Citation Nr: 0310993 Decision Date: 06/02/03 Archive Date: 06/10/03 DOCKET NO. 96-22 876 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Honolulu, Hawaii THE ISSUE Entitlement to service connection for post-traumatic stress disorder (PTSD). REPRESENTATION Appellant represented by: Mark R. Lippman, esq. WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Eric S. Leboff, Associate Counsel INTRODUCTION The veteran had active military service from March 1968 to January 1970. He had no combat awards or decorations, his military specialty was "Auto Rpr Prts Spec" (Automotive Repair Parts Specialist), and he had 9 months and 11 days of foreign service (DD 214). This matter has been before the Board on three prior occasions. In December 1997, a remand was ordered to accomplish further development. In January 1999, the matter was denied by the Board. The veteran appealed that decision to the United States Court of Appeals for Veterans Claims ("Court"). In a November 2000 Order, the Court vacated the February January 1999 Board decision, and remanded the matter back to the Board for development consistent with the Appellee's Motion for Remand and for a Stay of Proceedings. The matter again came before the Board in August 2001, at which time another remand was ordered. FINDINGS OF FACT 1. All relevant evidence necessary for an equitable disposition of this appeal has been obtained by the RO. 2. The veteran was stationed with the Headquarters and Headquarters Company (HHC), 17th Combat Aviation Group (CAG) at Nha Trang in Vietnam for a little over 9 months; his principal duty was automotive repair parts specialist. 3. The veteran has no awards or decorations indicating personal participation in combat with the enemy. 4. The veteran did not engage in combat with the enemy. 5. The veteran's accounts of exposure to a rocket attack shortly after arriving with his unit in Vietnam, exposure to very frequent rocket attacks, exposure to fire from 16-inch guns and claims of duties as an automatic weapons specialist in Vietnam are each shown by service department records to be false. 6. The claimant demonstrably advanced false statements for the purpose of pursuing compensation benefits; he has no credibility as to his evidentiary assertions concerning events in service and alleged subjective symptoms claimed as manifestations of PTSD advanced in support of a claim for monetary benefits. 7. The evidentiary assertions submitted on behalf of the claimant by H.P. of exposure to a rocket attack shortly after arriving with his unit in Vietnam, exposure to very frequent rocket attacks are shown to be false by service department records; no credibility can be assigned to the evidentiary assertions of H.P. CONCLUSION OF LAW PTSD was not incurred in or aggravated by active service. 38 U.S.C.A. §§ 101, 1110, 1112, 1113, 1154(b), 5103A, 5107(b) (West 1991 & Supp. 2001); 66 Fed. Reg. 45,630-32 (Aug. 29, 2001) (to be codified as amended at 38 C.F.R. §§ 3.102, 3.159); 38 C.F.R. §§ 3.6, 3.102, 3.303 (2001). REASONS AND BASES FOR FINDINGS AND CONCLUSION The Board finds that this matter turns fundamentally upon the appellant's credibility. The claimant had full notice that the Board had found him without credibility in its prior determination and that this was the critical element of the claim. He was again advised that this was a critical question in the Board's remand of August 2001. Because the Board has determined that the claimant has made multiple false material statements in pursuit of his claim for compensation benefits for PTSD, the Board concludes that he is pursuing this claim in bad faith. Accordingly, the Board finds that his claim for service connection must be denied and that there is no remaining duty of VA to notify the claimant or to assist the claimant to develop the claim. Relevant law and regulations Service connection- in general According to the law, service connection is warranted if it is shown that a veteran has a disability resulting from an injury incurred or a disease contracted in the line of duty, or for aggravation of a preexisting injury or disease in active military service. 38 U.S.C.A. § 1110 (West 1991 & Supp. 2001); 38 C.F.R. § 3.303 (2001). Service connection may also be granted for any disease diagnosed after discharge when all of the evidence establishes that the disease was incurred in service. See 38 C.F.R. § 3.303(d). Additionally, service connection shall be established for a disability which is proximately due to or the result of a service-connected disability. 38 C.F.R. § 3.310(a). Service connection- PTSD Generally, the elements required to establish a claim of service connection for PTSD have changed during the course of the appeal. See Karnas v. Derwinski, 1 Vet. App. 308, 313 (1991). Under the current version of the law, service connection for PTSD requires medical evidence diagnosing the condition in accordance with 38 C.F.R. § 4.125(a), a link, established by medical evidence, between current symptoms and an in-service stressor; and credible supporting evidence that the claimed in-service stressor occurred. 38 C.F.R. § 3.304(f). The provisions of 38 C.F.R. § 4.125(a) require that a diagnosis of a mental disorder conform to the Diagnostic and Statistical Manual, Fourth Edition (DSM-IV). Prior to March 1997, 38 C.F.R. § 3.304(f) provided that service connection for PTSD required medical evidence establishing a clear diagnosis of the condition, credible supporting evidence that the claimed in service stressor actually occurred, and a link, established by medical evidence, between current symptomatology and the claimed in- service stressor. [[Both versions of this regulation must be considered in the present case since the change in regulation became effective during the course of the veteran's appeal.]] Further relating to claims of service connection for PTSD, in Zarycki v. Brown, 6 Vet. App. 91 (1993), the United States Court of Appeals for Veterans Claims (Court) set forth the analytical framework and line of reasoning for determining whether a veteran was exposed to a recognizable stressor during service, which, as discussed above, is an essential element in solidifying a claim for service connection for PTSD. In Zarycki, it was noted that, under 38 U.S.C.A. 1154(b), 38 C.F.R. 3.304(d) and (f), and the applicable provisions contained in VA Manual 21-1, the evidence necessary to establish the incurrence of a recognizable stressor during service to support a claim of service connection for PTSD will vary depending on whether the veteran "engaged in combat with the enemy." See Hayes v. Brown, 5 Vet. App. 60 (1993). The determination as to whether the veteran "engaged in combat with the enemy" is made, in part, by considering military citations that expressly denote as much. Doran v. Brown, 6 Vet. App. 283, 289 (1994). However, the Court has held that the Board may not rely strictly on combat citations or the veteran's military occupational specialty to determine if he engaged in combat; rather, other supportive evidence of combat experience may also be accepted. See Dizoglio v. Brown, 9 Vet. App. 163, 166 (1996); West v. Brown, 7 Vet. App. 70, 76 (1994). If combat is affirmatively indicated, then the veteran's lay testimony regarding claimed combat-related stressors must be accepted as conclusive as to their actual occurrence and no further development or corroborative evidence will be required, provided that the veteran's testimony is found to be "satisfactory," i.e., credible, and "consistent with the circumstances, conditions, or hardships of such service." Zarycki, 6 Vet. App. at 98. If there is no combat experience, or if there is a determination that the veteran engaged in combat but the claimed stressor is not related to such combat, there must be independent evidence to corroborate the veteran's statement as to the occurrence of the claimed stressor. Doran, 6 Vet. App. at 288-89 (1994). The veteran's testimony, by itself, cannot, as a matter of law, establish the occurrence of a non-combat stressor. Dizoglio, 9 Vet. App. at 166 (1996). Further, an opinion by a mental health professional based on a post-service examination of the veteran cannot be used to establish the occurrence of a stressor. Moreau v. Brown, 9 Vet. App. at 395-96 (1996); Cohen v. Brown, 10 Vet. App. 128 (1997). PTSD- diagnostic criteria The Diagnostic and Statistical Manual for Mental Disorders, 3d Edition, [hereafter DSM-III] added PTSD to the nomenclature in 1980. The diagnostic criteria for PTSD began with category "A" concerning a "stressor" event. The diagnostic criteria then mandated that the "stressor" event must result in a number of certain other characteristic manifestations set forth in categories "B" (Reexperiencing of the trauma), "C" (Numbing of responsiveness or reduced involvement with the external world), and "D" (at least two of a list of six types of symptoms such as hyperalertness, sleep disturbance, etc.). The Diagnostic and Statistical Manual for Mental Disorders, 3d Edition, Revised, [hereafter DSM-IIIR] revised the criteria in 1987. Those DSM-IIIR criteria are set out in Pitman, R.K., & Orr, S.P. "Psychophysiologic testing for post-traumatic stress disorder: forensic psychiatric application," Bulletin of American Academy of Psychiatry and the Law, Vol. 21, No. 1, (1993) 38 [hereafter Pitman & Orr]. They begin with category "A" concerning a "stressor" event. The diagnostic criteria then mandate that the "stressor" event must result in a number of certain other characteristic manifestations set forth in categories "B" (Reexperiencing criteria), "C" (Avoidance criteria), "D" (Arousal Criteria) and "E" (Duration criteria). Under both DSM-III and DSM-IIIR, only a specified number of characteristic manifestations need be present to satisfy categories "B", "C" and "D". Unless each of the criteria is satisfied with the requisite number of characteristic manifestations, however, the diagnosis of PTSD is not in accordance with the DSM provisions. The diagnostic criteria for PTSD were revised again in Diagnostic and Statistical Manual for Mental Disorders, 4th Edition (1994) [hereafter DSM-IV]. In Cohen, supra. the Court addressed the significant of this revision with regard to category "A," the "stressor" event. The Court took judicial notice that the "major effect" of the revision was to