The record before the Board consists solely of electronic files known as Virtual VA

and the Veterans Benefits Management System.

REMAND

The Board's review of the record reveals that further development is warranted.

The Veteran seeks entitlement to service connection for a psychiatric disability,

claimed as posttraumatic stress disorder (PTSD) due to an in-service rape.

A May 1969 service treatment record (STR) notes that the Veteran was admitted for
"situational-maladjustment reaction, impulsive," after he attempted to commit
suicide by overdose on a prescription medication. The Veteran indicated that his
attempt was related to receiving a Dear John letter. A September 1969 performance
review notes that the Veteran's military appearance was "lax," he had to be
reminded to "Square Away" often, and personal problems made him moody. In October
1969, the Veteran received a psychiatric consultation, "for feelings of inner
agitation, panic, anxiety, restlessness, loss of appetite, apathy, lethargy, and
general irritability." He reported being unable to adapt to military life and was
not motivated to continue military service. The record notes that the Veteran had
had an unauthorized absence and was repeatedly seen for anxiety. He was diagnosed
with passive-aggressive personality, and discharged for unsuitability in December
1969.

VA Medical Center (VAMC) treatment records document psychiatric treatment from July
1979 to November 1979 after the Veteran reported contemplating suicide by
motorcycle accident. The Veteran stated he was, "very confused, unable to make
decisions and acting like a zombie." He also reported chest pain related to stress
and difficulties related to an ongoing separation from his wife. VAMC records also
indicate the Veteran enrolled in a counseling program for anxiety, depression, and
low self-esteem from May 1984 to January 1997, "due in part to marital problems."

A March 2008 VA treatment note is the first documented disclosure of military

sexual trauma that was reported while the Veteran sought treatment for other
psychiatric symptoms. An April 2008 treatment record reports that the Veteran was
at a bus station en route to his naval vessel when a man invited him to wait for
the bus at his home. The Veteran reported having a drink then vaguely remembering
a sexual assault, throwing up in the man's bathroom, and being dropped off at the
bus station. Upon return to his ship, he began huffing glue and drinking
excessively, which led to disciplinary actions, counseling, and a suicide attempt.
A VA nurse practitioner diagnosed PTSD as a result of military sexual trauma and
the Veteran began psychiatric treatment, to include treatment at the VA Center for
Sexual Trauma Services (CSTS).

In a September 2008 VA examination report, the examiner noted the Veteran's 1969
diagnosis of passive aggressive personality and VAMC diagnosis of PTSD and
determined that it would be resorting to mere speculation to give a definitive
diagnosis to the Veteran. The VA examiner further found it "as likely as not" that
the Veteran's current symptoms were the same mental disorder he was diagnosed with
during service (passive aggressive personality), but noted that it would now be
characterized as antisocial personality disorder. The VA examiner opined it would
require speculation to attribute any of the Veteran's symptoms to a claimed sexual
trauma.

Subsequent VAMC treatment notes document the Veteran's assertion that the September
2008 VA examiner barely spoke to the Veteran. A November 2008 VAMC treatment note
indicates that the Veteran was reassured that his symptomatology was consistent
with experiencing sexual trauma. A December 2008 VAMC treatment note states that
there was no evidence that the Veteran had a personality disorder and that the
Veteran's diagnoses were PTSD and mood disorder secondary to severe cardiac
disease.

A May 2008 VAMC treatment note reports that the Veteran's symptoms increased after
participation in CSTS therapy. In September 2008, the Veteran "blacked out" in a
state of rage that the VA psychiatrist indicated was due to exacerbation of his
PTSD symptoms since he disclosed his sexual trauma. A January 2009 VAMC treatment
note indicates that the Veteran had a history of avoidance as a coping mechanism
related to trauma and that the Veteran began drinking and using drugs to avoid
feelings and memories after his assault. The Veteran reported that he planned on
shooting himself in October 2009.

In January 2010, the Veteran was admitted for in-patient psychiatric treatment due
to an incident in which he shot his gun in the air after his wife came home drunk
and he told her she would not receive his VA benefits if he committed suicide. The
VA treatment note reports that the Veteran had symptoms of poor sleep, rage,
anxiety, racing thoughts, impulsivity, and depression. The VA psychiatrist
diagnosed bipolar II illness and the discharge report notes that the Veteran's
angry mood swings were perceived to be caused by military service trauma and
related to PTSD. The psychiatrist stated, "however it is very possible that the
trauma precipitated a mood condition, concommitently with his anxiety problems."

