Citation Nr: 22017278
Decision Date: 03/24/22	Archive Date: 03/24/22

DOCKET NO. 17-31 639
DATE: March 24, 2022

REMANDED

Entitlement to service connection for an acquired psychiatric disorder, to include an adjustment disorder is remanded.

REASONS FOR REMAND

The Veteran served on active duty from August 1968 to May 1970 and is the recipient of the Combat Action Ribbon and Purple Heart. These matters are before the Board of Veterans' Appeals (Board) on appeal of a March 2017 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO).

In October 2021 the Board remanded the appeals for further development. The issue has now been returned to the Board.

In its October 2021 remand, the Board directed that the Veteran be provided a VA examination to address the nature and etiology of his claimed acquired psychiatric disorder. In November 2021 a VA examiner diagnosed the Veteran with an adjustment disorder with mixed anxiety and depressed mood. The examiner opined that the adjustment disorder was not related to service on the basis that there was "no medical evidence or records indicating that his recent diagnosis of adjustment disorder is related to service or incurred in or caused by an in-service injury, event or disease to include the Veteran's conceded in-service combat stressors."  

The October 2021 VA examiner's opinion is inadequate because it failed to consider the Veteran's competent lay reports of ongoing psychiatric symptoms since service. See Buchanan v. Nicholson, 451 F.3d 1331, 1336 n.1 (Fed. Cir. 2006) (noting that VA's examiner's opinion, which relied on the absence of contemporaneous medical evidence, "failed to consider whether the lay statements presented sufficient evidence of the etiology of [the veteran's] disability such that his claim for service connection could be proven without contemporaneous medical evidence"). An April 2021 VA treatment record noted that the Veteran "reported that he has struggled with some symptoms associated with his deployment to Vietnam since his return." At his August 2021 Board hearing, the Veteran reported "anger issues" since service. The October 2021 examiner did not explain why the Veteran's lay statements describing psychiatric symptoms since service were discounted. Remand is required to obtain an adequate medical opinion which considers these competent lay statements. 

Additionally, a May 2021 VA treatment record noted that the Veteran was planning to attend a local Vet Center after leaving the clinic that same day. Any outstanding Vet Center records have not been requested. Remand is thus required to obtain any relevant Vet Center records. 

The matters are REMANDED for the following action:

1. Obtain any relevant Vet Center records.

2. Obtain an addendum opinion from an appropriate clinician to determine the nature and etiology of an acquired psychiatric disorder, to include an adjustment disorder. In-person examination is not required unless deemed necessary by the examiner. The examiner must answer the following questions:

a.	What diagnosed acquired psychiatric disorders, to include an adjustment disorder have been present since December 21, 2016?

b.	For each such disorder, is it related to an in-service injury, event, or disease to include the Veteran's conceded in-service combat stressors? Why or why not?

The examiner must discuss the Veteran's lay report of an onset of psychiatric symptoms in service with ongoing symptoms thereafter (see August 2021 Board Hearing Transcript p. 4 and April 2021 VA treatment record). If the examiner finds the lay reports are insufficient to support an in-service etiology of an acquired psychiatric disorder, the examiner must clearly explain why that is the case. Please be aware that lay evidence does not lack credibility merely because it is unaccompanied by contemporaneous medical evidence.

 

 

LAURA E. COLLINS

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Bametzreider, Paul J.

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.