change from an objective standard ("would evoke . . . in almost anyone") in assessing whether a stressor is sufficient to cause PTSD to a subjective standard (a "more susceptive individual may have PTSD based on exposure to a stressor that would not necessarily have the same effect on 'almost anyone'"). Cohen, 10 Vet. App. at 140-142, 153. While Cohen addressed the "subjective" nature of the "stressor" event in category "A" as revised by DSM-IV, it did not address the "subjective" nature of the "B" and "C" criteria, as well as the reliance of clinicians upon subjective reporting to establish the presence of the "D" criteria. (The Board notes that DSM-IV also added "F" criteria that the symptoms produce clinically significant distress or impairment in social, occupational or other important areas of functioning. This criterion is not a determinative factor in this matter because its presence or absence could not change the outcome if Criteria "B", "C" and/or "D" were not met.) Cohen held that the sufficiency of the event alleged as "stressor" to cause PTSD rested on an individual's particular susceptibility and was a medical determination. The Board finds nothing in Cohen, however, that holds or implies that the fact finder is precluded from making credibility determinations in PTSD cases, particularly as to subjective symptoms in the "B" and "C" criteria or the use of subjective reporting to establish the "D" criteria. Nor can the Board find any other case that holds that PTSD cases are exempted from the Board's well established responsibility for making credibility determinations detailed below. In this regard, the Board notes specifically that neither in Suozzi v. Brown, 10 Vet. App. 307, 310 (1997) nor Pentecost v. Principi, 16 Vet. App 124 (2002) did the Court address the situation where the claimant had advanced false statements in support of a claim for compensation benefits for PTSD. On the other hand, the Court has held clearly that "[j]ust because a physician or other health professional accepted the appellant's description of his active service experiences as credible and diagnosed the appellant as suffering from PTSD does not mean the [Board is] required to grant service connection for post-traumatic stress disorder." Wilson v. Derwinski, 2 Vet. App. 614, 618 (1992). The Board is not required to accept an appellant's uncorroborated account of his active service experiences. See Wood v. Derwinski, 1 Vet. App. 190, 192 (1991). The medical texts added to the record by the Board emphasize the subjective nature of the symptoms of PTSD, quite apart from the question of whether the event claimed as the stressor occurred, and the critical significance of the credibility of the individual claiming to experience the disorder. As Spar, L.F., & Pankratz, L.D. stated: "Simulation [of PTSD] is easy, since the symptoms described by DSM-III mostly reflect private phenomenology and since by definition the symptoms are caused by events now past." ("Factitious posttraumatic stress disorder," American Journal of Psychiatry, 140, p. 1016-1019 (August 1983) at p. 1018). As Pitman & Orr commented, even under DSM-IIIR, the notion that the there was an objective standard for assessing whether an event was of an adequate nature to constitute a "stressor" for purposes of causing PTSD was "illusory" for a variety of reasons. These authors challenged whether there was a "range of usual human experience" from a cross cultural perspective. These authors further stated that: One the one hand, because of the tendency of PTSD patients to avoid recalling the trauma, superficial questioning may miss the diagnosis. On the other hand, recitation of structured interview items incorporating PTSD diagnostic criteria may be treated by motivated respondent as a series of leading questions evoking answers that too readily lead to a PTSD diagnosis. Since the diagnostic criteria for PTSD are available through publications and word-of-mouth, there is little to stop a motivated claimant from leaning what symptoms must be reported to qualify for the diagnosis. Id. at p. 40. Because DSM-IV did not move the "B," "C" or "D" criteria to an objective basis, manifestly the same analysis holds true with respect to these criteria. This conclusion is supported by the fact that the same basic principles are reiterated in Pitman, R.K., Sparr, L.F, Sounders, L.S., & McFarlane, A.C. "Legal issues in post-traumatic stress disorder," van der Kola, BA, McFarlane, AC, and Weisaeth, L. eds., Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body, and Society, p. 378 - 396 (Guildford Press, 1996) [hereafter Pitman, Sparr, Sounders & MacFarlane], published two years after DSM-IV was adapted, sometimes employing nearly identical language. (See particularly pp. 388-94.) As Pitman, Sparr, Sounders & MacFarlane stated: Just as the evaluator in the forensic (as opposed to therapeutic) setting is unwilling to accept the claimant's word that he or she has a certain symptom without being shown how and why, the evaluator should not expect the jury to accept the evaluator's word that the claimant has or does not have PTSD without being shown how or why. Id. at 389. As to the probative value of psychometric testing to establish the presence of absence of PTSD, Pitman, Sparr, Sounders & MacFarlane point out the lack of validity scales for many psychometric test instruments and the inability of even the psychometric testing with the best validity scales to detect fabricated PTSD. Finally, Perconte, S.T., & Goreczny, A.J, "Failure to detect fabricated posttraumatic stress disorder with the use of the MMPI in a clinical population," American Journal of Psychiatry, 147:8, p. 1057-1060 (August 1990) points out the failure of health care providers to detect fabricated posttraumatic stress disorder. In this regard, the Board provided the claimant with specific notice that it would rely on medical texts to establish the subjective nature of the diagnostic criteria, the significance of the veracity of the individual claiming to experience the disorder and the inability of psychometric testing to distinguish false versus valid claims of PTSD. Credibility It is the Board's principal responsibility to assess the credibility, and therefore the probative value of proffered evidence of record in its whole. Owens v. Brown, 7 Vet. App. 429, 433 (1995); see Elkins v. Gober, No. 00-7023 (Fed. Cir. Oct. 13, 2000). As the United States Court of Appeals for the Federal Circuit has commented, there is a considerable body of law imposing a duty on the Board to analyze the credibility and probative value of evidence sua sponte, when making its factual findings. Further, the Board has the "authority to discount the weight and probity of evidence in the light of its own inherent characteristics and its relationship to other items of evidence." Madden v. Gober, 125 F.3d 1477, 1481 (Fed. Cir. 1997). Credible testimony is that which is plausible or capable of being believed. See Indiana Metal Prods. v. NLRB, 442 F.2d 46, 52 (7th Cir. 1971) (citing Lester v. State, 212 Tenn. 338, 370 S.W.2d 405, 408 (1963)); see also Weliska's Case, 125 Me. 147, 131 A. 860, 862 (Me. 1926); Erdmann v. Erdmann, 127 Mont. 252, 261 P.2d 367, 369 (Mont. 1953) ("A credible witness is one whose statements are within reason and believable . . . ."). The term "credibility" is generally used to refer to the assessment of oral testimony. See, e.g., Anderson v. Bessemer City, 470 U.S. 564, 575, 84 L. Ed. 2d 518, 105 S. Ct. 1504 (1985) ("only the trial judge can be aware of the variations in demeanor and tone of voice that bear so heavily on the listener's understanding of and belief in what is said"); NLRB v. Walton Manufacturing Co., 369 U.S. 404, 408, 7 L. Ed. 2d 829, 82 S. Ct. 853 (1962) (trier of fact "sees the witnesses and hears them testify, while the [NLRB] and the reviewing court look only at cold records"); Jackson v. Veterans Admin., 768 F.2d 1325, 1331 (Fed. Cir. 1985) (trier of fact has opportunity to observe "demeanor" of witness in determining credibility). The credibility of a witness can be impeached by a showing of interest, bias, inconsistent statements, or, to a certain extent, bad character. See State v. Asbury, 187 W. Va. 87, 415 S.E.2d 891, 895 (W. Va. 1992); see also Burns v. HHS, 3 F.3d 415, 417 (Fed. Cir. 1993) (testimony was impeached by witness' "inconsistent affidavits" and "expressed recognition of the difficulties of remembering specific dates of events that happened . . . long ago"); Mings v. Department of Justice, 813 F.2d 384, 389 (Fed. Cir. 1987) (impeachment by testimony which was inconsistent with prior written statements). Although credibility is often defined as determined by the demeanor of a witness, a document may also be credible evidence. See, e.g., Fasolino Foods v. Banca Nazionale Del Lavoro, 761 F. Supp. 1010, 1014 (S.D.N.Y. 1991); In Re National Student Marketing Litigation, 598 F. Supp. 575, 579 (D.D.C. 1984). In determining whether documents submitted by a veteran are credible, the Court in Caluza v. Brown, 7 Vet. App. 498, 511 (1995), summarized that the Board may consider internal consistency, facial plausibility, and consistency with other evidence submitted on behalf of the claimant. In Burns v. HHS., supra, a special master for the secretary of HHS in a claim for compensation based upon alleges damages stemming from a vaccination concluded: Because of petitioner's inconsistent affidavits and her expressed recognition of the difficulties of remembering specific dates of events that happened so long ago, [I] give greater credence and weight to the contemporaneous medical records filed in this matter. Burns v. HHS., 1992 U.S. Cl. Ct. LEXIS 528. The special master was found to have followed the Federal Circuit's instruction in Cucuras v. Department of Health & Human Resources, 993 F.2d 1525, 1528 (Fed. Cir. 1993): Moreover the Supreme Court counsels that oral testimony in conflict with contemporaneous documentary evidence deserves little weight. United States v. Unites States Gypsum Co., 333 U.S. 364, 396, 92 L. Ed. 746, 68 S. Ct. 525 (1947). This court's predecessor adopted the same principle. Montgomery Coca Cola Bottling Co. v. United States, 222 Ct. Cl. 356, 615 F.2d 1318, 1328 (Ct. Cl. 1980). Medical records, in general, warrant consideration as trustworthy evidence. The records contain information supplied to or by health professionals to facilitate diagnosis and treatment of medical conditions. With proper treatment hanging in the balance, accuracy has an extra premium. These records are also generally contemporaneous to the medical events. As the trier of fact, the Board further finds that the following jury instructions provide instructive guidelines in assessment of credibility. In Clark v. United States, 391 F.2d 57, 60 (8th Cir.), cert. denied, 393 U.S. 873 (1968), the court held that the following instruction given by the trial court correctly set out the factors to be considered by the jury in determining the credibility of the witnesses: You are instructed that you are the sole judges of the credibility of the witnesses and of the weight and value to be given to their testimony. In determining such credibility and weight you will take into consideration the character of the witness, his or her demeanor on the stand, his or her interest, if any, in the result of the trial, his or her relation to or feeling toward the parties to the trial, the probability or improbability of his or her statements as well as all the other facts and circumstances given in evidence. 