Saturday, December 24, 2011

Single Judge Application, Treatment Records More Probative Than Compensation Records, Harvey v. Brown, 6 Vet.App. 390, 394 (1994); Probative Value of Conflicting Medical Opinions

Excerpt from decision below: "In reaching its credibility determination, the Board found that the appellant's prior statements, which were made for treatment purposes, outweighed his more recent contentions regarding an in-service onset and continuous postservice symptoms, which were made for disability compensation purposes. R. at 11-13 (citing Harvey v. Brown, 6 Vet.App. 390, 394 (1994) (Board decision properly assigned more probative value to a private hospital record that included lay history that was made for treatment purposes than to subsequent statements made for compensation purposes)). Thus, the Board heavily relied on the appellant's reported history in a 1979 treatment note that his hallucinations began in 1978 (R. at 593-94) and the absence of any treatment records that reported a history of symptoms in service (R. at 11-12) to find his recent assertions of an in-service onset not credible. However, in finding the appellant not credible on this basis, the Board failed to account for a December 1984 treatment note in which the appellant reported that he "first" experienced psychiatric problems in 7 1971 while he was in the military. R. at 666-68. The Secretary attempts to downplay the significance of this evidence because the report does not state that the appellant experienced "hallucinations" in service. Secretary's Br. at 9-10. However, it is the Board's duty to analyze the credibility and probative value of the evidence and, as noted above, this duty is heightened in cases such as this where the appellant's service treatment records are unavailable. See Washington supra; see also R. at 6. Here, the Board found the appellant not credible, in part, because no postservice treatment reports included a history of "symptoms in service." R. at 11; see also R. at 13. This is clearly contrary to the December 1984 treatment note, which noted " psychiatric problems . . . in the military." R. at 666. On remand, the Board must account for this evidence and explain its probative worth when it assesses the appellant's credibility regarding the onset his psychiatric symptoms. See Washington, Allday, and Caluza, all supra. Additionally, because the Board relied on the appellant's report of a postservice onset in 1978 to find his assertion of treatment soon after service not credible, on remand the Board may need to examine whether its analysis regarding the onset of symptoms impacts its finding that the appellant was not credible when he reported that he sought treatment shortly after service and that the records are no longer available because of the physician's death. See R. at 13-14. 2. Probative Value of Conflicting Medical Opinions The appellant argues that it was improper for the Board to discount Dr. Smith's favorable medical opinion because it was based on an "inaccurate history" reported by the appellant, yet find the VA examiner's opinion probative, when both examiners reviewed the same history and the same record, but drew different conclusions. Appellant's Br. at 9-10. The Secretary argues, contrary to the appellant's assertions, that the Board acknowledged that the appellant provided an "incorrect history" to the VA examiner. Secretary's Br. at 11. In support of this assertion, the Secretary relies on the following analysis: The history given by the [v]eteran in 1979 dates the onset of symptoms to 1978, still over five years after service separation. . . . This more contemporaneous history given by the [v]eteran in 1979 for treatment purposes contradicts the [v]eteran's later contentions in October 2007 hearing testimony and at the June 2008 VA examination,which were made for VA disability compensation purposes, that he had had auditory hallucinations or other psychotic symptoms since service. R. at 12 (emphasis added); see Secretary's Br. at 12. 8 The appellant persuasively argues in his reply brief that the Secretary's position is untenable, that is, if the VA examiner also relied on an inaccurate history, as conceded by the Secretary, then the Board must explain why the inaccurate factual history impugns the bases for Dr. Smith's opinion but does not diminish the probative worth of the VA examiner's opinion.Reply Br. at 4-5. The Court agrees. It is true that "[a]n opinion based upon an inaccurate factual premise has no probative value." Reonal v. Brown, 4 Vet.App. 458, 461 (1993). The problem with the Board's analysis is that it failed to consistently apply this rule when it evaluated the conflicting medical opinions of record. That is, although the Board found the appellant's recent contentions regarding the onset and continuity of psychiatric symptoms