Citation Nr: 22018495 Decision Date: 03/29/22 Archive Date: 03/29/22 DOCKET NO. 15-43 125 DATE: March 29, 2022 REMANDED Service connection for a psychiatric disorder, to include posttraumatic stress disorder (PTSD), depression, and anxiety. REASONS FOR REMAND The Veteran served on active duty from July 1976 to July 1980. The case is on appeal from a September 2013 rating decision. In September 2018 and February 2020, the Board remanded the matter for additional development. Service connection for a psychiatric disorder, to include PTSD, depression, and anxiety. Pursuant to the Board's February 2020 remand, the Veteran was scheduled for a VA examination in January 2022. The Veteran failed to report for the scheduled examination. However, January 2022 records from the VA Medical Center (VAMC) in Birmingham, Alabama reflect that the Veteran is homeless. Specific procedures for contacting homeless veterans are set forth in 38 C.F.R. § 1.710. For instance, correspondence may be delivered to the Agent Cashier of a VA medical facility, if the Veteran attends that facility or is likely to attend that facility. In that respect, in December 2021, the Veteran had a telephone encounter with a VA social worker as a participant of the United States Department of Housing and Urban Development - VA Supportive Housing (HUD-VASH) program. In addition, May 2021 records reflects that the Veteran attended telehealth appointments via the phone number he provided, that he was staying in Huntsville, Alabama, taking care of his mother, and that his prescription was available for pick up at the Huntsville VA Clinic Pharmacy. On remand, the RO must follow the procedures set forth in 38 C.F.R. § 1.710, unless the RO clearly confirms and documents that the Veteran has obtained a fixed address and is reachable by the usual means. The Veteran is advised that VA's duty to assist is not always a one-way street. Wood v. Derwinski, 1 Vet. App. 190, 193 (1991). He must cooperate in VA's efforts to obtain evidence in support of his claim, including keeping his contact information on file and up-to-date with the VA RO and VA medical facilities, attending scheduled VA examinations, and/or promptly communicating with VA as to why he cannot attend a scheduled VA examination. 38 C.F.R. § 3.159 (c) (requiring claimant to "cooperate fully with VA's efforts" to obtain both VA and non-VA medical records). The Veteran is further advised that his failure to appear at a scheduled VA examination without good cause may result in the denial of his claim. 38 C.F.R. § 3.655 (b). In view of the remand, updated VA treatment records should be associated with the record. The matter is REMANDED for the following action: 1. Obtain VA treatment records since January 2022. 2. If, on remand, the RO determines that the Veteran is currently homeless, then it must comply with the complete process set forth in 38 C.F.R. § 1.710 (d) for all correspondence pertaining to this appeal. The RO must fully document its efforts to comply with this process. 3. After completion of the above, schedule the Veteran for an examination (or telehealth interview, records request, etc. if an in-person examination is not feasible) by an appropriate clinician to determine the nature and etiology of any psychiatric disorder, to include PTSD, depression, and anxiety. The claims file must be made available to and reviewed by the clinician. Any indicated studies should be performed, and all findings should be reported in detail. The clinician is then asked to opine as to the following: (a.) Identify all psychiatric disorders experienced by the Veteran at any point during the period on appeal. (b.) For each diagnosed psychiatric disorder, to include PTSD, depression, and anxiety, opine whether it is at least as likely as not (50 percent or greater probability) that the disorder had its onset during or within the initial year of separation or is otherwise related to an in-service injury, event, or disease. (c.) For each diagnosed psychiatric disorder, to include PTSD, depression, and anxiety, opine whether it is at least as likely as not that the psychiatric disorder was either (1) proximately caused by service-connected syphilis or (2) aggravated by service-connected syphilis. See January 2013 Statement in Support of Claim & September 2013 rating decision. Aggravation is an increase in severity beyond the natural progress of the disease. In formulating the above opinions, the clinician is asked to consider and discuss the evidence, to include the Veteran's lay statements. (Continued on the next page) If the Veteran fails to report for the scheduled examination, the clinician should provide the opinions above based upon the evidence of record. Rationale for all opinions expressed should be provided. If the clinician is unable to provide the requested opinion without resort to speculation, it must be so stated, and he or she must provide the reasons why an opinion would require speculation. RYAN T. KESSEL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Taylor 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.