391 F.2d at 60. In United States v. Merrival, 600 F.2d 717, 719 (8th Cir. 1979), the court held that the following general credibility instruction provided protection for the accused in a criminal matter: You, as jurors, are the sole judges of the truthfulness of the witnesses and the weight their testimony deserves. You should carefully study all the testimony given, the circumstances under which each witness has testified, and every matter in evidence which tends to show whether a witness is worthy of belief. Consider each witness' ability to observe the matters as to which he or she has testified and whether each witness is either supported or contradicted by other evidence in the case. 600 F.2d at 720 n.2. The general credibility instruction given in United States v. Phillips, 522 F.2d 388, 391 (8th Cir. 1975) is more expansive: The jurors are the sole judges of the weight and credibility of the testimony and of the value to be given to each and any witness who has testified in the case. In reaching a conclusion as to what weight and value you ought to give to the testimony of any witness who has testified in the case, you are warranted in taking into consideration the interest of the witness in the result of the trial; take into consideration his or her relation to any party in interest; his or her demeanor upon the witness stand; his or her manner of testifying; his or her tendency to speak truthfully or falsely, as you may believe, the probability or improbability of the testimony given; his or her situation to see and observe; and his or her apparent capacity and willingness to truthfully and accurately tell you what he or she saw and observed; and if you believe any witness testified falsely as to any material issue in this case, then you must reject that which you believe to be false, and you may reject the whole or any part of the testimony of such witness. (Emphasis added.) The instruction in the text is basically a paraphrase of Ninth Circuit Criminal Instruction 3.07 and 3 Edward J. Devitt, et al., FEDERAL JURY PRACTICE AND INSTRUCTIONS: Civil § 73.01 (4th ed. 1987), as approved in United States v. Hastings, 577 F.2d 38, 42 (8th Cir. 1978). The Board finds these guidelines persuasive. In finding these persuasive, the Board is not concluding or implying that a claim for benefits under title 38 United States Code is in any manner similar to an adversarial hearing, much less a criminal prosecution. Rather, the Board finds them useful because they are provided in the stringent context of defending the rights of an accused party where liberty or even life, not merely monetary benefits, may be at stake. In other words, they are taken as a high hurdle that must be overcome to find the claimant's credibility in question. Ruling in the Alternative In Holbrook v. Brown, 8 Vet. App. 91 (1995) (aff'd, 86 F.3d 1178 (Fed. Cir. 1996), the Court expressly rejected a challenge to the Board's "fundamental authority" to rule in the alternative. Duty to notify/assist There has been a significant change in the law during the pendency of this appeal. The Veterans Claims Assistance Act of 2000 (VCAA), Pub. L. No. 106-475, 114 Stat. 2096 (2000), now codified at 38 U.S.C.A. §§ 5100, 5102, 5103, 5103A, 5107 (West Supp. 2001). The legislation has eliminated the well- grounded claim requirement, has expanded the duty of VA to notify the appellant and the representative, and has enhanced its duty to assist an appellant in developing the information and evidence necessary to substantiate a claim. See generally VCAA. VA issued regulations to implement the VCAA in August 2001. 66 Fed. Reg. 45,620 (Aug. 29, 2001) (to be codified as amended at 38 C.F.R. §§ 3.102, 3.156(a), 3.159 and 3.326(a)). The amendments were effective November 9, 2000, except for the amendment to 38 C.F.R. § 3.156(a) that is effective August 29, 2001. Except for the amendment to 38 C.F.R. § 3.156(a), the second sentence of 38 C.F.R. § 3.159(c), and 38 C.F.R. § 3.159(c)(4)(iii), VA stated that "the provisions of this rule merely implement the VCAA and do not provide any rights other than those provided in the VCAA." 66 Fed. Reg. 45,629. Accordingly, in general where the record demonstrates that the statutory mandates have been satisfied, the regulatory provisions likewise are satisfied. The United States Court of Appeals for Veterans Claim (Court) held in Holliday v. Principi, 14 Vet. App. 280 (2001) that the VCAA was potentially applicable to all claims pending on the date of enactment, citing Karnas v. Derwinski, 1 Vet. App. 308 (1991). Subsequently, however, the United States Court of Appeals for the Federal Circuit held that Section 3A of the VCAA (covering the duty to notify and duty to assist provisions of the VCAA) was not retroactively applicable to decisions of the Board entered before the effective date of the VCAA (Nov. 9, 2000). Bernklau v. Principi, No. 00-7122 (Fed. Cir. May 20, 2002); See also Dyment v. Principi, No. 00-7075 (Fed. Cir. April 24, 2002). In reaching this determination, the Federal Circuit appears to reason that the VCAA may not apply to claims or appeals pending on the date of enactment of the VCAA. However, the Federal Circuit stated that it was not reaching that question. The Board notes that VAOPGCPREC 11-2000 (Nov. 27, 2000) appears to hold that the VCAA is retroactively applicable to claims pending on the date of enactment. Further, the regulations issued to implement the VCAA are to be applicable to "any claim for benefits received by VA on or after November 9, 2000, the VCAA's enactment date, as well as to any claim filed before that date but not decided by VA as of that date." 66 Fed. Reg. 45,629 (Aug. 29, 2001). Precedent opinions of the chief legal officer of the Department and regulations of the Department are binding on the Board. 38 U.S.C.A. § 7104(c) (West 1991). For purposes of this determination, the Board will assume that the VCAA is applicable to claims or appeals pending on the date of enactment of the VCAA. In the present case, the RO included the VCAA provisions in the July 2002 supplemental statement of the case. Thus, the veteran has been put on notice as to the new requirements regarding the duty to assist. Moreover, the Board has reviewed the file, and finds that the requirements under the VCAA have been met in view of the facts of this case. In that regard, the Board concludes that the veteran was provided adequate notice as to the basic evidence needed to substantiate his claim, which included copies of the rating actions, a statement of the case issued in April 1996, and supplemental statements of the case issued in July 1997, March 1998 and July 2002. He was provided a further detailed analysis of why the evidence or record did not substantiate his claim in the Board's January 1999 decision. The Board further finds that the RO made satisfactory efforts to ensure that all relevant evidence had been associated with the claims file. For example, per the Board's December 1997 remand, the RO attempted to obtain treatment records dated from 1986 to 1989 from the VA Medical Center in Santa Barbara, as identified by the veteran in 1993 correspondence. A response dated February 1998 indicated that no such records could be found. Furthermore, per the Board's August 2001 remand instructions, the RO requested the veteran's morning reports in February 2002 and May 2002. A response on the May 2002 request form indicated that morning reports were mailed. It further indicated that some reports from September 1969 to December 1969 was negative. Further regarding the VCAA, the claims file contains VA outpatient and hospitalization reports from May 1992 to April 2002. Also of record are treatment reports dated July 1992 to July 1993 from private physician D.D.L., as well as June 2001 reports from M.M.M., Ph.D. Moreover, Operational Reports from the Army are associated with the claims file. Furthermore, a letter from H.P., a fellow serviceman is contained in the claims file. Also of record are various scientific and psychiatric articles, of which the veteran was afforded notice in the July 2002 supplemental statement of the case. Finally, a transcript of the veteran's June 1996 personal hearing before the RO is associated with the claims file. With respect as to whether the claimant understood the division of responsibilities between VA and the claimant in providing evidence to substantiate the claim, the Board finds that the record leaves no doubt that the claimant and his attorney were fully aware of their critical responsibilities with regard to the determinative question of the claimant's credibility. Not only the communications of the RO to the claimant, but also the Board's decision of January 1999 set forth the law, the state of the record and the basis upon which the determination was made. From these communications, the record demonstrates beyond reasonable dispute that the claimant understood the obligations that rested upon him to provide information and evidence that would substantiate the existence of the events alleged as "stressors" in this matter as well as the Board's determination that