Citation Nr: 22016132 Decision Date: 03/21/22 Archive Date: 03/21/22 DOCKET NO. 17-40 055A DATE: March 21, 2022 REMANDED Entitlement to service connection for an acquired mental disorder other than PTSD, including anxiety disorder, and to include as due to service-connected knee disability, is remanded. Entitlement to service connection for insomnia (claimed as sleeping disorder) is remanded. REASONS FOR REMAND The Veteran had active service from August 2007 to December 2011. The Veteran testified before the undersigned Veterans Law Judge at a Virtual Board hearing, and a transcript of the hearing is of record. The undersigned received testimony solely on the service connection issues noted in the Title Page. Any reference to the knee disability was solely for purposes of addressing secondary service connection. See 09/28/2021 Hearing Transcript. Entitlement to service connection for an acquired mental disorder other than PTSD, including anxiety disorder, and to include as due to service-connected knee disability, and insomnia are remanded. At the hearing the Veteran testified that his anxiety symptoms had onset in active service. In addition to the rigors of his duties aboard his ship, the USS Hue City, he also attributed some of his symptoms to the fact that other than aspiration of his injured knee, he did not receive treatment for his injured knee on his ship. See Hearing Transcript, P. 6. He and his representative also referenced a 2012 positive opinion from a VA clinician who opined that the Veteran's anxiety had onset or was exacerbated by his active service. See 10/15/2015 Medical Treatment-Government Facility. Although the Agency of Original Jurisdiction (AOJ) considered the Veteran's VA outpatient records, he was not afforded an examination as part of the assistance rendered him on the anxiety claim. The Board finds that the evidence of record, including the Veteran's hearing testimony, triggers a VA examination on the issue. See McLendon v. Nicholson, 20 Vet. App. 79, 83 (2006); see also 38 C.F.R. §§ 3.102, 3.159(c)(4). The matters are REMANDED for the following action: 1. The AOJ shall obtain any relevant treatment records extant generated since the SOC and add them to the claims file. 2. After the above is complete, regardless of whether any records are added to the file, arrange an examination of the Veteran by an appropriate mental clinician. Ask the clinician to opine on whether it is at least as likely as not (at least a 50 percent probability) that the Veteran has an acquired mental disorder other than PTSD, including an anxiety disorder, that had onset in active service or is otherwise causally connected to active service? If the above is answered in the negative, then is it at least as likely as not that any currently diagnosed acquired mental disorder other than PTSD is due to the service-connected knee disability? If the answer is no, then is it at least as likely as not that the service-connected knee disability has worsened any currently diagnosed acquired mental disorder other than PTSD? Inform the clinician that the Veteran's lay report of his history and symptoms must be considered. Inform the clinician further that a full explanation must be provided for all opinions rendered. As concerns the issue of secondary service connection, inform the clinician that any worsening or aggravation of a mental disorder by the knee disability need not be chronic or permanent. Instead, if it is at least as likely not that the knee disability causes any flare-ups of a mental disorder that impairs the Veteran's earning capacity is enough for a positive nexus opinion. If aggravation is found, the examiner should attempt to identify the baseline level of disability prior to such aggravation. Eric S. Leboff Veterans Law Judge Board of Veterans' Appeals Attorney for the Board W. T. Snyder 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.