Citation Nr: 22014137 Decision Date: 03/11/22 Archive Date: 03/11/22 DOCKET NO. 18-16 455 DATE: March 11, 2022 REMANDED Entitlement to service connection for a psychiatric disorder is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from February 1992 to October 1992. This matter is on appeal from a March 2016 rating decision. In April 2021, the Veteran testified at a virtual hearing with the undersigned Veterans Law Judge of the Board. A transcript of the hearing is associated with the record. In June 2021, the Board remanded this matter for further development by the originating agency. Psychiatric disorder The Board remanded the claim for an examination to determine whether the Veteran has a psychiatric disability which is eligible for service connection and related to his service. The Board also requested an examiner to consider and address the VA treatment records noting DSM-V diagnoses of an adjustment disorder, a depressive and an anxiety disorder in providing an opinion as to whether any psychiatric disorder, other than the Veteran's diagnosed personality disorder, was related to his service. Pursuant to the Board's remand, on October 2021 VA mental disorders Disability Benefits Questionnaire examination a VA examiner diagnosed borderline personality disorder and alcohol use disorder. In an October 2021 VA medical opinion the examiner opined that the Veteran's alcohol use disorder and borderline personality were not related to his service. The examiner also opined that there is no evidence that the Veteran's service exacerbated his personality disorder. However, the examiner failed to provide any opinion as to whether the personality disorder was subject to a superimposed disease or injury in service. In another October 2021 opinion the examiner opined that the Veteran, "loosely referenced symptoms that could be interpreted as anxiety or depression, but are clearly more closely related to poor coping skills and inability to deal with stress and problem solve effectively." The examiner further opined that there was not "a lot [of] basis for any additional diagnoses or logical reasoning behind the onset of his reported symptoms." However, the examiner failed to consider or address the VA treatment records noting DSM-V diagnoses of an adjustment disorder, a depressive, and an anxiety disorder as requested in the remand directives. Accordingly, in light of the foregoing and deficiencies in the October 2021 VA medical opinions, another addendum should be obtained. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007); Stegall v. West, 11 Vet. App. 268 (1998). The matter is REMANDED for the following action: Obtain an appropriate addendum by an examiner, other than the October 2021 VA examiner, regarding the nature and etiology of the Veteran's claimed psychiatric disorder. Unless the examiner finds that a new examination is required, the Veteran need not be examined again. The claims file, including a copy of this remand, must be made available to the examiner for review who should indicate that the claims file was reviewed. (a) Does the Veteran have a current diagnosis of any acquired psychiatric disorders (other than borderline personality disorder)? If so, please provide the diagnosis or diagnoses. In addressing this matter, the examiner must consider and address the VA treatment records noting DSM-V diagnoses of an adjustment disorder, a depressive and an anxiety disorder. If there are different diagnoses other than those currently of record, the examiner should attempt to reconcile the diagnoses with the evidence of record. (b) If there are diagnoses of a psychiatric disorder (other than borderline personality disorder), is it at least as likely as not (50 percent or greater probability) that such diagnosed disorders were incurred in, caused by, or etiologically related to the Veteran's service? (c) Regarding the diagnosis of borderline personality disorder, is it at least as likely as not (50 percent or greater probability) that the personality disorder was subject to a superimposed disease or injury in service (e.g., psychiatric disorder) resulting in additional disability? If so, identify any additional disability that the Veteran suffered as a result of an injury that was superimposed on his personality disorder. In rendering these opinions, 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 the Veteran's reports are discounted, the examiner should provide a reason for doing so. The Board, by this remand, makes no determination, expressed or implied, concerning the credibility of any statements on file. A fully articulated medical rationale for each opinion expressed must be set forth in the medical report. The examiner is asked to consider and discuss as necessary the pertinent evidence of record to include the Veteran's testimony and lay statements, including those made to medical providers, and the relevant medical literature or studies as applicable to this case, which may reasonably explain the medical analysis in the study of this case. (Continued on the next page) 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. KELLI A. KORDICH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Adams, 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.