he had submitted false allegations in pursuit of his claim for benefits. As the Board expressly advised him in its January 1999 determination: Finally, should the claimant chose to exercise his right to apply to reopen a claim for compensation benefits based upon claims for service connection for a psychiatric disorder of service origins including PTSD, he is advised that the basis for this denial is his complete lack of credibility as to evidentiary assertions with respect to such a claim. Thus, his first objective in attempting to reopen would be to restore his credibility. It is difficult for the Board to conceive of any role for medical evidence in such an effort as credibility is an adjudicative matter. Moreover, it would not be sufficient for the claimant to establish the existence of some event in service that a medical provider would deem to meet the requirements of a "stressor" for this would still leave the appellant facing fundamental problems with regard to the lack of credibility of his current evidentiary assertions as to his subjective reaction to such an event and his current subjective symptoms. Thus, the task of restoring squandered credibility is far easier to describe than to accomplish, but it is for any future adjudicator or Board Member to determine if he has met this challenge. While the Court vacated the Board's January 1999 decision in accordance with the Joint Motion, that motion and the order of the Court did not address the Board's finding that the claimant lacked credibility as to evidentiary assertions with regard to his claim for service connection for PTSD. In the August 2001 remand, the Board again pointed out that the basis for the prior determination was that the claimant was not credible in his evidentiary assertions advanced in support of his claim for service connection for PTSD. The lack of credibility extended not only to his account of events in service, but also as to the subjective symptoms currently reported to support the diagnosis. He was further advised of medical texts that point out in substance that the diagnosis of PTSD is dependent upon the credibility of the individual claiming the disorder. He was advised that his first task to prevail in the claim was to restore his credibility. In September 2001, in accordance with the Board's remand, the RO provided the claimant with a detailed summary of his alleged "stressor" events. The claimant was further requested to review the statement and add as much detailed information as possible in order to permit VA to conduct an effective search for substantiating information. The RO advised the claimant of what he was required to do to substantiate his claim and what VA would do. The claimant was also provided copies of the medical texts added to the record by the Board and provided an opportunity to submit evidence or agreement concerning these texts. In a communication dated later in September 2001, the claimant through his attorney indicated he was not submitting any additional evidence. As far as the Board can determine, at the time this decision is entered no competent Court has yet addressed the question of what obligations remain to be discharged by VA once it is determined that the claimant is not credible in his evidentiary assertions and, in fact, has made false statements in pursuit of a claim for service connection, particularly PTSD. The Board concludes that under both the old and the new law there are limits on the duty to assist and those limits clearly are relevant where false claims evidencing bad faith are made. As stated by the Court long before the VCAA, the duty to assist is not unlimited in scope. The VA's 'duty' is just what it states, a duty to assist, not a duty to prove a claim with the claimant only in a passive role. See Wood v. Derwinski, 1 Vet. App. 190, 193 (1993). Nor is the VA required to search for evidence which, even if obtained, would make no difference in the result. See Colvin [v. Derwinski], 1 Vet. App. at 174. In short, the 'duty to assist' is not a license for a 'fishing expedition' to determine if there might be some unspecified information which could possibly support a claim. In connection with the search for documents, this duty is limited to specifically identified documents that by their description would be facially relevant and material to the claim. (Emphasis in original.) The Court has further held that if a claimant wishes assistance, he cannot passively wait for it in circumstances where he should have information that is essential in obtaining the putative information. Wamhoff v. Brown, 8 Vet. App. 517 (1996); Wood v. Brown, 1 Vet. App. 190 reconsidered 1 Vet. App. 406 (1991). The VCAA itself does not provide a blank check for the limitless expenditure of scarce VA adjudicatory resources. Rather the VCAA provides expressly that VA is only obligated to embark upon "reasonable efforts to assist the claimant in obtaining evidence necessary to substantiate the claim for the benefit sought," and that VA's obligations end when there is "no reasonable possibility exists that such assistance would aid in substantiating the claim." 38 U.S.C.A. § 5103A(a). Therefore, based upon the law and case law noted above, the Board concludes that under the standard existing before the VCAA, the limits on the duty to assist are at least: (a) That the claimant can not remain passive when her cooperation is necessary; (b) that the claimant must provide information essential to obtain putative information; and (c) that the duty to pursue evidence ends when, even if the putative evidence could be obtained, it could not make a difference in the result. (Emphasis added.) Under the VCAA, the limits on the duty to assist are: (a) Only reasonable efforts are required to obtain evidence that could substantiate the claim; and (b) the duty ends where there is no reasonable possibility that assistance would aid in substantiating the claim. (Emphasis added.) Based on the foregoing, the Board finds that all relevant facts have been properly and sufficiently developed in this appeal. Because the Board has determined that the claimant has no credibility as to his evidentiary assertions advanced in support of a claim for compensation benefits for PTSD and, in fact, has made false statements, it is clear that further development of the record could not made a difference in the result and that there is no reasonable possibly that additional assistance would aid in substantiating the claim. This is because the pattern of multiple false statements establishes bad faith. Once it is determined that the claimant's evidentiary assertions are not credible as to events in service or claimed subjective symptoms related to these events, there is no reasonable possibility of establishing the presence of the claimed disability. Factual background The veteran's DA Form 20, Enlisted Qualification Record, shows that he was in Vietnam from March 29, 1969, to January 10, 1970. This period totals 285 days. His record of assignments demonstrates that on April 4, 1969, his principle duty was automotive repair parts specialist, and he was assigned to Headquarters and Headquarters Company (HHC), 17th Combat Aviation Group (CAG), United States Army, Pacific, (USARPAC). He was in a casual status as of January 9, 1970. The period he was assigned to this unit thus totals 280 days. He received an Army Commendation Medal for meritorious performance of duty in Vietnam. He also received training in 1968 as an automatic weapons crewman and was assigned to the Headquarters and Headquarters Battery (HHB), 3d Battalion, 62nd Artillery, at Ft. Bliss, Texas prior to his service in Vietnam. At no time was he assigned duties as an automatic weapons crewman in Vietnam. The veteran's service medical records are void for any complaints or findings of a psychiatric disorder. The veteran's original claim for disability benefits in May 1970 made no reference to any psychiatric problems. The veteran's application for service connection for PTSD was received in March 1993. He reported treatment for PTSD between 1986 and 1989 and again beginning in 1991. The veteran was seen at a VA medical facility in late March 1993. He reportedly was referred from a Vet Center where he had been seeing a local psychologist for several months. He stated he had experienced flashbacks for 12 years, and they had increased. Reference was made to dreams, hallucinations, and severe insomnia. He dreamed of being in a bunker with a Vietcong standing over him, killing him and taking his body away; he would awake in a cold sweat. He reported being in Vietnam for 9 months, "M-60 expert Na Trang guard duty." Harassment fire was received everyday and a friend was killed next to him with a "head shot." The diagnosis was post- traumatic stress disorder, moderate, R/O (rule out) mild schizophrenia. The veteran was hospitalized at a VA medical facility in May and June 1993, for assessment and treatment of PTSD. He reported a history of combat exposure in Vietnam for 9 months, and since Vietnam had recurring nightmares 1 to 2 times a month, with a theme of helplessness. Acute anxiety and flashbacks were said to be triggered by loud noises, and helicopter sounds. He "self-medicated" with alcohol. He reported VA psychiatric treatment in 1986 when he was diagnosed with a substance use disorder. The axis I diagnoses were PTSD; ETOH (alcohol) dependence; ETOH intoxication, withdrawal; and polysubstance abuse. The veteran was followed on an outpatient basis to March 1994, throughout which time alcohol problems were noted. In November 1993 he reported "flashbacks" in which he would lose contact with reality and think he was in Vietnam. Received in May 1994 were copies of records of private medical treatment for the veteran in 1993 and 1994, and some VA clinic records, noted above. In June and July 1992 the veteran's psychiatric functional limitation was rated. It was noted that he had an anxiety related disorder, manifested by hyperalterness, sleep disturbance, decrease in attention and concentration, nightmares, and decrease in social and occupational functioning. M.M.M., Ph.D., in a July 1993 evaluation for disability determination, noted first examining the veteran in May 1992, with the last examination in June 1993. It was recorded that the veteran reported re-experiencing