not credible, and relied on this credibility determination to render Dr. Smith's opinion worthy of little probative value, the Board failed to similarly discuss how its credibility determination impacted its assessment of the VA examiner's opinion, which was based on the same factual premise. Additionally, the Board failed to explain why the VA examiner's opinion was "more probative" given the examiner's reliance on the appellant's statement that he had hallucinations prior to military service, which contradicts the Board's reliance on the appellant's reported history of a postservice onset in 1978. For this reason, the appellant argues that the Board erred when it relied on the VA examiner's "incomplete" opinion, which assumed a preservice onset. Appellant's Br. at 10-11. The Secretary argues that the appellant's report of a history to the VA examiner that was different than the history provided in other medical reports does not result in error by the examiner in taking the history and including it in the examination report. Secretary's Br. at 12. Although it may have been proper for the examiner to record the appellant's history of having had hallucinations prior to service, as noted above, the Board should have explained its reasons for finding the VA examiner's opinion "more probative" when it was clearly based on a history that was rejected by the Board.1 See R. at 105 ("While the day-to-day stress of military service may have exacerbated the 1. The Board's reasons for finding the opinion probative are unclear because, in stating that it was relying on the opinion, the Board acknowledged that the examiner considered whether the stress in the military aggravated the appellant's preexisting psychotic symptoms (R. at 14), yet the Board proceeded to find that the appellant was not credible because postservice treatment records indicated that his symptoms began in 1978. 9 veteran's pre-existing psychotic symptoms, there is no clear evidence that [] his military service has served as a long-term aggravating factor." (emphasis added)). The Court also agrees with the appellant that the Board failed to provide an adequate statement of reasons or bases for assigning less probative weight to Dr. Smith's opinion because he "failed to discuss" the appellant's service separation notation that his nervousness was treated and improved. Appellant's Br. at 8-9; Reply Br. at 2-3." ===================================== ---------------------------------------------------- Designated for electronic publication only UNITED STATES COURT OF APPEALS FOR VETERANS CLAIMS NO. 09-4329 RONNY D. HAGEWOOD, APPELLANT, V. ERIC K. SHINSEKI, SECRETARY OF VETERANS AFFAIRS, APPELLEE. Before SCHOELEN, Judge. MEMORANDUM DECISION Note: Pursuant to U.S. Vet. App. R. 30(a), this action may not be cited as precedent. SCHOELEN, Judge: The appellant, Ronny D. Hagewood, appeals through counsel a November 10, 2009, Board of Veterans' Appeals (Board) decision that denied disability compensation benefits for a psychiatric disorder, to include depression and schizophrenia. Record of Proceedings (R.) at 3-20. The Board also dismissed the appellant's claim for disability compensation benefits for a thoracolumbar spine disorder (R. at 8-9), which the appellant has not pursued on appeal. See Appellant's Brief (Br.) at 1. This appeal is timely, and the Court has jurisdiction over the case pursuant to 38 U.S.C. §§ 7252(a) and 7266(a). Both parties filed briefs, and the appellant filed a reply brief. Single-judge disposition is appropriate. See Frankel v. Derwinski, 1 Vet.App. 23, 25-26 (1990). Because the Board failed to provide an adequate statement of reasons or bases for it credibility determination and the relative probative weight it assigned to the conflicting medical opinions of record, the Court will vacate the November 10, 2009, decision and remand the mater for further proceedings consistent with this decision. I. FACTS The appellant served honorablyin the U.S. Air Force from October 1968 to September 1972. R. at 4, 737. "The only service treatment records available are the [ appelant's] enlistment and separation examinations, as well as the accompanying reports of medical history." R. at 6. No psychiatric disorders were noted on his entrance examination. R. at 721-22. At his June 1972 separation examination, the appellant reported that had "nervous trouble" ( R. at 713), which the examiner described as "[n]ervousness 1970 [as a result of] job tension, treated and improved, no comp[lications] or seq[uelae]." R. at 714; see also R. at 716. Additionally, the examiner's report of medical examination indicates that the appellant's psychiatric evaluation was "normal" and that he suffered from no psychiatric disorder, including a "personality deviation." R. at 715. In December 1984, a VA regional office (RO) denied the