Citation Nr: 21042581 Decision Date: 07/13/21 Archive Date: 07/13/21 DOCKET NO. 16-58 829A DATE: July 13, 2021 REMANDED Entitlement to service connection for an acquired psychiatric disorder, other than posttraumatic stress disorder (PTSD), is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1982 to November 1986. In the December 2016 Substantive Appeal, VA Form 9, the Veteran requested a Board hearing. Thereafter, in August 2019, the Veteran's attorney, by and on his behalf, requested to withdraw the hearing request. Accordingly, the Veteran's hearing request is considered withdrawn. 38 C.F.R. § 20.704(e). Pursuant to Clemons v. Shinseki, 23 Vet. App. 1 (2009), the Veteran's claim has been recharacterized to include any acquired psychiatric disorder. Such is appropriate as a review of the record reflects that the Veteran has additional psychiatric diagnoses. However, as the Veteran's claim for service connection for PTSD was previously adjudicated in a finally decided April 2012 rating decision, the Board has limited the claim as noted above. Entitlement to service connection for an acquired psychiatric disorder, other than PTSD, is remanded. On September 12, 2013, the Veteran was provided a VA addendum opinion to assess the etiology of his diagnosed psychiatric disorder. The examiner indicated that the Veteran's current mood disorder was at least as likely as not related to his situational depression and explained that medical research supported that an initial episode of depression, which first occurred as a result of a verified stressor, could make an individual more susceptible to further episodes later in life. One day later, on September 13, 2013, a different VA examiner provided another positive nexus opinion and indicated that the Veteran had various depression diagnoses and longstanding depression could be a reoccurring disorder. Following these VA medical opinions, the Regional Office (RO) sought clarification because the September 12, 2013 VA medical opinion was based on an unverified stressor and procured a November 2013 VA medical opinion. The November 2013 VA examiner rendered a negative nexus opinion and explained that since the Veteran did not experience a stressor, his depression might have been due to his cocaine use, because cocaine withdrawal could cause depression. In spite of the RO's attempts at obtaining an adequate VA medical opinion, the Board finds that the VA medical opinions provided above are not sufficient for rating purposes. As indicated, the September 12, 2013 VA medical opinion was not sufficient because it was based on an unverified stressor. The September 13, 2013 VA medical opinion is also insufficient because, although the examiner suggested that the Veteran's depression was longstanding, this statement is conclusory because the examiner did not otherwise explain how the Veteran's longstanding depression was related to the service. Moreover, the September 13, 2013 VA examiner did not provide clarification as to the question of whether the Veteran's in-service depression was caused by or related to cocaine use. Notably, the Veteran's service treatment records (STRs) reflect that he had mild situational depression after being reprimanded for using cocaine. See October 1986 STRs. The Board also emphasizes that, while the November 2013 VA examiner explained that the Veteran's depression may have been due to cocaine use/withdrawal, this explanation was speculative and was otherwise conclusory because the examiner did not consider/discuss the other evidence of record, to include the Veteran's lay statements, that suggest the Veteran had longstanding depression. Accordingly, remand is warranted for a new VA medical opinion consistent with the directives herein. The Board acknowledges the August 2019 private positive nexus opinion of record. However, the private examiner based this opinion on stressors that have yet to be verified, to include the Veteran's reports of friends committing suicide, discovery of their bodies, attacks from Syrian suicide bombings, bombing of airplanes in Libya, and supply battleships in Iran. The Board highlights that, aside from an attempt to verify the Veteran's stressor of witnessing one of his friends commit suicide, the RO has not attempted to verify the Veteran's other reported stressors. Accordingly, further development is needed to attempt to verify the Veteran's reported stressors. The matter is REMANDED for the following actions: 1. Contact any appropriate entity to attempt to corroborate the Veteran's reported in-service stressors. Specifically, the Veteran reported that, when he was stationed aboard the USS Mount Baker from March 1983 to November 1986, his friends committed suicide and he discovery their bodies, there were attacks from Syrian suicide bombings, bombings of airplanes in Libya, and supply battleships in Iran. If more details are needed, contact the Veteran to request the information. 2. Obtain a VA medical opinion from an appropriate examiner to determine the nature and etiology of the Veteran's acquired psychiatric disorder, other than PTSD, (an in-person examination may be conducted, if deemed necessary). The claims folder (including a copy of this remand) must be provided to and reviewed by the examiner as part of the examination. a) Identify/diagnose any acquired psychiatric disorder (other than PTSD) that presently exists or that has existed during the appeal period. b) The examiner must provide an opinion as to whether it is at least as likely as not (50 percent probability or greater) that any acquired psychiatric disorder (other than PTSD) had its onset in or is otherwise related to active duty service, to include his in-service diagnosis for situational depression and/or any verified in-service stressor. In rendering the above opinion, the examiner must consider and discuss the Veteran's STRs showing mild situational depression in October 1986 after being reprimanded for cocaine use. The examiner must also consider the Veteran's reports that he had longstanding psychiatric symptoms and sought treatment from 1988 to 1994 for anxiety and sleep disturbance. See March 2012 VA Examination report. The examiner is 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 his reports are discounted, the examiner should provide a reason for doing so. (Continued on the next page) 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. A. ISHIZAWAR Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Metzner, Paul 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.