Vietnam nightmares, intrusive memories, and obsessing about events that actually occurred. He reported loss of control over mental process when "hallucination-like horror image invade his consciousness." He had numbing, rage, short-term memory problems, and relationship problems. He reported alcohol abuse to control the recurrent Vietnam horror. The diagnosis was PTSD. Received in June 1994 was an extensive statement from the veteran in which he reported being stationed in a headquarters company in Nha Trang, and about 10 days after arriving, he experienced his first "122" rocket attack, with one landing approximately 30 feet from him, blowing him off of his feet "& landing about 10 ft from where I was standing." He stated the local barber or cook during daylight could be a VC at night so there was never a safe moment. He reported that it seemed like he was on night guard duty at least 3 times a week and it was always very scary and lonely for him. While on guard duty on the flight line he could hear the 16-inch guns from a ship blasting the mountains approximately 7 miles inland. He could hearing the air rushing past as the 2 tons of explosives went overhead and then saw it explode on the mountain. He stated that the first 122-rocket attack set the stage for his feelings of helplessness during his tour of Vietnam and later in the development of his severe and chronic PTSD. He also expressed his displeasure at the denial of his claim and at the request that he provide information. When hospitalized at a VA medical facility in February 1995, military history as reported by the veteran included his serving in Vietnam as an automatic weapons specialist "(Quad 50s to duster)" and receiving the "Veterans Combat Medal"(sic). His traumatic events included being blown out of bed by "122's" within the first 10 days; being on guard duty every other night-perimeter or flight line with 3-4 ton shells going over head; harassment fire 2-3 times a week and at 0600 hours. He also reported encountering mines or booby traps while on patrol; seeing Americans killed or wounded; being surrounded by the enemy; having his "own safety or buddies jeopardized;" and indirectly/directly experiencing feelings of shame, guilt grief, self-hatred, rage, and alienation about observing or participating in "instances of abuse violence." The veteran reported recurring dreams of 122's coming in, and flashbacks in which he felt completely helpless and fatigued with sweats and 104-degree temperatures. His first drinking and drugs were in Vietnam. He recounted actions after service which he felt were related to his Vietnam experience. His first flashback was in 1973 when a helicopter flew over. In 1980 his anxiety attacks increased as well as his social problems and isolation. In 1988 he saw an article on PTSD and sought VA help, and the psychologist attributed his problems to substance abuse. He stopped the use of all substances but his dreams and flashbacks increased in frequency and were more vivid and he became severely suicidal. Assessment and evaluation were accomplished, and the Axis I diagnoses were PTSD, and alcohol and marijuana dependence. The veteran was hospitalized again from April to June 1995. The military history at that time included a claim of duties in Vietnam as an automatic weapons specialist, but did not include a claim of an award of the "Veterans Combat Medal." Traumatic events included being blown out of bed by rockets within 10 days of arrival and succeeding attacks averaging 2 to3 times a week for the remainder of his tour; observing senseless mutilation of Vietnamese Nationals by Army Special Forces unit; and witnessing the refusal of medical service to a Vietnamese woman with her abdomen sliced open and bowels hanging out. He reported that he first drank and used drugs in service. He stated that he stopped when he returned home, but during his first thunderstorm he jumped out of bed and while disoriented ran into a wall. After that event, he resumed drinking. The veteran's reported signs and symptoms of PTSD in the past 6 months included intrusive thoughts, nightmares, flashbacks, exacerbation of symptoms when exposed to similar circumstances, avoidance of reminders of the war, inability to remember details, decreased interest in activities, isolation, numbing, disturbance in sleep and concentration, uncontrollable anger, hypervigilance, startle response, and survival guilt. He reported recurring dreams of the 122's coming in; flashbacks in which he feels completely helpless; and fatigue and sweats with 104-degree temperatures. The report of hospitalization from April 1995 to June 1995 further noted that the veteran moved to the island of Hawaii in 1990 to retire and moved to the "jungle." In 1992 he had a major flashback when someone dropped a board at a construction site and he found himself hiding in the forest an hour later. This incident caused him major depression and he was suicidal and diagnosed as having PTSD and was an inpatient at a VA facility for 26 days. On examination he was mildly anxious, with no other pertinent findings. During his sixth week, 2 of his peers sharing their traumas brought up memories the veteran thought long buried. The first was mutilated bodies when he passed the Special Forces compound, and the second was the Vietnamese woman with her bowels hanging out, and he created such a ruckus at the hospital to get her treatment that the military police were called to take him away. The Axis I diagnoses were PTSD and alcohol and marijuana dependence. A July 1995 letter from the Pacific Center for PTSD reported that the veteran was a patient in the PTSD Residential Rehabilitation Program from April to July 1995 and had been referred to outpatient for continuing outpatient care. A 30- day period of convalescence was recommended. VA outpatient clinic records for PTSD continuing care from August 1995 to February 1996, reported some stress due to physical problems. The veteran, in hearing testimony in June 1996, reported that 10 days after arriving in the country, with 17th "Aviation Battalion" or "17th Headquarters Company," Nha Trang, there was a rocket attack with 20 to 30 rounds, one hitting 20 feet from the door to the motor pool where he lived. It blew the veteran completely out of bed, he woke totally disoriented and another round hit the roof as he was running to the door, and they had to run down to the Headquarters Company and get their weapons "cause we were in charge of that bunker on the north end." The bunker was right on the perimeter, the veteran had a M-60 machine gun, and it took 30 minutes to get 200 yards from building to building. The veteran considered this his biggest stressor, Transcript (T.) pp. 2 and 3. The feeling of helplessness, and lack of control over his destiny causes him to still have nightmares about the rocket attack. T. p. 4. His base was right next to the airfield and the harassment fire would hit his base "every day" at 6 AM, "you could set your watches by it." T. p. 5. He recalled guard duty every other night, walking to the airfield and listening to the 16-inch guns, "ammo going over your head" and seeing them hit the mountains. He was in a bunker every morning. T. p. 6. His friend [redacted] or [redacted], was up in a 60-foot guard tower and he grabbed the wire and burned three fingers off, and another guy grabbed him and was blown out of the tower by the electricity. The veteran went to the hospital to see his friend and a Vietnamese woman, about age 50, with her family, was bleeding badly and holding her guts in and "they" wouldn't give her a bed because they were all filled, and the veteran "freaked out" and 2 or 3 M. P.'s (military police) escorted him out, and "at that point, the war was over for me." T. pp. 7 and 8. Another incident was when the veteran and his partner were walking inside the compound and there was a half block of bars and women, and an M. P. came out of the crowd and grabbed the veteran and threw him down and stuck a .45 in his mouth and said, "if you move, I'm gonna shoot you right now." The veteran had no idea why he did that; he found out later that somebody had thrown a satchel charge or grenade in one of the bars. The veteran was taken to the M. P. station put in a wire mesh cage, just big enough for two people to stand up in, for 2 hours. He refused to go when released, and Colonel Ming picked him up. The veteran later heard that the sergeant involved was busted two field grades. T. pp. 9 and 10. The veteran recalled that when driving a low-boy from Nha Trang to Cam Ranh Bay to pick up supplies, he was number 2 in a 6 vehicle convoy, they received small arms fire, with 3 rounds hitting his right hand passenger door which was armor plated. H. started blasting with a M-60 on his truck, and he took off so fast that he was ready to pass the lead jeep. Three miles out of Nha Trang on the 100-mile trip to Cam Ranh Bay, was a big sign, "free fire zone." T. p. 11. After discussions with a counselor at the veteran's center, the veteran recalled an event after 6 months in Vietnam, occurring around September, when he was standing in the airfield and an Air Vietnam plane came in with a big black hole back of the door. Smoke was coming out, and when he tried to set it down it bounced and took out a jeep, he broke a sergeant's arm. Another individual sustained a concussion. The plane ended up in a school and children 10 and 12 years old were burned. T. pp. 12 and 13. An April 1996 statement from the veteran noted his arrival in Vietnam, unit of assignment, duties, and rocket attack on day 10. He also recounted the attack on the truck he was driving, the plane that crashed into a school, and observed electrical shock to a specialist 4th class, who was burned and lost 3 fingers. The veteran recalled freaking out seeing the many dead and wounded at the hospital. Five months into his tour the Enlisted Club was blown up by a satchel charge and he again reported the M. P. incident, noting that the M. P. received "NJP" (non-judicial punishment) for the incident. He also reported that when leaving Nha Trang and flying to Cam Ranh Bay, he was at an LZ (landing zone) loading bodies, and was fired upon by automatic weapons. The veteran, in a form for Environmental Support Group (ESG) research, dated in May 1996, noted that his duties included