Citation Nr: 22017886 Decision Date: 03/26/22 Archive Date: 03/26/22 DOCKET NO. 18-17 039 DATE: March 26, 2022 REMANDED Entitlement to service connection for bipolar disorder is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from September 1956 to September 1960, with periods of additional service in the Army National Guard and Army Reserves. This matter comes before the Board of Veterans' Appeals (Board) from a July 2017 rating decision by the Agency of Original Jurisdiction (AOJ). The issue was reopened and remanded in a May 2019 Board decision. Thereafter, a July 2020 Board decision denied the claim of entitlement to service connection for bipolar disorder. The Veteran appealed the Board's July 2020 decision to the United States Court of Appeals for Veterans Claims (Court). In a May 2021 Order, the Court granted a Joint Motion for Remand (JMR), vacating the July 2020 Board decision and remanding the issue to the Board for development consistent with the JMR. In September 2021, the Board remanded the claim to the AOJ to obtain and associate with the claims file VA treatment records for the period from June 2020 to the present and to obtain an addendum VA opinion from an appropriate clinician regarding the etiology of the Veteran's bipolar disorder. The Veteran contends that he developed bipolar disorder as a result of noise exposure, sleep deprivation, and hitting his head numerous times during his service. A June 1995 private examiner noted that the Veteran reported that his difficulties with bipolar disorder began more than 30 years prior to the examination. See June 1995 letter from Dr. M.T. The record shows that the Veteran reported that he injured his head during his active service as a result of bumping it on the engine and from falling debris during an inspection. See June 2004 statement in support of claim. He also reported sleep deprivation and noise exposure. See November 2016 statement in support of claim. Additionally, the Veteran's wife submitted a statement in which she related his bipolar disorder to service, including that it was triggered by in-service noise exposure, head injuries, and lack of sleep. See October 2016 Buddy / Lay Statement. In response to the September 2021 remand directives, an October 2021 addendum opinion was obtained. The examiner opined that it is at least as likely as not that the Veteran's bipolar disorder began during his military service based on a January 1993 medical note diagnosing hypomania, explaining that such was evidence of bipolar symptoms while the Veteran was still in the military. The Board notes that the Veteran's service between October 1991 and July 1998 was in the Army Reserves and his service personnel records document no points were received between May 1991 to May 1994 for any inactive or active duty for training. See July 1997 U.S. Army Reserve Personnel Center Chronological Statement of Retirement Points; see also 38 C.F.R. § 3.6(a). The Board finds the October 2021 opinion does not provide sufficient medical evidence to decide the claim as it does not address whether bipolar disorder was related to the Veteran's active service from September 1956 to September 1960, to include whether it had its onset during within one year of discharge or was incurred therein. 38 C.F.R. § 3.159(c)(4). A medical opinion must be obtained that addresses the Veteran's lay statements that in-service (during active duty) sleep deprivation, noise exposure, and head trauma caused his bipolar disorder. Remand is necessary to fully consider and address the Veteran's lay statements in compliance with the prior Board directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Accordingly, the matter is REMANDED for the following action: Obtain an addendum medical opinion from an appropriate clinician. The evidentiary record, including a copy of this remand, must be made available to and be reviewed by the clinician. After the record review, the reviewing clinician is asked to provide an opinion as to whether it is it at least as likely as not that the Veteran's bipolar disorder was incurred in active service (September 1956 to September 1960) or is otherwise related to an in-service injury, event, or disease. The reviewing clinician is advised that the Veteran and his spouse are competent to report his symptoms and history. Such reports must be acknowledged and considered in formulating any opinion, including statements of active duty head injuries, lack of sleep, and noise exposure as well as a June 1995 private treatment record indicating the Veteran's bipolar disorder began after a head injury in approximately 1970. If the examiner rejects the Veteran's reports, he or she must provide an explanation for such rejection. The examiner is advised that an adequate medical opinion may not be predicated solely on the absence of an in-service diagnosis or documented complaints. 2. Then, readjudicate the Veteran's claim. If the benefit sought remains denied, provide the Veteran and his representative with a supplemental statement of the case (SSOC), and return the case to the Board. A. Odya-Weis Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. Wilson, Associate 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.