Citation Nr: 18131199
Decision Date: 08/31/18	Archive Date: 08/31/18

DOCKET NO. 16-03 501
DATE:	August 31, 2018
REMANDED
Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD), to include as secondary to service-connected disability right hip disability is remanded.
Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) is remanded.
REASONS FOR REMAND
The Veteran had active duty for training (ACDUTRA) from March 2007 to August 2007, and additional National Guard service.
The Veteran initially claimed entitlement to service connection for a psychiatric condition variously diagnosed as depression, anxiety, bipolar disorder, and PTSD.  Thus, the Board has characterized the claim as to include any acquired psychiatric disorder.  See Clemons v. Shinseki, 23 Vet. App. 1 (2009).
The Board cannot make a fully-informed decision on the issue of service connection for an acquired psychiatric disorder because no VA examiner has opined whether any acquired psychiatric disorder is related to his ACDUTRA service or is aggravated by his service-connected right hip disability
Evidence also indicates that there may be outstanding relevant VA and private treatment records.  The Veteran’s VA treatment records from the Altoona VA Medical Center identifies that the Veteran had additional psychiatric treatment at the Pittsburgh VA Medical Center, including inpatient treatment, and that he was hospitalized at the Lewistown Hospital in Lewistown, Pennsylvania following an overdose on medication in a possible suicide attempt.  Records of such treatment are not associated with the record.  A remand is required to allow VA to obtain the outstanding VA treatment records and obtain authorization and request any outstanding private treatment records.  See 38 C.F.R. § 3.159.  
Finally, because a decision on the remanded issue of service connection for an acquired psychiatric disorder could significantly impact a decision on the claim for TDIU, the issues are inextricably intertwined.  A remand of the claim for TDIU is required.
The matters are REMANDED for the following action:
1. Take all appropriate action to verify whether the Veteran had any training dates after August 2007.  If so, obtain all related records. 
2. Obtain the names and addresses of all medical care providers who treated the Veteran for any psychiatric complaints, including psychiatric hospitalizations since August 2007.  After securing the necessary release, take all appropriate action to obtain these records, including private treatment records from Lewistown Hospital in Lewistown, Pennsylvania, records from the Pittsburgh VAMC, and any updated VA treatment records from the Altoona VAMC since January 2017.
3. After the completion of the above, schedule the Veteran for a psychiatric examination to determine the nature and etiology of any acquired psychiatric disability. The examiner should address the following:
(a.) Identify all psychiatric disorders diagnosed since February 2013, to include bipolar disorder and anxiety disorder, and specifically whether the Veteran has PTSD.
(b.) If a diagnosis of PTSD is warranted, the examiner should identify the alleged stressor found to be sufficient to produce PTSD and provide an opinion as to if it is at least as likely as not that the Veteran’s PTSD stressor is related to the Veteran’s ACDUTRA service. 
(c.) For any psychiatric disability diagnosed other than PTSD during the period of the claim, to include bipolar disorder and anxiety disorder is it at least as likely as not related to the Veteran’s ACDUTRA service?
(d.) For any psychiatric disability diagnosed other than PTSD during the period of the claim, to include bipolar disorder and anxiety disorder, is it at least as likely as not (1) proximately due to, or (2) aggravated (defined as any increase in disability) by his service-connected right hip disability?
The examiner should consider and discuss as necessary the Veteran’s lay statements that his acquired psychiatric condition began during his ACDUTRA service and that he had continued symptomatology since his ACDUTRA service. 
4. After the above development, and any additionally indicated development, has been completed, readjudicate the issues on appeal, including the inextricably intertwined claim for TDIU.  If the benefit sought is not granted to the Veteran’s satisfaction, send the Veteran and his agent a Supplemental Statement of the Case and provide an opportunity to respond.  If necessary, return the case to the Board for further appellate review.
 
M.E. Larkin
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	Department of Veterans Affairs

For A Complete Guide To VA Disability Claims and to find out more about your potential VA disability case and how to obtain favorable VA Rating Decision! Visit: VA-Claims.org

For More Information on Veterans Disability Compensation Benefits! Visit: DisableVeteran.org ~ A Non-Profit Non Governmental Agency


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