parts clerk, gas truck driver, and convoy driver. His most terrifying, life threatening military experience was being bombed or shelled, and his nightmares occurred 4 times each month, he recalled the event 15 times each month, and flashbacks occurred once each month. The veteran, in a certified statement dated in June 1996, reported that he did not know the name or unit of the M. P. that threatened him, that it occurred sometime in September or October 1969, and that H.P., who he had not had contact with since 1971, was a witness. He also recounted the convoy small arms fire, with no date for the event, and stated that the "process of trying to re-collect this incidents has really caused me tremendous pain and suffering. When does it end?" The ESG, in a statement dated in June 1997, noted that enclosed were extracts of Operational Reports - Lessons Learned (LL's) from January through October 1969 for the 17th Combat Aviation Group. The ESG also included LL's from the 54th General Support Group (GSG) for this period as they also covered Nha Trang, the base camp location of the claimant's listed unit. The LL's documented that elements of the 17th CAG received several standoff rocket and mortar attacks during the above period. LL's for the period ending April 30, 1969, noted a total of twenty three stand off rocket and mortar attacks launched at 17th Combat Aviation Group facilities during the period: Ban Me Thuot 6, Pleiku 5, Kontum 4, Nha Trang 2, LZ English 2, Hensel 1, Qui Nhon 1, Phan Thist 1 and Dong Ba Thin 1. The LL of the 54th GSG for the quarter ending 30 April 1969 contains a detailed list of enemy stand off attacks with mortars and rockets during this period. This list documented that on 21 April, the 4 mortar rounds fell at 0535 in the "Nha Trang area." There was no personnel or property damage in the 54th GSG area. The report lists no rocket attack in the Nha Trang area during the dates when the claimant was present. The LL of the 54th GSG for the period ending July 1969 showed mortar fire May 12 at the Nha Trang POL (petroleum, oil, lubricant) area, no injuries or damage. For the period ending October 31, 1969, the LL of the 54th GSG reflects that on October 11th Camp John F. McDermott at Nha Trang received incoming 107 and 122-millimeter rocket fire, no damage or casualties. On the 12th, LSA (logistics support area) at Nha Trang received incoming 57-millimeter recoilless rocket fire, no damage or casualties. The summary for the 17th Combat Aviation Group notes that enemy standoff attacks from May to July continued at a "moderately slow" rate. The report stated these attacks numbered May 14, June 16 and July 4. Casualties were "light" with no killed in action. The report identified the three bases that were most frequently hit, and this list did not include Nha Trang. The summary of these reports by the ESG stated that documented stand off attacks on Nha Trang during the time of the claimant's presence occurred on 21 April 12 May and 11 and 12 October 1969. In a certified statement dated in July 1997 the veteran noted that records documented an attack on Nha Trang April 21, 1969, which he believed helped to verify the incident. With regard to the M. P. and convoy incidents he indicated that he had supplied as much information as possible in his June 1996 statement and hearing testimony. Received in February 1998 was a written statement signed by H.P. with a social security number below the signature. It was recorded that H.P. was with the veteran in the 17th Combat Aviation Group on a daily basis from the time the appellant arrived to the time he left. H.P. explicitly stated that he and the veteran arrived in Vietnam on the same date. H.P. stated he remembered the first rocket attack which he related "still seems to me after 1 week in Vietnam," with approximately 20 to 30 rounds into the compound with one or two rounds hitting within 30 feet of the sleeping area. Large pieces of the rocket, or rocks, landed on the roof, and this attack had a major impact on their attitude. He stated they were subjected to such attacks two to five times per month. H.P. further reported being with the appellant when he was assaulted by the M. P., and nighttime guard duty with the big guns from the ships firing over the base inland to the highlands. H.P. was also with the appellant when the airplane crashed into the school, and when they were in a jeep at the end of a flight line and a jet fighter could not stop, crashed through the perimeter wire and just about hit the jeep. The plane had fire damage and 50 caliber rounds started going off. H.P. reported that the 122 rocket attack had "left more of an impression on me." In a response to an inquiry concerning records for the veteran, requests were made for alleged records of VA treatment at Santa Barbara between 1986 and 1989. Response from the Santa Barbara facility required inquiry to the VA medical center in Los Angeles, California. That facility responded in February 1998, that they had no records of treatment for the veteran for that period. Initially, the service department could not verify service by H.P. based upon the Social Security number originally supplied with H.P.'s statement. Later, a different Social Security number was supplied for H.P. and the service department did confirm that H.P. did have active service. Further VA outpatient treatment reports reflect care for PTSD and a variety of other conditions through April 2002. His diagnosis at that time was PTSD, chronic and in control. Following the Board's remand in August 2001, the RO requested that the service department custodians search for Morning Report entries during the claimant's service in Vietnam. In February 2002, the RO itemized the dates for the requested search, the claimant's unit of assignment and the incident or events concerning which confirmation was sought. In response, the record custodians reported that the veteran is among those listed on a morning report dated April 9, 1969. No further detail is noted. The RO notified the claimant in May 2002 that certain records of treatment form a Dr. Lee and from the VAMC Santa Barbara had not been obtained. The RO requested the claimant's assistance in securing these records. The claimant responded with copies of records from this provider dated from 1992 to 1993. Also submitted was an outpatient appointment card from the VAMC in Santa Barbara showing a scheduled appointment in 1990. No detail as to the nature of the treatment was indicated. A statement from a VA employee in May 2002 reflects that records showed the claimant had three psychiatric visits during the month of November 1990. Analysis I. General The starting point with regard to PTSD is one or more events meeting the criteria for a "stressor." The question of a "stressor" also bears upon credibility determinations from both a legal and a practical standpoint. From a legal standpoint, certain veterans who "engaged in combat with the enemy" gain evidentiary presumptions, provided their accounts are "satisfactory" (credible). 38 U.S.C.A. § 1154(b); C.F.R. § 3.304(d) (2001); Caluza, Supra. Under the controlling regulation, there must be credible supporting evidence that the claimed service stressor actually occurred. 38 C.F.R. § 3.304(f). The existence of an event alleged as a "stressor" that results in PTSD, though not the adequacy of a verified event to cause PTSD, is an adjudicative, not a medical determination. Zarycki v. Brown, 6 Vet. App. 91, 97- 98 (1993). As noted above, from a practical standpoint the diagnosis of PTSD is contingent upon a host of subjective symptoms that are wholly dependent upon the credibility of the evidentiary assertions of the claimant. As Spar, L.F., & Pankratz, L.D. pointed out: "Simulation [of PTSD] is easy, since the symptoms described by DSM-III mostly reflect private phenomenology and since by definition the symptoms are caused by events now past." (Id. at p. 1018). The subsequent revisions of the diagnostic criteria, particularly in category "B", "C" and "D" did not serve to make them more objective. Generally, under the framework established in Zarycki, the legal analysis of PTSD claims requires that adjudicators make an explicit determination as to whether the veteran engaged in combat with the enemy. The VA General Counsel addressed the question of what evidence is considered satisfactory proof that a veteran engaged in combat with the enemy in VAOPGCPREC 12-99 (October 18, 1999). The General Counsel held that the plain language of 38 U.S.C.A. § 1154(b) requires that the veteran have "personally participated in events constituting an actual fight or encounter with a military foe or hostile unit or instrumentality." The determination as to whether a veteran "engaged in combat with the enemy" necessarily must be made on a case-by-case basis with reference to the general statutory standards. Evidence that the veteran participated in attacking or defending an attack of the enemy would ordinarily show that the veteran had engaged in combat, but the general description would not be exhaustive if circumstances made in an individual case were found to constitute engagement in combat. The Court has indicated that evidence submitted to support a claim that a veteran engaged in combat may include the veteran's own statements and an "almost unlimited" variety of other types of evidence. Gaines v. West, 11 Vet. App. 353, 359 (1998). The Gaines Court also stated that 38 U.S.C.A. § 1154(b) does not require the acceptance of the veteran's assertions that he engaged in combat. Id. at 359. However, the Court has made clear that VA cannot ignore the veteran's assertions and must evaluate his statements along with all other relevant evidence. Id. II. Combat stressors In the present case, the veteran received no award or decoration specifically denoting combat participation appropriate to his branch of service (such as the Combat Infantryman Badge), combat incurred wounds (the Purple Heart Medal), or valor in combat with the enemy. In addition to receipt of designated awards and decorations, "conclusive evidence" of combat participation may also be established by "other supportive evidence" that the claimant was in a plane crash, ship sinking, explosion, rape or assault, or duty on a burn ward or in a graves registration unit. See Zarycki, supra. The