Citation Nr: 18132257
Decision Date: 09/06/18	Archive Date: 09/06/18

DOCKET NO. 15-42 963
DATE:	September 6, 2018
REMANDED
Entitlement to service connection for an acquired psychiatric disability, to include PTSD, is remanded.
REASONS FOR REMAND
The Veteran served on active duty in the United States Navy from July 1972 to May 1978.
As an initial matter, the Board notes that the Veteran filed a claim for PTSD.  However, during the pendency of the appeal, the Veteran has also been diagnosed with adjustment disorder, generalized anxiety disorder, panic disorder, and depression.  In Clemons v. Shinseki, 23 Vet. App. 1 (2009), the United States Court of Appeals for Veterans Claims (Court) clarified the scope of a claim on appeal by holding that when a claimant makes a claim, he/she is seeking service connection for symptoms regardless of how those symptoms are diagnosed or labeled.  The Court in Clemons held that that the scope of a disability claim includes any disability that may reasonably be encompassed by the Veteran’s description of the claim, reported symptoms, and other information of record.  Accordingly, the Veteran's claim has been revised to include a claim for any acquired psychiatric disability, not just PTSD.
1. Entitlement to service connection for an acquired psychiatric disability, to include PTSD, is remanded.
The Veteran is seeking entitlement to service connection for an acquired psychiatric disability, to include PTSD, which he attributes to a number of stressful non-combat events in service.
The Veteran’s service treatment records are negative for any complaints of or treatment for an acquired psychiatric disability, and there is no evidence of any complaints of or treatment for any psychiatric problems for decades after separation from service.  
In an October 2013 letter, G.R., a nurse practitioner, and Dr. R.S., stated that the Veteran had a diagnosis of past diagnosis of PTSD related to his active service and that his current generalized anxiety and panic disorder were attributable to this PTSD.  In a May 2014 letter, G.R. opined that the Veteran's generalized anxiety and panic disorder stemmed primarily from the Veterans PTSD, which is related to service.  
However, although G.R. and Dr. R.S. attribute the Veteran's generalized anxiety and panic attacks to his active service, VA outpatient treatment records from Oakland and Palo Alto contain frequent references to non-service connected causes of anxiety, panic attacks, and depression, including the deaths of several close family members and employment stress, which appear to be the primary cause of the Veteran's psychological distress.  Neither G.R. not Dr. R.S. discuss these non-service related stressors or offer any explanation for their conclusion that the Veteran's current disability is more likely caused by his active military service than by current life events.  Accordingly, the Board finds that these medical opinions are inadequate and referral for a VA medical opinion is required to clarify the etiology of the Veteran's current acquired psychiatric disability.  
The matter is REMANDED for the following action:
1. Schedule the Veteran for a psychiatric examination to determine the nature and etiology of any posttraumatic stress disorder (PTSD).  If the Veteran is diagnosed with PTSD, the examiner must explain how the diagnostic criteria are met and opine whether it is at least as likely as not related to a verified in-service stressor.  
If any other acquired psychiatric disorders are diagnosed, the examiner must opine whether each diagnosed disorder is at least as likely as not related to an in-service injury, event, or disease, to include the Veteran's reported in-service stressors.  

 
MATTHEW TENNER
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	E. D. Anderson, Counsel

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