Citation Nr: 23019658 Decision Date: 03/30/23 Archive Date: 03/30/23 DOCKET NO. 14-39 153 DATE: March 30, 2023 REMANDED Entitlement to service connection for an acquired psychiatric disorder is remanded. REASONS FOR REMAND The Veteran served on active duty with the United States Navy from October 1978 to July 1981. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a May 2013 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In February 2020 and in July 2022, the Board remanded this appeal for further development by the RO. 1. Entitlement to service connection for an acquired psychiatric disorder is remanded. In both prior remands, the Board directed the RO to provide the Veteran with a psychiatric examination. In the July 2022 remand, the Board instructed that "[i]f the Veteran again fails to report for the exam, VA should obtain a medical opinion based on review of the file alone." Although it appears the Veteran was a no-show to a scheduled examination in October 2022, a medical nexus opinion based on the claims file was not obtained. As a matter of law, a remand by the Board confers upon the Veteran the right to compliance with the Board's remand order. Stegall v. West, 11 Vet. App. 268, 270-71 (1998). In accordance with Stegall, a remand for full compliance with the Board's prior remand is warranted. The Veteran avers that prior to military service, he had depression, and that his preexisting depression was exacerbated by service. During a VA mental health examination in October 2011, the Veteran reported that he was placed on a submarine and could not adjust to it. On his April 2014 notice of disagreement (NOD), the Veteran reported that he had depression prior to service. He indicated that up until being sent to corpsman school, he was functioning at a "very good level." He stated that his (mental health) symptoms were triggered by "overwhelming stress" in that school. The Veteran's October 1978 medical examination at entry does not indicate any mental health history or psychiatric disorders. Service personnel records reflect that he was examined and initially found qualified for submarine school. An entry dated in February 1979 appears to reflect that he did not graduate, and was determined to be 'environmentally unadaptable.' Service records contain a subsequent request to attend hospital corpsman school in 1980, which was approved. Beginning in November 1980, service personnel records reflect regular disciplinary actions, including failure to obey orders or appear for duty. In January 1981, he was referred for a psychological evaluation due to problems with performance and command. A January 1981 Consultation Report shows that he was assessed by a psychology intern as having no current psychological diagnosis but displaying passive-aggressive and schizoid personality traits. He received a general discharge seven months later. The matter is REMANDED for the following action: Obtain a medical opinion based on review of the claims file. The claims file and a copy of this remand must be made available for the examiner's review. Following a review of the pertinent evidence, and identifying all psychiatric disorders currently found, to include any schizoaffective disorder and/or depressive disorder, the examiner must address the following: a) Did a psychiatric disorder clearly and unmistakably (undebatable) preexist the Veteran's service? Why or why not? b) If the examiner finds a psychiatric disorder did clearly and unmistakably preexist service, was it clearly and unmistakably not aggravated by service? Why or why not? c) If the examiner finds that a psychiatric disorder either did not clearly and unmistakably preexist service or was not clearly and unmistakably not aggravated by service, then the examiner must opine whether it is at least as likely as not that it either began in service or is otherwise related to service, including as a result of either submarine training or "overwhelming stress" during corpsman school. In doing so, the examiner is also asked to discuss whether the symptoms noted in service are indicative of a psychiatric disorder present during military service The examiner must provide a rationale to support the opinion. In providing the opinion for d), consider the Veteran's description of his in-service injury (i.e., submarine training and experiencing "overwhelming stress" during corpsman school) and symptoms as well as his post-service symptoms. If there is any medical reason to accept or reject the proposition that the Veteran's reported injury and symptoms in service and thereafter represented the onset of his current psychiatric disorder(s), this should be noted. Stated another way, do the Veteran's reports about his symptoms align with how the currently diagnosed psychiatric disorder(s) is known to develop or are the Veteran's reports generally inconsistent with medical knowledge or implausible? D. JOHNSON Veterans Law Judge Board of Veterans' Appeals Attorney for the Board W. Stearns, 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.