Board finds the term "other supportive evidence" is unclear as to the limitations, if any, on what can constitute "other supportive evidence." At a minimum, however, the case law from the Court would preclude the use of the claimant's own assertions as "other supporting evidence," nor would post-service medical evidence suffice as "other supporting evidence." To the extent that the term "other supporting evidence" in this context could consist of service department records, the Board finds that there are no service department medical or administrative records to establish that the claimant was in a plane crash, ship sinking, explosion, rape or assault, or had duty on a burn ward or in a graves registration unit. The Board acknowledges Department of the Army documentation showing that aircraft from the 17th CAG engaged in combat with the enemy. However, there is no documentation the veteran was a member of a flight crew or with any air or ground unit that engaged in combat with the enemy. His administrative records are quite to the contrary. Thus, the Board finds that the service department records do not contain "conclusive evidence" that the veteran "engaged in combat with the enemy." Where the service department records, as here, fail to establish that the veteran engaged in combat with the enemy, the veteran's lay statements as to in-service stressors cannot be accepted without further corroboration through independent evidence. Doran, 6 Vet. App. at 288-89. In this case, the critical components of the veteran's self-described military history are not corroborated by official military records associated with the claims file. As will be discussed below, his key accounts are, in fact, refuted. On multiple occasions the veteran has alleged specifically that within ten days of his arrival at his unit in Vietnam he was subjected to an attack by a score or more of rocket rounds. He specifically has identified this as the most stressful event in service. He also has alleged that he was subjected to frequent rocket attacks. During his hospitalization from April to June 1995 he reported rocket attacks 2-3 times per week for remainder of tour, apparently after the first alleged attack. The Board notes that he was with his unit for 280 days. Assuming the first attack was on day ten, there followed 270 days. Those 270 days equal a little over 38 weeks. Two rocket attacks per week would indicate he was subjected to a total of 76 attacks. Three rocket attacks per week would compute to a total of 114 attacks. The Board further notes that at the June 1995 hearing, he reported harassment fire every day at 0600; however, it is not clear that he was claiming each of these "harassing fire" events involved rockets, mortars or other forms of fire. For purposes of the analysis here, it is not necessary for the Board to determine whether "harassing fire" every day meant rocket attacks or other forms of fire. The appellant provided specifics of a date and place that permitted the RO to seek confirmation from the service department. The results of that development show that, not only was there no confirmation of the accounts, but that the service department records flatly refute the accounts. Records from the service department demonstrate that during the claimant's entire tour of assignment with the 17th Combat Aviation Group at Nha Trang, the base region sustained exactly one attack by rockets. That attack occurred not early on within approximately ten days of the claimant's arrival with his unit, but in October 1969. The attack did not involve a score or more of rockets and caused no damage or casualties. The records also show that during the entirety of his tour, there was one mortar attack in April, one in May, and one recoilless rifle attack in October. This record thus shows that not only is the initial rocket attack story refuted, but that the allegation of frequent rocket attacks is completely bogus. There were not between 76 and 114 attacks but one rocket attack. Even if all the indirect fire attacks of the mortars and the one direct fire attack of the recoilless rifle were lumped together, this amount to four events, not remotely 76 or 114. Thus, the account of a large number of rocket attacks falls not into the category of minor imprecision or readily understandable slippage of memory over decades but of grotesque and purposeful misrepresentation. The Board has considered whether the confirmation of the rocket attack in October 1969 and the other two mortar and one recoilless rifle attack shown by the service department records would support a finding that the claimant was entitled to the presumptions provided under 38 U.S.C.A. § 1154(b) as one who "engaged in combat with the enemy." For this purpose, the Board will assume without deciding that simply being sporadically or on one occasion under indirect fire, or in the vicinity of direct fire qualifies as "combat with the enemy." Under Collette v. Brown, 82 F.3d 389 (Fed. Cir. 1996) and Caluza, supra., the correct application 38 U.S.C.A. § 1154(b) requires a three-step, sequential analysis: (1) Has the claimant produced "satisfactory lay or other evidence of such injury or disease." "Satisfactory evidence" is defined as "credible evidence that would a allow a reasonable fact finder to conclude that the alleged injury or disease was incurred in or aggravated by the veteran's combat service." (2) Is the proffered evidence "consistent with the circumstances, conditions, or hardships of such service." (3) Once these the first two steps are met, the Secretary "shall accept" the veteran's evidence as "sufficient proof of service connection," even if no official record of such incurrence exists, unless the government can met the burden of showing "clear and convincing evidence to the contrary." In Collette, it was expressly held that during the first two steps of this sequential analysis, the credibility determination must be made as to the veteran's evidence standing alone, not weighing the veteran's evidence with contrary evidence. Only in the third step may contrary evidence, such as a Report of Medical Examination at Separation, be brought into play. Collette, 82 F.3d at 393. Under this framework, the Board has only reached the question of the credibility of the claimant's assertions at step three, when the contrary evidence can be weighed. In this instance, however, it is clear that the claimant's statements are not satisfactory, i.e. credible, because both the account of the event the claimant himself has styled as his most significant alleged stressor, the rocket attack about ten days after his arrival, and the allegations of exposure to a massive number of rocket attacks are flatly refuted by the service department record. Nor are these isolated examples of false statements advanced by the claimant in pursuit of a claim for compensation benefits for PTSD. The veteran has further stated that, while in service, 16-inch shells were fired over his head. The available documentation in the service records shows he was assigned to his unit at Nha Trang (where he alleges this took place) on 4 April 1969. The Dictionary of American Naval Fighting Ships, Vol. V, Navy Department, Office of the Chief of Naval Operations, Naval History Division (Washington: Reprint 1979) 60-63, establishes that the only ship fitted with 16-inch guns to operate off Vietnam, the battleship New Jersey, completed her one deployment to Vietnam and sailed from Subic Bay in the Philippines for the United States on 3 April 1969. In other words, the New Jersey was en route to the United States the day before service records show the appellant reached his unit. It follows that his recollection of being exposed to hearing or seeing 16-inch gunfire is refuted. Finally, the veteran has also offered accounts that he served in Vietnam as an automatic weapons specialist. Such statements are simply not supported, but are actively refuted by the service department records that show his assigned duties were those of an automotive parts specialist. Thus, in total no fewer than four critical allegations by the claimant are not simply unsupported or not verified, but are demonstrably false: the initial rocket attack within ten days of arrival at his unit; exposure to a vast number of rocket attacks; exposure to the fire of 16-inch guns; and duties involving assignment as an automatic weapons specialist in Vietnam. Manifestly, his assertions are not "satisfactory" or "credible" and thus he is not entitled to the presumptions provided by 38 U.S.C.A. § 1154(b). In addition to the veteran's own statements, a letter from H.P., a fellow serviceman, has been offered to "corroborate" the veterans claims of in-service stressors. As detailed earlier, in that letter H.P. stated that he was with the veteran in the 17th Combat Aviation Group on a daily basis from the time the appellant arrived to the time he left. H.P. remembered the first rocket attack one week after entering Vietnam, approximately 20 to 30 rounds into the compound with one or two rounds hitting within 30 feet of the sleeping area. H.P. further reported frequent rocket attacks totaling two to five per month. The Board notes that according to H.P.'s account, therefore, the rocket attacks in the over 38 weeks (or 9.5+ months) of the veteran's tour should have numbered between approximately 19 and 47. The service department records that demonstrate the claimant's accounts as to these events are false likewise demonstrate that the purported supporting evidence form H.P. is false. As noted above, there was no rocket attack within one week or any time proximate to that during the tour of the claimant and H.P. There was no rocket attack involving twenty or more rounds. Further, the service department records demonstrate that H.P. allegations of frequent rocket attacks are likewise false. Where the relevant evidence demonstrates that a witness has submitted false statements concerning the rocket attacks, the Board finds that no credibility can be assigned to the statements of H.P. related to other alleged stressor events for which there is no independent corroboration. As noted in Phillips, supra., above, once it is clear that a witness is submitting false statements, the fact finder is entitled to disregard not only the demonstrably false statements, but