MAJOR DEPRESSIVE DISORDER

Summary

The Veteran, who served from February 2019 to September 2021, January 2023 to May 2023, and February 2025 to January 2026, appeals the denial of service connection for an acquired psychiatric disorder, specifically major depressive disorder, claimed as secondary to service-connected lumbosacral strain and bilateral knee strain. The Veteran submitted a private physician's opinion which diagnosed major depression, generalized anxiety disorder, panic disorder, and alcohol dependence, stating these conditions were more likely than not secondary to chronic pain from service-connected back and knee injuries. The opinion detailed direct and indirect effects, such as distraction, intrusive thoughts, and sleep issues. A VA psychiatric examination was scheduled but canceled due to the Veteran not receiving the notification letter, and a subsequent rescheduling was prevented by the Veteran's deployment. The Board found the evidence to be in equipoise regarding the nexus between the psychiatric disorder and the service-connected musculoskeletal conditions. Applying the benefit of the doubt, the Board granted service connection for an acquired psychiatric disorder. The Board noted the Veteran's claim was initially for major depressive disorder but expanded it to acquired psychiatric disorder based on private medical diagnoses, consistent with Clemons v. Shinseki. Service connection for the acquired psychiatric disorder is granted.

Rationale

Private physician opinion found condition more likely than not secondary to service-connected injuries.; Evidence found to be in equipoise regarding nexus.; Benefit of the doubt resolved in Veteran's favor.

Full Decision Text

Citation Nr: A26037085
Decision Date: 04/21/26	Archive Date: 04/21/26

DOCKET NO. 250324-527472
DATE: April 21, 2026

ORDER

Entitlement to service connection for an acquired psychiatric disorder, to include major depressive disorder, and to include as secondary to the service-connected lumbosacral strain and bilateral knee strain, is granted.

FINDING OF FACT

The Veteran's acquired psychiatric disorder is due to his service-connected lumbosacral strain and bilateral knee strain.

CONCLUSION OF LAW

The criteria for service connection for an acquired psychiatric disorder, to include major depressive disorder, as secondary to the service-connected lumbosacral strain and bilateral knee strain, are met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.310.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran had active military service from February 2019 to September 2021, from January 2023 to May 2023, and from February 2025 to January 2026.

The rating decision on appeal was issued in November 2024 and constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies. Although the Veteran initially requested Higher-Level Review when submitting the November 2024 VA Form 20-0996, Decision Review Request: Higher-Level Review, the Higher-Level Reviewer determined in a December 2024 rating decision that there had been a duty to assist error and transferred the claim to the Supplemental Claim decision review option for additional development. In March 2025, the Agency of Original Jurisdiction (AOJ) issued the supplemental claim decision on appeal, which found that new and relevant evidence had been received and denied the claim based on the evidence of record at the time of that decision. In the subsequent March 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket. 

Therefore, the Board of Veterans' Appeals (Board) may only consider the evidence of record at the time of the March 2025 AOJ supplemental claim decision on appeal. 38 C.F.R. § 20.301. If evidence was submitted after the AOJ issued the supplemental claim decision on appeal, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.301, 20.801. If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. 

Finally, the Veteran originally filed his claim for major depressive disorder. See July 2024 VA 21-526EZ Form. The AOJ adjudicated the claim as major depressive disorder in the rating decision. In characterizing the issue on appeal, the Board recognizes that when a claimant makes a claim, he is seeking service connection for symptoms regardless of how those symptoms are diagnosed or labeled.  Clemons v. Shinseki, 23 Vet. App. 1 (2009). As the medical evidence of record indicates that the Veteran has received multiple psychiatric diagnoses from a private physician (as described below), the service connection issue has been expanded as noted above, consistent with Clemons.

1. Entitlement to service connection for an acquired psychiatric disorder, to include major depressive disorder, and to include as secondary to the service-connected lumbosacral strain and bilateral knee strain.

The Veteran contends that his current major depressive disorder is secondary to his service-connected right knee strain. See July 2024 VA 21-526EZ Form. 

In the March 2025 rating decision, the AOJ made Favorable Findings that the Veteran has current diagnoses of major depressive disorder and generalized anxiety disorder, and that the Veteran is currently service connected for a lumbosacral strain and bilateral knee strain. 

Regarding a nexus between the Veteran's current acquired psychiatric disorder diagnosis and his service-connected lumbosacral strain and bilateral knee strain, there is only one medical opinion of record. In the July 2024 Mental Disorders Disability Benefits Questionnaire, a private physician opined that, "After a careful review of records, psychological testing, and a 2 -hour interview, it is my professional medical opinion that the [V]eteran meets diagnostic criteria for
EZ Form. 

In the March 2025 rating decision, the AOJ made Favorable Findings that the Veteran has current diagnoses of major depressive disorder and generalized anxiety disorder, and that the Veteran is currently service connected for a lumbosacral strain and bilateral knee strain. 

Regarding a nexus between the Veteran's current acquired psychiatric disorder diagnosis and his service-connected lumbosacral strain and bilateral knee strain, there is only one medical opinion of record. In the July 2024 Mental Disorders Disability Benefits Questionnaire, a private physician opined that, "After a careful review of records, psychological testing, and a 2 -hour interview, it is my professional medical opinion that the [V]eteran meets diagnostic criteria for Major Depression, severe, recurrent w/psychotic features (F33.3). Generalized Anxiety Disorder (F41.1), Panic Disorder (F41.0), and Alcohol Dependence (F10.2). Veteran is experiencing chronic pain resulting from service-connected injuries to back and knees, resulting in the above psychiatric disorders and their social and occupational effects. NEXUS STATEMENT: The [V]eteran's Major Depression, severe, recurrent (F33.3). Generalized Anxiety Disorder (F41.1), Panic Disorder (F41.0), and Alcohol Dependence (F10.2) are MORE LIKELY THAN NOT secondary to (caused by) chronic pain due to Lumbosacral Strain (20%), Left Knee Strain (10%), and Right Knee Strain (10%). The effects are both direct (distraction, intrusive thoughts) and indirect (sleep issues leading to chronic fatigue

and irritability)."

A VA examination and medical opinion is not of record. The AOJ scheduled the Veteran for a VA psychiatric examination in January 2025. An Exam Scheduling Request Contention Cancellation states that the Veteran was a No Show for the examination. In a January 13, 2025, Report of General Information, the Veteran called and asked for the examination to be rescheduled, as he never received the examination notification letter. The Board notes that an examination notification letter is not contained in the Veteran's claims file. The Veteran stated that he would attend the rescheduled examination. The Veteran was subsequently deployed on active duty in February 2025 and the AOJ did not reschedule the Veteran for an examination prior to the rating decision on appeal. However, based on the current lay and medical evidence of record, the Board finds that a remand of this claim to obtain a VA examination is not necessary.

Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran's current acquired psychiatric disorder is due to the service-connected lumbosacral strain and bilateral knee strain. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for an acquired psychiatric disorder is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. The claim is granted.

 

 

MARJORIE A. AUER

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	S. M. Watkins, 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.