appellant's claim for compensation benefits for a "nervous condition" based on its finding that "[s] chizophrenia was not incurred in or aggravated by [his] military service." R. at 697-99. In October 2005, the appellant submitted another claim for compensation benefits for "schizophrenia" and " depression." R. at 486-96. In February 2006, the RO denied entitlement to compensation benefits for depression (R. at 473-75), and in April 2006 the RO found that the appellant failed to submit new and material evidence to reopen a claim for entitlement to benefits for schizophrenia (R. at 207-10 ). The appellant timely perfected an appeal to the Board (R. at 169-70, 173-93, 198-201), and in October 2007 testified at a Board hearing (R. at 128-46). The appellant testified that he was diagnosed with and treated for a " nervous disorder" in 1971 while he was on active duty in Korea, which he attributed to "[s] tress." R. at 140, 142-43. He described his in-service "nervousness" as "feel[ing] like people were plotting against me and doing things against me." R. at 143. He also stated that he was "hearing voices and things" and that the doctor informed him that he "was working too hard." Id. He stated that this was the first time he experienced something like this and that his symptoms had continued since service. R. at 144. He also indicated that he was first diagnosed with schizophrenia in "1978 – 77" and that he was currently receiving treatment at the VA hospital for "schizophrenia and depression." R. at 141. In April 2008, the Board reopened the appellant's claim, remanded the matter to provide the appellantaVApsychiatricexamination, anddirectedtheexaminertoidentifyallcurrentlydiagnosed psychiatric disorders and opine whether the appellant's schizophrenia and depression are at least as likely as not related to service. R. at 112-27. On June 18, 2008, the appellant underwent a compensation and pension examination in which the examiner diagnosed schizophrenia, paranoid 2 type and depression, not otherwise specified. R. at 96-106. The VA examiner's report indicates that he reviewed the appellant's claims file and conducted a clinical interview and a psychological examination of the appellant. Id. The examiner noted that the appellant's claims file contained multipletreatmentrecordsthatconfirmedhis longhistoryoftreatment forschizophreniaandvarying levels of functioning over time. R. at 97. The examiner also noted that the appellant was "often described as being a poor historian." Id. Although he stated that "the appellant's ability to provide a history has been variable," the examiner found him to be a "fair historian" at present. R. at 104-05. During the examination, the appellant reported that he experienced his " first hallucinations" at the age of 18, when he frequently worked overtime and began to "'hear things' when fatigued." R. at 98. The appellant also reported that he "'cracked up'" while he was stationed in Korea. Id. The appellant described having the shakes, difficulty sleeping, and hearing things. Id. He stated that a treating doctor informed him that he was "working too hard." Id. The appellant also reported that "in the wake of his discharge" he received mental health treatment from Dr. Darcy Brown in Nashville, Tennessee. R. at 100. Although the VA examiner was satisfied that the appellant's presentation, self-report, and clinical history showed that the appellant met the criteria for schizophrenia, paranoid type and depressive disorder, not otherwise specified, the examiner stated that the "course of [the appellant's] symptoms is less clear." R. at 105. In this regard, he noted that the appellant reported some symptoms of schizophrenia (auditory hallucinations) prior to military service and that he described them as worsening during service. Id. The examiner noted, however, that the appellant completed his tour of duty and that his "post-military clinical record indicate[d] a significant post-military decline in functioning." Id. The examined stated, in pertinent part: While the day-to-day stress of military service may have exacerbated the veteran's pre-existing psychotic symptoms, there is no clear evidence that [] his military service has served as a long-term aggravating factor. One could assert that his pre[- ]military hallucinatory experiences would have remitted or remained circumscribed were it not for the stress of military service. However, given the normal patterns of emergence for schizophrenia . . . , and given the worsening of his presentation after his service stress was removed, this is the weaker argument. R. at 105-06. With regard to the appellant's depressive disorder, the VA examiner noted the appellant's report of a limited set of depressive symptoms during service, which he described as "mild and 3 intermittent until his divorce in 1980." R. at 106. The