In multiple written statements and testimony before the Board, the Veteran
contended that his in-service behavioral changes and suicide attempt were related
to the personal assault and that he made up receiving a Dear John letter because he
did not want to disclose the rape.

In a December 2013 VA therapy note, the Veteran was assessed with PTSD per history,
secondary to military sexual trauma, with current symptomatology subthreshold.

In March 2013, the Board remanded the Veteran's claim, in part, for a VA
examination to determine whether the Veteran's PTSD stressor of an in-service rape
could be verified, to resolve conflicting evidence of record regarding the
Veteran's current psychiatric diagnoses and to ascertain the etiology of all
acquired psychiatric disorders present during the pendency of the claim.

The report of an April 2013 VA examination reflects that the VA examiner determined
the Veteran did not warrant a diagnosis of PTSD and was unable to determine whether
the Veteran's in-service markers were indicative of a sexual assault. The VA
examiner noted that the Veteran's service record included, "complaints of inner
agitation, panic, anxiety, restlessness with loss of appetite, apathy, lethargy,
and general irritability, with difficulties adapting to the regimentation of
military life, resenting having to take orders, and lack of motivation for further
military service." The VA examiner also pointed to notations in the Veteran's
service record that he had an unauthorized absence and suicidal gesture that were
related to marital difficulties, a diagnosis of passive aggressive personality, and
administrative discharge due to unsuitability when determining that no opinion
could be rendered. The VA examiner opined that it would require speculation to
address whether the Veteran's in-service markers were indicative of an alleged
sexual assault in March 1969. Further, it would be, "mere speculation to provide
that opinion as there was over endorsement of symptoms of PTSD in this examiner's
professional opinion." The VA examiner was unable to "differentiate legitimate
symptoms from exaggerated or feigned symptoms and is unable to provide a diagnostic
impression or give an assessment of occupational and social functioning."

After reviewing the April 2013 VA examination report, the Board has determined that
the originating agency did not substantially comply with the March 2013 remand
directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998). The Board finds
the April 2013 VA medical opinion to be inadequate for adjudicative purposes. When
VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure
that the examination or opinion is adequate. Barr v. Nicholson, 21 Vet. App. 303,
312 (2007).

Here, the conclusions reached by the April 2013 VA examiner do not fully address
the requested inquiries. The April 2013 VA examiner failed to provide an opinion
on all acquired psychiatric disorders present during the period of the claim, to
include March 2008 diagnoses of PTSD as a result of military sexual trauma and
depressive disorder related to cardiac condition, December 2008 diagnoses of PTSD
and mood disorder secondary to severe cardiac disease, and January 2010 in-patient
diagnoses of bipolar illness, II, current episode hypomania, and PTSD. In
determining that an opinion could not be rendered in relation to the Veteran's
claimed PTSD, the VA examiner only considered the symptoms presented at the
examination, but failed to discuss the Veteran's diagnosis of PTSD that was
confirmed in VA medical treatment records during the period of the claim. The
Board notes that the Veteran has a current disability for purposes of VA
compensation when the disability is present at the time a claim for VA disability
compensation is filed or during the pendency of that claim even though the
disability resolves prior to the Secretary's adjudication of the claim. See
McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). Additionally, the VA examiner
failed to provide a supporting rationale to explain why it would be "with resort to
mere speculation" to determine whether the Veteran's in-service markers evidence a
personal assault. See Jones v. Shinseki, 23 Vet. App. 382, 390 (2010) (requiring
an opinion to clearly consider "all procurable and assembled data" when determining
that a conclusion cannot be reached without resort to speculation).

In light of these circumstances, this case is REMANDED to the RO or the Appeals

Management Center (AMC), in Washington, D.C., for the following actions:

1. The RO or the AMC should undertake appropriate development to obtain any

outstanding, pertinent medical records.

2. Then, the Veteran should be afforded a VA examination by a psychiatrist or

psychologist (other than the April 2013 examiner) to determine the nature and
etiology of all acquired psychiatric disorders present during the period of the
claim.

All pertinent evidence in the electronic files should be made available to and
reviewed by the VA examiner. Any indicated studies should be performed.

