Citation Nr: 18160465
Decision Date: 12/26/18	Archive Date: 12/26/18

DOCKET NO. 16-04 809
DATE:	December 26, 2018
Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD), and to include as secondary to service-connected residuals, adenocarcinoma of the prostate is remanded.
This case was most recently before the Board in September 2017 when the issue of service connection for an acquired psychiatric disorder, to include PTSD was remanded for additional developments.  Unfortunately, there has not been substantial compliance with the Board’s previous remand directives.  Another remand is required.  Stegall v. West, 11 Vet. App. 268, 271 (1998).
The September 2017 remand directed the examiner to identify whether the Veteran had a diagnosis of PTSD and to provide nexus opinions on all diagnosed psychiatric disorders.  The Board specifically identified that on September 2015 VA examination, an adjustment disorder was diagnosed.  On remand, the June 2018 VA examiner found that the Veteran’s symptoms did not meet the DSM-5 diagnostic criteria for PTSD and he did not have a separate mental disorder that met DSM-5 criteria.  While the examiner identified the Veteran had a history of treatment for an adjustment disorder, he did not provide an opinion regarding the etiology of his adjustment disorder, to include whether it was caused or aggravated by his service-connected residuals of prostate cancer.  Accordingly, a remand is necessary to obtain an opinion addressing on all acquired psychiatric disorders diagnosed during the period on appeal
Additionally, updated treatment records should be obtained.  See 38 C.F.R. § 3.159.  See also Bell v. Derwinski, 2 Vet. App. 611 (1992).
The matter is REMANDED for the following action:
1. Obtain the names and addresses of all treatment providers who treated the Veteran for any psychiatric disorder since June 2018.  After securing the necessary release, take all appropriate action to obtain these records, including any updated VA treatment records June 2018.  
2. After the completion of the above, arrange to obtain an addendum opinion from the June 2018 examiner (or from another appropriate clinician if the June 2017 examiner is unavailable).  The entire record, including this remand, must be reviewed by the examiner.  Based on the record, the examiner should provide an opinion to the following:
(a.) Identify all acquired psychiatric disorders diagnosed since May 2012, to include an adjustment disorder.
(b.) For each diagnosed acquired psychiatric disorder, is it at least as likely as not related to an in-service injury, event, or disease?
(c.) For each diagnosed acquired psychiatric disorder is it at least as likely as not (1) proximately due to, or (2) aggravated (defined as any increase in disability) by the Veteran’s service-connected residuals, adenocarcinoma of the prostate?
The examiner must explain the rationale for all opinions in detail, citing to supporting clinical data and/or medical literature, as appropriate. If an opinion cannot be provided, the examiner should indicate why.
M.E. Larkin
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	Eric Struening, Associate Counsel 

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