examiner opined, "[ b]ased on the available evidence,"that the appellant's "[s]chizophrenia and [m]ood disorder [not otherwise specified] is less likely as not (less than 50/50) probability caused by or a result of his military service." Id. In an October 2008 decision, the Board denied the appellant's claim. R. at 62-67. The appellant appealed to the Court and on June 5, 2009, the Court granted the parties' joint motion for remand. R. at 53-60. On remand, the appellant submitted a September 2009 medical opinion byDr. Smith, a board-certified forensic psychiatrist, and written argument in support of favoring Dr. Smith's opinion over the unfavorable June 2008 VA examiner's opinion. R. at 31-36, 39-44. After reviewing the "entire Record Before The Agency," Dr. Smith opined that "it is more likelythan not that the veteran experienced his first psychotic break while in Kunsan on active duty." R. at 35. Dr. Smith noted that the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) states that "'[t]he model age of onset for[ schizophreniain] men is between 18 and 25 years'" and that the appellant "was 21 or 22 years of age in Kunsan." R. at 35. Dr. Smith also stated that the DSM-IV indicates: (1) "Schizophrenia onset maybe abrupt or insidious, with the slow and gradual development of a variety of signs and symptoms"; and (2) " 'Most studies of the course and outcome in Schizophrenia suggest that the course may be variable, with some individuals displaying exacerbations and remissions, whereas others remain chronically ill.'" R. at 35 (citing DSM-IV at 308-09). Dr. Smith stated that "[i]n reviewing the record, [he] did not find any inconsistencies or evidence of exaggeration, or an attempt to deceive examiners on the part of [the appellant]." Id. With regard to whether the appellant experienced any pre- service symptoms, Dr. Smith stated that "[i]f he had any symptoms prior to active duty, which is not clear, they were not to the degree that he needed to seek care." Id. With regard to his postservice symptoms, Dr. Smith stated that "[s]ubsequent to his release from active duty he has had a typical course of [s]chizophrenia and continues to be treated to this day. His symptoms have waxed and waned through the years. This is one of the typical courses for this disorder." Id. Dr. Smith also opined that the appellant's depression is "most likely secondary to his chronic [ s]chizophrenia, [because] comorbidity of the two is high." Id. In the November 10, 2009, decision here on appeal, the Board denied the appellant's claim for compensation benefits for a psychiatric disorder, to include schizophrenia and depression. R. at 4 3-20. After weighing the conflicting medical opinions of record and finding the appellant's lay evidence not credible, the Board assigned less probative weight to Dr. Smith's opinion. R. at 13-16. The Board determined that Dr. Smith's opinion was less probative because ( 1) Dr. Smith only discussed the favorable evidence of record and failed to discuss the appellant's separation examination, whichnotedthathisnervousness was treated and improved; (2) Dr. Smith's conclusion that the appellant's "testimony and contentions are consistent" was not supported by the record; and (3) the bases for Dr. Smith's nexus opinion are an inaccurate history reported by the appellant. R. at 15-16. The Board foundtheVA examiner's opinion against the claim more probative because "the VA opinion discussed all the evidence on file." R. at 15. The Board explained that its conclusion that a psychiatric disorder was not chronic in service or continuous since service was based on several factors, including the absence of chronic psychiatric disability contained in the[v] eteran'sJune1972serviceseparationmedicalhistoryandphysicalexamination reports, the [v]eteran's own reported histories, post-service medical evidence that do not show a chronic psychiatric disorder until several years after service discharge, and the nexus opinion against the claim. R. at 16-17. After weighing all the evidence, lay and medical, the Board concluded that the preponderance of the evidence was against the appellant's claim. Id. This appeal followed. On appeal, the appellantargues that the Board's decision was clearlyerroneous because there was no plausible basis for the Board to favor the June 2008 VA examiner's opinion over Dr. Smith's opinion. Appellant's Br. at 5-12. In the alternative, the appellant argues that the Board failed to provide an adequate statement of reasons or bases for the relative probative weight assigned to the conflicting medical opinions and for finding the appellant's statements concerning the onset, chronicity and continuity of his symptoms not credible. Id. at 12-16. The Secretary argues for affirmance of the Board's decision. Secretary's Br. at 7-17. The Secretary argues that the