Based on the review of the Veteran's pertinent history and the examination results,
the examiner should specifically attempt to reconcile the opinion with all other
pertinent evidence of record, including the Veteran's lay assertions of in-service
personal assault stressors, the service records showing behavioral changes and
psychiatric treatment subsequent to the claimed sexual assault. The examiner
should consider an April 2008 diagnosis of PTSD, rendered in accordance with the
DSM-IV, that determined the disorder was a result of an in-service sexual assault.
In addition, the examiner should expressly consider the September 2008 VA
examination report, in which the examiner opined the Veteran's symptoms represented
an antisocial personality disorder and the April 2013 VA examination report showing
that the examiner found no diagnosis of a psychiatric disorder to be warranted,
indicating that it would be mere speculation to opine upon in-service markers'
relationship to military sexual trauma. The examiner should also consider the
Veteran's post-service treatment records, showing treatment for a "nervous
condition" and stress that did not result in a DSM-IV diagnosis. Finally, the
examiner should consider the Veteran's statements, and any other competent evidence
of record, regarding conflicting evidence of the etiology of psychiatric problems
since service. Dalton v. Nicholson, 21 Vet. App. 23 (2007).

The examiner should specifically comment on whether it is at least as likely as not

(50 percent or greater probability) that the Veteran's diagnosis of PTSD is due to
a March 1969 in-service rape, or any other in-service personal assault. The
examiner should expressly determine whether there were any behavioral changes in
service indicative of the alleged in-service personal assault.

The examiner should specifically address whether there is a 50 percent or better

probability that the diagnoses of depressive disorder, mood disorder, and bipolar
illness, II, are etiologically related to the Veteran's active service, to include
an in-service personal assault and in-service psychiatric symptoms.

The rationale for all opinions expressed must also be provided. If the examiner is
unable to provide any required opinion, he or she should explain why. If the
examiner cannot provide an opinion without resorting to mere speculation, he or she
shall provide a complete explanation as to why this is so. If the inability to
provide a more definitive opinion is the result of a need for additional
information, the examiner should identify the additional information that is
needed.

3. The RO or the AMC should also undertake any other development it determines to
be warranted.

4. Then, the RO or the AMC should readjudicate the issue on appeal. If the benefit
sought on appeal is not granted to the Veteran's satisfaction, the Veteran and her
representative should be furnished an appropriate supplemental statement of the
case and be afforded the requisite opportunity to respond. Thereafter, the case
should be returned to the Board for appellate action.

By this remand, the Board intimates no opinion as to any final outcome warranted.

The Veteran need take no action until he is otherwise notified, but he may furnish
additional evidence and/or argument during the appropriate time frame. See
Kutscherousky v. West, 12 Vet. App. 369 (1999).

This REMAND must be afforded expeditious treatment. The law requires that all
claims that are remanded by the Board or the Court for additional development or
other appropriate action must be handled in an expeditious manner. See 38 U.S.C.A.
�� 5109B, 7112 (West Supp. 2013).

_________________________________________________
Shane A. Durkin
Veterans Law Judge, Board of Veterans' Appeals

Under 38 U.S.C.A. � 7252 (West 2002), only a decision of the Board of Veterans'
Appeals is appealable to the United States Court of Appeals for Veterans Claims.
This remand is in the nature of a preliminary order and does not constitute a
decision of the Board on the merits of your appeal. 38 C.F.R. � 20.1100(b) (2013).

United Nations Workshop

on Small Arms and Light Weapons in Beijing

Beijing, China, 19-21 April 2005

OPENING SESSION

Welcome remarks by Mitsuro DONOWAKI

Special Assistant to the Minister for Foreign Affairs of Japan

Ladies and gentlemen, Distinguished Participants, Excellencies,

On behalf of the Government of Japan, one of the three co-sponsoring

governments of this workshop, I wish to join with my previous speaker in extending
a
hearty welcome to all participants of this workshop. Also, I would especially like
to
express my appreciation to the Government of China for its initiative to host this
workshop. It was almost 30 years ago that I took part in the negotiation and
successful
conclusion of the Treaty of Peace and Friendship between our two countries as head
of
the political section of the Embassy of Japan here in Beijing. Now, I am pleased to
see
with my own eyes today?? modernized and developed city of Beijing.

Dear Colleagues,

Small Arms and Light Weapons, 630 million of which are estimated to be in
circulation in the world, are sometimes called ??e-facto weapons of mass
destruction??.
Although Asia may not be the most SALW-affected region compared with Africa or
Latin
America, Asia is nevertheless greatly affected by the problems of small arms. SALW
killed or wounded a huge number of people in the countries afflicted by recent
internal

1
conflicts in Asia, such as Cambodia, Timor-Leste and Afghanistan, and even today
innocent people, most of them women and children, fall victim to these weapons used
in
terrorist activities in our region. Tackling the problems of SALW, and also
combating