may also find no credibility can be attached to the whole of the witness's evidence. The current leaves the distinct inference that the claimant knowingly procured the false statement from H.P. since the claimant knew the story of the rocket attack shortly after his arrival and the claim of a vast number of rocket attacks were false. (As the Federal Circuit noted the Board has the "authority to discount the weight and probity of evidence in the light of its own inherent characteristics and its relationship to other items of evidence." Madden, 125 F.3d at 1481.) What is settled is that the claimant attempted to support his false statement with a false statement from another individual. The inquiry as to the claimant's status as a combat veteran demonstrates that he has advanced false stories of his experiences in service. The numerous occasions on which the veteran's contentions as to material facts have been contradicted by official military records support a finding that the claimant is not acting in good faith. The Board further concludes that since it is clear that the claimant is acting in bad faith, no reasonable fact finder could assign any credibility to any evidentiary assertion by the claimant advanced to support his claim for service connection for PTSD. As noted by the Phillips Court, a fact finder that concludes that "any witness testified falsely as to any material issue in this case . . . must reject that which you believe to be false, and you may reject the whole or any part of the testimony of such witness." In this matter the claim of direct combat participation is manifestly a "material issue." The wholesale pattern of the claimant's false testimony as to this material issue provides the mandate for the fact finder to reject the whole of his evidentiary assertions. Under the authority of Bethea v. Derwinski, 2 Vet. App. 252 (1992), the Board finds the memorandum decision in Pruitt v. West, No. 97-381 (U.S. Vet. App. Mar 6, 1998) to contain particularly persuasive reasoning as to the appropriate course of action to be followed when false claims of combat are advanced by a veteran in a claim for service connection for PTSD. As the Court stated: This claim for benefits has been grounded on what now has been found to be a false claim to combat-related stress. When faced with this reality, the stress from having been in combat shifted to hardship of Army life and severe Korean weather. The appellant, now having been found by the Board to lack credibility by falsely claiming combat experience, is hardly in a position to continue his quest for benefits. He has expended resources of VA and this Court at the expense of delaying legitimate claims. Such conduct on his part could well violate 18 U.S.C. § 1001 (false statement), but, in any event, he has done a great disservice to those who have service in our armed forces and honorably pursued veterans benefits in a system having no room for one falsely claiming combat related disabilities. Thus, the Board concludes that the veteran did not engage in combat with the enemy as defined within 38 U.S.C.A. § 1154(b) (West 1991). As a result, as a matter of law, a medical provider cannot provide supporting evidence that the claimed in-service event actually occurred based on a post-service medical examination. Moreau v. Brown, 9 Vet. App. 389, 395-6 (1996). In addition, the veteran's own testimony will not be sufficient. Id. Other credible supporting evidence from any source must be provided. The Board finds there is no "other credible supporting evidence from any source" to support the conclusion that the claimant engaged in combat with the enemy. Likewise, the Board notes that even if the rule of law in Moreau did not apply, the fact is that none of the post-service clinicians that have dealt with the claimant and reported or suggested the presence of PTSD have any first hand knowledge of the events in service or the claimant's reaction to those events. Thus, they can not corroborate events in service; they can only reiterate the claimant's assertions. III. Non-combat events Whether being subjected to rocket attacks, gunfire from 16- inch guns, or duties as a automatic weapons specialist as alleged by the claimant constituted combat events or noncombat events, the Board has found all these allegations to be false. From this conclusion, the Board has further found that the claimant is acting in bad faith and no credibility can be attached to his evidentiary assertions in pursuit of his claim for service connection for PTSD. Phillips, supra. As noted above, not only the subjective reaction of an individual to an alleged stressor event, but the validity of the presence of a series of additional symptoms under criteria "B," "C," and "D" are dependent upon the credibility of the claimant. No human being, whatever his or her medical credentials may be, can objectively observe in inner thoughts of another human being, nor can a human being objectively verify at a distant remove the subjective reaction of another individual to an event long past. Thus, it is fallacious to believe that a clinician can contribute to a determination as to whether or not PTSD is present and, if so, if the PTSD is related to events in service once it is clear that a claimant is advancing a false claim. Once it is clear that a claimant and his purported supporting witness H.P. are presenting false statements, the disposition of the claim rests with adjudicators, not clinicians. As the single judge noted above in Pruitt, one would scarcely believe that any purpose would be served by further pursuit of the claim once it is clear that false allegations of combat events have been advanced. The Board finds this analysis would apply equally if the various events noted above concerning rocket attacks, exposure the shelling from 16-inch guns or duties as an automatic weapons specialist were classified as non combat events. To further pursue this matter would be a pointless waste of adjudicative resources at the expense of other veterans advancing meritorious claims. It would effectively create a policy that advancing false claims is of no consequence and that system of compensation benefits for veterans is not merely nonadversarial, but actually indifferent to false claims. It is inherent in the case law cited above concerning credibility determinations, however, that consequences do follow from a properly supported determination that the claimant lacks credibility. This is particularly so in a claim involving PTSD where the diagnosis is completely dependent upon the credibility of the party claiming the disorder. It is now clear that the claimant is pursuing a false claim. No credibility can be attached to his allegations as to his subjective reaction to events alleged as a "stressor" or as to a host of subjective symptoms allegedly relating to such events. Thus, the claim fails regardless of and without necessity of further pursuit of alleged "stressor" events, whether combat or non combat. IV. Conclusion Although the veteran is entitled to the benefit of the doubt when the evidence supporting a grant of the claim and evidence supporting a denial of the claim are in approximate balance, the benefit of the doubt doctrine is inapplicable where, as here, the overwhelming preponderance of the evidence is against the claim. Gilbert v. Derwinski, 1 Vet. App. 49, 58 (1990). This matter further illuminates a now chronic problem in the adjudicative system. No one who has dealt with claims for veterans as has the undersigned for over 27 years can fail to be impressed with the fact that the overwhelming majority of veterans bring their claims in good faith. A tiny minority of perhaps a very few percentage points, however, has now emerged who plainly are not acting in good faith. This tiny minority has a baneful effect of the claims system vastly out of proportion to its number. In this matter for example, a fair estimate would be that the resources consumed in this appeal would easily have permitted the handling of between at least five and ten other average appeals. Statistically, those five to ten appeals likely would have resulted on average in a grant of some benefit for one or two veterans outright. Another two to four veterans would have gained additional development of the record that on average would result in the grant of a benefit for between one and two additional veterans. Thus, this matter alone has delayed the grant of benefits on average to between two to four veterans. If one of the those veterans died during the processing of his appeal during the time expended in the processing of this claim, that benefit would have been lost or possibility severely reduced if paid as accrued benefits to his or her dependents. These are the sorts of costs of this false claim alone at the appeal level. This does not count the costs of processing at the regional office, but it can be safely presumed to be several multiples of the cost at the Board, particularly since initial claims have a far greater allowance rate. Thus, this is an example of where an individual has attempted to trade for his own benefit on the honorable behavior and sacrifice of others-and at the expense of other veterans with meritorious claims. ORDER Service connection for PTSD is denied. Richard B. Frank Member, Board of Veterans' Appeals IMPORTANT NOTICE: We have attached a VA Form 4597 that tells you what steps you can take if you disagree with our decision. We are in the process of updating the form to reflect changes in the law effective on December 27, 2001. See the Veterans Education and Benefits Expansion Act of 2001, Pub. L. No. 107-103, 115 Stat. 976 (2001). In the meanwhile, please note these important corrections to the advice in the form: ? These changes apply to the section entitled "Appeal to the United States Court of Appeals for Veterans Claims." (1) A "Notice of Disagreement filed on or after November 18, 1988" is no longer required to appeal to the Court. (2) You are no longer required to file a copy of your Notice of Appeal with VA's General Counsel. ? In the section entitled "Representation before VA," filing a "Notice of Disagreement with respect to the claim on or after November 18, 1988" is no longer a condition for an attorney-at-law or a VA accredited agent to charge you a fee for representing you.