Board was permitted to favor one medical opinion over another, and that the Board provided an adequate statement of reasons or bases to support its determination that the VA examiner's opinion was entitled to greater weight than Dr. Smith's opinion. Id. at 7-14. The Secretaryfurther argues that the Board's credibilitydetermination was not clearlyerroneous and that the Board adequately explained its reasons for finding the appellant not credible. Id. 5 II. ANALYSIS A. Law Establishing service connection generally requires medical or, in certain circumstances, lay evidence of (1) a current disability; (2) incurrence or aggravation of a disease or injury in service; and (3) a nexus between the claimed in-service injury or disease and the current disability. See Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009); Hickson v. West, 12 Vet.App. 247, 252 (1999); Caluza v. Brown, 7 Vet.App. 498, 506 (1995), aff'd per curiam, 78 F.3d 604 (Fed. Cir. 1996) (table). A finding of service connection, or no service connection, is a finding of fact that the Court reviews under the "clearly erroneous" standard. See Swann v. Brown, 5 Vet. App. 229, 232 (1993). A finding of material fact is clearly erroneous when the Court, after reviewing the entire evidence, "is left with the definite and firm conviction that a mistake has been committed." United States v. U.S. Gypsum Co., 333 U.S. 364, 395 (1948); see also Gilbert v. Derwinski, 1 Vet.App. 49, 52 (1990). In rendering its decision, the Board must include a written statement of the reasons or bases for its findings and conclusions on all material issues of fact and law presented on the record; the statement must be adequate to enable an appellant to understand the precise basis for the Board's decision, and to facilitate informed review in this Court. See 38 U.S.C. § 7104(d)(1); Allday v. Brown, 7 Vet.App. 517, 527 (1995); Gilbert, 1 Vet.App. at 57. To comply with this requirement, the Board must analyze the credibility and probative value of the evidence, account for the evidence it finds persuasive or unpersuasive, and provide the reasons for its rejection of anymaterial evidence favorable to the claimant. Caluza, 7 Vet.App. at 506; see also Washington v. Nicholson, 19 Vet.App. 362, 367-68 (2005) (stating that it is the Board's duty, as factfinder, to determine the credibility and weight to be given to the evidence); Smith v. Derwinski, 1 Vet.App. 235, 237-38 (1991) (holding that "[d]etermination of credibilityof veteran's sworn testimonyis a function for the Board"). When a veteran's service medical records (SMRs) have been lost or destroyed, the Board is "under a heightened duty to consider and discuss the evidence of record and supply well-reasoned bases for its decision as a consequence of the missing SMRs." Washington, 19 Vet.App. at 371. "It is not error for the [Board] to favor the opinion of one competent medical expert over another when the Board gives an adequate statement of reasons or bases." Owens v. Brown, 7 Vet.App. 429, 433 6 (1995). Such assessments will be overturned by this Court only if they are "clearly erroneous." Id.; see also Gilbert, 1 Vet.App. at 52. "When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant." 38 U.S.C. § 5107(b); see also Mariano v. Principi, 17 Vet.App. 305, 313 (2003) (also referring to benefit of the doubt rule as "equipoise standard"); 38 C.F.R. § 3.102 (2011). B. The Board's Reasons and Bases In the instant case, the Court agrees with the appellant that the Board failed to provide an adequate explanation for finding his contentions regarding the onset of psychiatric symptoms not credible and for finding the VA examiner's opinion more probative than Dr. Smith's opinion. See Owens, supra. This failure renders the Board's statement of reasons of reasons or bases inadequate to facilitate review; therefore, remand, not reversal, is the appropriate remedy. See Tucker v. West, 11 Vet.App. 369, 374 (1998) (holding that remand is the appropriate remedy " where the Board has incorrectly applied the law, failed to provide an adequate statement of reasons or bases for its determinations, or where the record is otherwise inadequate"). 