Citation Nr: 23019486 Decision Date: 03/29/23 Archive Date: 03/29/23 DOCKET NO. 19-08 326 DATE: March 29, 2023 ORDER Service connection for adjustment disorder with depressed mood is granted. REMANDED 1. An initial rating in excess of 10 percent for right elbow arthritis post open reduction and internal fixation. 2. An initial compensable rating prior to February 7, 2020, and in excess of 20 percent thereafter, for right elbow ununited fracture of the head of the radius post open reduction and internal fixation. ? FINDING OF FACT The Veteran's adjustment disorder with depressed mood is caused by the service-connected right elbow disability. CONCLUSION OF LAW The criteria for service connection for adjustment disorder with depressed mood are met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from September 1990 to September 2016. The case is on appeal from a December 2016 rating decision. In January 2020, the Board remanded a higher initial rating claim for the Veteran's service-connected right elbow disability for additional development. Thereafter, in an August 2020 rating decision, the RO stated that they were recharacterizing the Veteran's prior right elbow rating from 10 percent for arthritis to 10 percent for the arthritis with ununited fracture, increasing that rating to 20 percent effective February 7, 2020, and granting a separate 10 percent rating for arthritis effective February 7, 2020. However, as explained in the text of the rating decision, what the RO actually did was deny an initial rating in excess of 10 percent for the Veteran's right elbow arthritis while also assigning a separate 20 percent rating for right elbow ununited fracture of the head of the radius effective February 7, 2020. Thus, for the initial period, the Veteran is assigned a 10 percent rating for all aspects of this disability and, effective February 7, 2020, he is assigned a 10 percent rating for arthritis and a separate 20 percent rating for the ununited fracture. Service connection for adjustment disorder with depressed mood. Legal Criteria Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. § 1110; 38 C.F.R. § 3.303. A veteran seeking compensation under these provisions must establish three elements: "(1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service." Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Service connection may also be granted for a disability that is proximately due to, or aggravated by, service-connected disease or injury. See 38 C.F.R. § 3.310. Analysis In January 2023, during the course of the right elbow rating claim on appeal, the Veteran filed a claim of service connection for a mental health condition. He also submitted a statement claiming that the right elbow disability results in a mental health condition including sleep impairment. He explained that the right elbow disability prevents him from exercising normally, including doing push-ups, weightlifting, and rowing. He also explained that it prevents him from enjoying hobbies like basketball and football. The Veteran stated that these limitations result in him feeling sad and unmotivated. He also stated that right elbow pain results in difficulty staying asleep. Although the mental health condition claim has not yet been adjudicated by the RO, this issue is part and parcel of the present appeal due to being reasonably raised during the adjudication of the right elbow rating claim and in conjunction with VA's duty to maximize benefits. See Morgan v. Wilkie, 31 Vet. App. 162, 167-68 (2019); see also Bailey v. Wilkie, 33 Vet. App. 188, 200-02 (2021). In February 2023, the Veteran was afforded an examination for this claim. The examiner reported that the Veteran became tearful and anxious when describing the physical limitations he experiences due to his service-connected disabilities. The examiner also reported psychiatric symptoms of depressed mood, chronic sleep impairment, and disturbances of motivation and mood. The examiner diagnosed the Veteran with adjustment disorder with depressed mood resulting in symptoms of depressed mod, chronic sleep impairment, and disturbances of motivation and mood. The examiner concluded that the Veteran's psychiatric diagnosis is at least as likely as not caused by the physical limitations and pain resulting from his service-connected right elbow disability as well as his service-connected left knee and sleep apnea conditions. The Board finds that the Veteran's adjustment disorder with depressed mood is caused by his service-connected right elbow disability. In this regard, the February 2023 mental health examiner found that the Veteran has this condition and that it is caused by his service-connected conditions, including the right elbow disability. In addition, there are no contrary opinions of record. Thus, service connection for adjustment disorder with depressed mood is warranted. REASONS FOR REMAND The Board notes that the following summary of the remanded claims and remand directives do not make any findings as to the competency or credibility of any of the evidence of record unless expressly stated otherwise. 1. An initial rating in excess of 10 percent for right elbow arthritis post open reduction and internal fixation. 2. An initial compensable rating prior to February 7, 2020, and in excess of 20 percent thereafter, for right elbow ununited fracture of the head of the radius post open reduction and internal fixation. The Veteran is seeking higher initial ratings for the service-connected right elbow disability. In a March 2019 VA Form 9, he claimed that he experiences right wrist pain secondary to the elbow condition. An examination and opinion have not yet been obtained in regard to whether he has a right wrist condition secondary to the right elbow disability. Therefore, a remand is required to obtain this development prior to adjudicating the right elbow rating claim. See Morgan, 31 Vet. App. at 167-68; see also Bailey, 33 Vet. App. at 200-02. These claims are REMANDED for the following action: Schedule the Veteran for a VA examination to determine the nature and etiology of any current right wrist disorder. The record, to include a copy of this remand, must be made available to and be reviewed by the examiner. Thereafter, the examiner should: (a.) Identify all current right wrist disorders, to include pain resulting in functional impairment. (b.) For any diagnosed disorder or functional impairment, state whether it is at least as likely as not caused or aggravated by the right elbow arthritis or ununited fracture of the head of the radius post open reduction and internal fixation. A rationale should be offered for the opinions expressed. RYAN T. KESSEL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Jimerfield 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.