Citation Nr: 21032868 Decision Date: 05/28/21 Archive Date: 05/28/21 DOCKET NO. 17-26 060 DATE: May 28, 2021 REMANDED Entitlement to service connection for the cause of the Veteran's death is remanded. REASONS FOR REMAND The Veteran served on active duty from April 2006 to May 2007, January 2008 to January 2009, June 2012 to April 2013, and May 2013 to April 2014. He died in September 2015. The appellant is his surviving spouse. This matter is before the Board of Veterans' Appeals (Board) on appeal from a June 2016 rating decision. In September 2020, the appellant presented testimony at a Virtual Board hearing before the undersigned Veteran Law Judge. A transcript of that hearing is associated with the record. Entitlement to service connection for the cause of the Veteran's death is remanded. The appellant contends that the Veteran committed suicide as a result of mental unsoundness due to an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD), that was caused by his multiple deployments to Iraq and Afghanistan. Service personnel records show that the Veteran served in Iraq from March 2008 to December 2008 and in Afghanistan from July 2012 to January 2013. Through various written statements and hearing testimony, the appellant testified that after the Veteran returned home from his deployment to Iraq where he served as a medivac pilot, he started having difficulty sleeping and nightmares and feeling guilty for the death he witnessed during the deployment. During his second deployment to Afghanistan, he started having trouble dealing with people and had anger issues. Since he returned home around May 2014, his condition got worse, he became more sleep deprived, nervous, agitated, and irritable. However, he did not seek treatment for mental health for fear of losing his security clearance and flight status. She submitted numerous lay statements from family and fellow service members attesting to the Veteran's behavioral changes after his service in Iraq and Afghanistan. VA treatment records show that the Veteran was hospitalized for paranoia and possible manic symptoms in May 2015. Psychiatric diagnoses on discharge were bipolar I disorder, with psychosis, in remission, and rule out PTSD, current mild to moderate. In September 2015, he presented to urgent care complaining of poor sleep, racing thoughts, dysphoria, and ideas of reference. The diagnosis was mixed bipolar affective disorder. He was cleared to return to work on September 8, 2015 but committed suicide later that day. The Veteran's death certificate notes that the immediate cause of death was asphyxia by oxygen exclusion; other significant condition contributing to death was incised wounds of the upper extremities. It is noted that the injuries occurred by securing plastic bag over head and slashing forearms. At the time of his death, the Veteran had no service-connected disabilities. However, the appellant contends that he suffered from a mental disorder of service origin "that caused him to commit suicide." Based on the foregoing, the Board finds that a VA medical opinion addressing whether the Veteran's death by suicide was due to mental disability incurred in service is necessary. See 38 U.S.C. § 5103A(a); DeLaRosa v. Peake, 515 F.3d 1319, 1322 (Fed. Cir. 2008); Wood v. Peake, 520 F.3d 1345 (Fed. Cir. 2008). The matter is REMANDED for the following actions: 1. Forward the claims file to a psychiatrist or psychologist for review and an advisory medical opinion regarding the cause of the Veteran's death in September 2015. Upon review of the record (including the appellant's hearing testimony, this remand, and any records obtained pursuant to the development ordered above), the provider should offer an opinion as to whether it is at least as likely as not (a 50 percent or higher probability) that the Veteran's death was due to an acquired psychiatric disability that had onset or otherwise related to his service, specifically his deployments to Iraq and Afghanistan. (Continued on the next page) A rationale should be given for all opinions and conclusions rendered. In proffering the opinions, the examiner must specifically address the appellant's lay statements and hearing testimony, as well as numerous buddy statements, concerning the Veteran's behavior following his first and second deployments to Iraq and Afghanistan. 2. After completing the above, readjudicate the issue on appeal. If the benefit sought on appeal remains denied, provide a supplemental statement of the case to the appellant, and return the appeal to the Board for appellate review, after the appellant and her representative have had an adequate opportunity to respond. L. CHU Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. J. In, 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.