Citation Nr: 22014111 Decision Date: 03/11/22 Archive Date: 03/11/22 DOCKET NO. 19-10 042 DATE: March 11, 2022 REMANDED Entitlement to service connection for an acquired psychiatric disability, to include anxiety, depression, or posttraumatic stress disorder (PTSD), is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Navy from March 1969 to December 1970. Although the Veteran filed separate service connection claims for anxiety, depression, and PTSD, the appeal has been expanded to include all potential acquired psychiatric disorders in accordance with the holding in Clemson v. Shinseki, 23 Vet. App. 1, 5 (2009) (the scope of a mental health disability claim includes any mental disability that may reasonably be encompassed by the claimant's description of the claim, reported symptoms, and the other information of record). In November 2021, the Veteran testified before the undersigned Veterans Law Judge in a virtual hearing. A copy of the transcript is of record. Entitlement to service connection for an acquired psychiatric disability, to include anxiety, depression, or PTSD, is remanded. The Veteran maintains entitlement to service connection for an acquired psychiatric disability which he believes he developed secondary to his service as an astronaut test subject. The record reflects that the Veteran has been variously diagnosed with anxiety and depression in a May 2017 VA treatment record, and with adjustment disorder with mixed anxiety and depressed mood at a January 2019 VA examination. His diagnosis of anxiety, characterized as severe, was further confirmed in a May 2019 letter from his private treating physician. Thus, it is clear that the Veteran has a current diagnosis of an acquired psychiatric disability. Further, the Veteran's service treatment records, photographs, and membership certificate in the Society of Interplanetary Free Floaters confirm that he participated in an experiment(s) for the Naval Aerospace Medical Institute. At issue is whether a nexus exists between the Veteran's current disability and his participation in said experiment(s) during his active duty service. The Board observes that the Veteran's private physician provided a positive nexus opinion in his May 2019 letter. However, this nexus opinion was not accompanied by rationale, so it is of no probative value. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008) ("It is the fully articulated, sound reasoning for the conclusion... that contributes probative value to a medical opinion."). The January 2019 VA examiner provided a negative opinion, indicating that the Veteran's current acquired psychiatric disability is more likely attributable to a combination of current psychosocial stressors, including vision impairments, a history of colon cancer and worries that it could return, and coping with financial strain. While the examiner notes that the Veteran's past as a test subject was confirmed, he does not explain why his current symptomatology is more likely attributable to other stressors and not this experience. Id. Further, the examiner does not address the Veteran's lay statements concerning the onset of the disability. Miller v. Wilkie, 32 Vet. App. 249 (2020) (explaining that a VA examination is inadequate if the examiner does not consider lay evidence). Thus, this opinion is also lacking in probative value. Notably, the examiner indicated that were the Veteran to obtain service connection for any of his medical conditions, he would be willing to be re-consulted for a medical opinion concerning secondary service connection. The Veteran has separate claims for service connection for a vision disability, an equilibrium disability, and a traumatic brain injury (TBI) pending at the Board. The examiner's statement raises the possibility of secondary service connection were any or all of these disabilities to be service-connected at a later time. The matter is REMANDED for the following action: 1. Schedule the Veteran for a VA examination for his claimed acquired psychiatric disability with an appropriate examiner. Please use an aerospace medicine specialist if available. The examiner must review the claims file. Is the Veteran's acquired psychiatric disability at least as likely as not related to service, including his confirmed service as an astronaut test subject? Provide a rationale to support the opinion. In providing the requested opinion, consider the Veteran's description of his in-service injury and symptoms as well as his post-service symptoms. If there is any medical reason to accept or reject the proposition that the Veteran's reported injury and symptoms in service and thereafter represented the onset of his current disability, this should be noted. Stated another way, do the Veteran's reports about his symptoms align with how the currently diagnosed disability is known to develop or are the Veteran's reports generally inconsistent with medical knowledge or implausible? 2. If a positive opinion is not rendered on a direct basis and the Veteran is service-connected for any or all of the following disabilities: a vision disability, an equilibrium disability, and/or a TBI, a copy of this remand should be provided to the VA examiner who proffered the January 2019 opinion. If the January 2019 examiner is not available, a copy of this remand should be provided to another appropriate examiner. The examiner should respond to the following: Is the Veteran's acquired psychiatric disability at least as likely as not proximately due to his now service-connected disability (vision disability, an equilibrium disability, and/or TBI)? Is Veteran's acquired psychiatric disability at least as likely as not aggravated, i.e., worsened beyond its natural progression, by his now-service connected disability (vision disability, an equilibrium disability, and/or TBI)? JENNIFER HWA Veterans Law Judge Board of Veterans' Appeals Attorney for the Board L. Bush 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.