encompassed by the claimant's description of the claim, reported symptoms, and the other information of record). Entitlement to service connection for an acquired psychiatric disability, to include major depressive disorder and generalized anxiety disorder, to include as due to service-connected neck and left eyebrow scars The Veteran's claim for an acquired psychiatric disability requires further development before an appeal can be decided. Specifically, the Veteran should be afforded a VA examination in which evidence of a link between in-service incidents and/or service-connected disabilities and current disorders is considered. The Veteran's service records, and his November 1970 separation examination do not contain treatment for or evidence of depression, anxiety, or other mental distress. However, there is evidence that his current mental diagnoses may be caused or aggravated by events occurring in service, or his service-connected scars, and particularly his service-connected neck scar. Indeed, the Veteran narrates that he was molested in the shower in service at age 18 as a new servicemember, and that he had previously avoided talking about it. The Board finds it likely that the Veteran would not have sought treatment in service for psychiatric symptoms arising from this event. Furthermore, a March 2005 examination report indicates that "his current day neck pain is a result of his in-service excision of calcified cyst and DDD that he has developed over the years." The Veteran's November 2005 examiner opined that his loss of motion in the neck is secondary to his neck scar. The Veteran stated to his December 2013 VA examiner that his inability to turn his neck contributed to his losing his job as a truck driver. Then, in a March 2014 record, the Veteran demonstrated chronic pain and clinical depression occurring together. In a subsequent March 2014 note, the Veteran espoused a "condition causing significant chronic pain with subsequent occupational and financial difficulties, as well as inability to engage in usual physical activities which provided a coping mechanism." Indeed, as he narrated in his January 2019 hearing, the Veteran attempted to get jobs outside of his usual occupation of truck driver. Unable to do so, his mental distress and functional impairment worsened. The Veteran has current diagnoses of several mental disorders. However, the record is incomplete as to whether his current psychiatric diagnoses are etiologically related to service or service-connected disorders. In other words, other than lay opinion, it is not clear whether the Veteran's psychiatric disorders actually onset due to the impairment caused by his chronic neck pain. A VA examination is needed to identify the various disorders from which the Veteran currently suffers, and which, if any, are etiologically related to service. This will ensure the most favorable rating possible for the Veteran's clinical symptoms. The matters are REMANDED for the following action: 1. Add all outstanding VA treatment records not currently associated with the Veteran's claims file. If the Veteran has obtained treatment outside of VA, he should be afforded an opportunity to add any applicable records. 2. Schedule the Veteran for a VA examination by an appropriate clinician to determine the nature, extent, onset, and etiology of his acquired psychiatric condition. The claims file should be provided to the examiner(s) for review. All indicated studies deemed necessary by the examiner(s) should be performed, and all findings of those tests should be reported in detail. The examiner should also provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that any currently diagnosed acquired psychiatric disorder is etiologically related to the Veteran's period of active duty service. If PTSD is diagnosed, the examiner is asked to specifically note the stressor event(s) that such a diagnosis is related to. The examiner should also provide an opinion as to whether it is at least as likely as not (a 50 percent or greater probability) that any currently diagnosed acquired psychiatric disorder is etiologically related or has been aggravated by his service-connected scars. The examiner is specifically asked to direct their attention to the Veteran's statements of development of psychiatric symptoms as a result of neck pain and functional limitation, as well as his statements of molestation as a new service member. If the examiner cannot provide any of the requested opinions without resorting to speculation, he or she should provide an explanation stating why this is so. In so doing, the examiner should explain whether the inability to provide a more definitive opinion is the result of a need for additional information or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question(s). B.T. KNOPE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Z. Maskatia