1. The Board's Credibility Determination The Court notes that a significant portion of the Board's analysis and assignment of relative weight to the evidence hinged on its determination that the appellant was not credible. In reaching its credibility determination, the Board found that the appellant's prior statements, which were made for treatment purposes, outweighed his more recent contentions regarding an in-service onset and continuous postservice symptoms, which were made for disability compensation purposes. R. at 11-13 (citing Harvey v. Brown, 6 Vet.App. 390, 394 (1994) (Board decision properly assigned more probative value to a private hospital record that included lay history that was made for treatment purposes than to subsequent statements made for compensation purposes)). Thus, the Board heavily relied on the appellant's reported history in a 1979 treatment note that his hallucinations began in 1978 (R. at 593-94) and the absence of any treatment records that reported a history of symptoms in service (R. at 11-12) to find his recent assertions of an in-service onset not credible. However, in finding the appellant not credible on this basis, the Board failed to account for a December 1984 treatment note in which the appellant reported that he "first" experienced psychiatric problems in 7 1971 while he was in the military. R. at 666-68. The Secretary attempts to downplay the significance of this evidence because the report does not state that the appellant experienced "hallucinations" in service. Secretary's Br. at 9-10. However, it is the Board's duty to analyze the credibility and probative value of the evidence and, as noted above, this duty is heightened in cases such as this where the appellant's service treatment records are unavailable. See Washington supra; see also R. at 6. Here, the Board found the appellant not credible, in part, because no postservice treatment reports included a history of "symptoms in service." R. at 11; see also R. at 13. This is clearly contrary to the December 1984 treatment note, which noted " psychiatric problems . . . in the military." R. at 666. On remand, the Board must account for this evidence and explain its probative worth when it assesses the appellant's credibility regarding the onset his psychiatric symptoms. See Washington, Allday, and Caluza, all supra. Additionally, because the Board relied on the appellant's report of a postservice onset in 1978 to find his assertion of treatment soon after service not credible, on remand the Board may need to examine whether its analysis regarding the onset of symptoms impacts its finding that the appellant was not credible when he reported that he sought treatment shortly after service and that the records are no longer available because of the physician's death. See R. at 13-14. 2. Probative Value of Conflicting Medical Opinions The appellant argues that it was improper for the Board to discount Dr. Smith's favorable medical opinion because it was based on an "inaccurate history" reported by the appellant, yet find the VA examiner's opinion probative, when both examiners reviewed the same history and the same record, but drew different conclusions. Appellant's Br. at 9-10. The Secretary argues, contrary to the appellant's assertions, that the Board acknowledged that the appellant provided an "incorrect history" to the VA examiner. Secretary's Br. at 11. In support of this assertion, the Secretary relies on the following analysis: The history given by the [v]eteran in 1979 dates the onset of symptoms to 1978, still over five years after service separation. . . . This more contemporaneous history given bythe [v]eteran in 1979 for treatment purposes contradicts the [v] eteran's later contentions in October 2007 hearing testimony and at the June 2008 VA examination,which were made for VA disabilitycompensation purposes, that he had had auditory hallucinations or other psychotic symptoms since service. R. at 12 (emphasis added); see Secretary's Br. at 12. 8 The appellant persuasivelyargues in his reply brief that the Secretary's position is untenable, that is, if the VA examiner also relied on an inaccurate history, as conceded by the Secretary, then the Board must explain why the inaccurate factual history impugns the bases for Dr. Smith's opinion but does not diminish the probative worth of the VA examiner's opinion.Reply Br. at 4-5. The Court agrees. It is true that "[a]n opinion based upon an inaccurate factual premise has no probative value." Reonal v. Brown, 4 Vet.App. 458, 461 (1993). The problem with the Board's analysis is that it failed to consistently apply this rule when it evaluated the conflicting medical opinions of record. That is, although the Board found the appellant's recent contentions regarding the onset and continuity of psychiatric symptoms not credible, and relied on this credibilitydetermination to render Dr. Smith's opinion worthy of little probative value, the Board failed to similarly discuss how its credibility determination impacted its assessment of the VA examiner's opinion, which was based on the same factual premise. Additionally, the Board failed to explain why the VA examiner's opinion was "more probative" given the examiner's reliance on the appellant's statement that he had hallucinations prior to military service, which contradicts the Board's reliance on the appellant's reported history of a postservice onset in 1978. For this reason, the appellant argues that the Board erred when it relied on the VA examiner's "incomplete" opinion, which assumed a preservice onset. Appellant's Br. at 10-11. The Secretary argues that the appellant's report of a history to the VA examiner that was different than the history provided in other medical reports does not result in error by the examiner in taking the history and including it in the examination report. Secretary's Br. at 12. Although it may have been proper for the examiner to record the appellant's history of having had hallucinations prior to service, as noted above, the Board should have explained its reasons for finding the VA examiner's opinion "more probative" when it was clearly based on a history that was rejected by the Board.1 See R. at 105 ("While the day-to-day stress of military service may have exacerbated the The Board's reasons for finding the opinion probative are unclear because, in stating that it was relying on the opinion, the Board acknowledged that the examiner considered whether the stress in the military aggravated the appellant's preexisting psychotic symptoms (R. at 14), yet the Board proceeded to find that the appellant was not credible because postservice treatment records indicated that his symptoms began in 1978. 9 1 veteran's pre-existing psychotic symptoms, there is no clear evidence that [] his military service has served as a long-term aggravating factor." (emphasis added)). The Court also agrees with the appellant that the Board failed to provide an adequate statement of reasons or bases for assigning less probative weight to Dr. Smith's opinion because he "failed to discuss" the appellant's service separation notation that his nervousness was treated and improved. Appellant's Br. at 8-9; ReplyBr. at 2-3. The Secretaryasserts that the Court should reject this argument because although Dr. Smith mentioned the separation examination "in passing," he failed to explain how the service examination influenced his opinion. Secretary's Br. at 10-11. However, in discounting Dr. Smith's opinion onthisbasis,the Board did not explain whyDr. Smith's discussion regarding the nature of schizophrenia and how the schizophrenia played out in the appellant's case did not adequately address why the absence of a psychiatric diagnosis at discharge did not alter his opinion that the appellant's schizophrenia began in service. In this regard, the Court notes that Dr. Smith relied on the DSM-IV, which describes the course of schizophrenia as being "'variable, with some individuals displaying exacerbations and remissions, whereas others remain chronically ill,'" and that the appellant's "symptoms have waxed and waned through the years[, which] is one of the typical courses for this disorder." R. at 35. As stated earlier, the Board is permitted to favorthe opinion of one competent medical expert over another provided that the Board supplies an adequate statement of reasons or bases for its conclusion. See Owens, supra. The Board did not do so here. Accordingly, the Court will remand the matter to the Board. See Tucker and Owens, both supra. C. The Appellant's Remaining Arguments BecausetheCourt hasdeterminedthatremandis the appropriate remedyhere, the Court need not address each of the appellant's remaining arguments that would not result in a broader remedy. See Mahl v. Principi, 15 Vet.App. 37, 38 (2001) (per curiam order) ( holding that "if the proper remedy is a remand, there is no need to analyze and discuss all the other claimed errors that would result in a remedy no broader than a remand"); see also Best v. Principi, 15 Vet.App. 18, 19 (2001) (per curiam order) (holding that the Court generallydecides cases on the narrowest possible grounds and therefore is not required to rule upon other allegations of error in effecting a remand). In pursuing his case on remand, the appellant is free to submit additional evidence and argument on the 10 remanded matters, and the Board is required to consider any such relevant evidence and argument. See Kay v. Principi, 16 Vet.App. 529, 534 (2002) (stating that, on remand, the Board must consider additionalevidenceandargumentinassessingentitlementto benefit sought); Kutscherousky v.West, 12 Vet.App. 369, 372-73 (1999) (per curiam order). The Court has held that "[a] remand is meant to entail a critical examination of the justification for the decision." Fletcher v. Derwinski, 1 Vet.App. 394, 397 (1991). The Board must proceed expeditiously, in accordance with 38 U.S.C. § 7112 (requiring Secretary to provide for "expeditious treatment"of claims remanded by the Court). III. CONCLUSION After consideration of the appellant's and the Secretary's briefs, and a review of the record, the Board's November 10, 2009, decision is VACATED and the matter REMANDED for further proceedings consistent with this decision. DATED: December 12, 2011 Copies to: Robin M. Webb, Esq. VA General Counsel (027) 11