Citation Nr: 21039973 Decision Date: 07/02/21 Archive Date: 07/02/21 DOCKET NO. 17-39 739A DATE: July 2, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disorder, to include major depressive disorder and adjustment disorder, is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1964 to July 1968. This matter was previously remanded by the Board of Veterans' Appeals (Board) for additional development in May 2019 and February 2021. Entitlement to service connection for an acquired psychiatric disorder, to include major depressive disorder and adjustment disorder, is remanded. The Veteran seeks service connection for an acquired psychiatric disorder, to include as secondary to service-connected tinnitus and/or a sleep disorder. Significantly, during the pendency of the appeal, service connection for sleep apnea was granted in an April 2021 rating decision. Although, there VA opinions were obtained in December 2019 and April 2021, these opinions only addressed the relationship between the Veteran's service-connected tinnitus, non-service-connected insomnia, and his acquired psychiatric disorder. In light of the recent grant of service connection for sleep apnea, remand is required for a VA opinion to assess what, if any, relationship exists between the Veteran's service-connected sleep apnea and his acquired psychiatric disorder. The matter is REMANDED for the following actions: 1. Obtain all relevant and outstanding VA and private medical records and associate them with the claims file. All attempts to obtain these records must be documented in the file. 2. After the above development, obtain a VA medical opinion from an appropriate examiner to assess the etiology of the Veteran's acquired psychiatric disorder. The claims folder (including a copy of this remand) must be provided to and reviewed by the examiner. Based on a review of the evidence of record, the examiner should respond to the following: The examiner must provide an opinion as to whether it is at least as likely as not (i.e., 50 percent probability or greater) that the Veteran's acquired psychiatric disorder is caused or aggravated by his service-connected sleep apnea. In rendering the above opinion, the examiner must specifically consider and discuss VA treatment records indicating that the Veteran's acquired psychiatric disorder is caused/aggravated by his sleep apnea. Specifically, a May 2016 VA treatment record shows that the Veteran was diagnosed with a mood disorder due to untreated sleep apnea and tinnitus in the elderly. The examiner must also consider and discuss the December 2019 VA examination report, wherein the examiner noted that sleep apnea had been found to be a significant contributing factor in the Veteran's depression. The examiner is also advised that the Veteran is competent to report his symptoms/history and that such reports must be acknowledged and considered in formulating any opinion. If the Veteran's reports are discounted, the examiner should provide a reason for doing so. A rationale for all requested opinions shall be provided. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation stating why this is so. In so doing, the examiner shall 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. If the examiner determines that a physical examination of the Veteran is necessary to provide the requested opinion, such should be scheduled. A. ISHIZAWAR Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Talton, John H. 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.