Citation Nr: 0802855 Decision Date: 01/25/08 Archive Date: 02/04/08 DOCKET NO. 06-12 556 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in No. Little Rock, Arkansas THE ISSUE Entitlement to service connection for Post Traumatic Stress Disorder ("PTSD"). REPRESENTATION Appellant represented by: Veterans of Foreign Wars of the United States WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD J. M. Wagman, Associate Counsel INTRODUCTION The veteran had active military service from June 1972 to June 1974. This case comes before the Board of Veterans' Appeals ("Board") on appeal from a September 2004 rating decision by the North Little Rock, Illinois Regional Office ("RO") of the Department of Veterans Affairs ("VA") that denied the veteran's claim for service connection for PTSD. FINDINGS OF FACT 1. There is competent medical evidence of record that links the veteran's military service to his diagnosis of PTSD. 2. There are at least two credible corroborating statements of record that support the veteran's account of his stressor statement. CONCLUSION OF LAW The criteria for establishing service connection for PTSD have been met. 38 U.S.C.A. § 1110 (West 2002); 38 C.F.R. §§ 3.303, 3.304 (2007). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS In this decision, the Board grants service connection for PTSD, which represents a complete grant of the benefit sought on appeal. Thus, no discussion of VA's duties to notify and assist is required. Service connection may be established where the evidence demonstrates that an injury or disease resulting in disability was contracted in the line of duty coincident with military service, or if preexisting such service, was aggravated therein. 38 C.F.R. § 3.303 (2007). Establishment for service connection for PTSD requires: (1) medical evidence diagnosing PTSD; (2) credible supporting evidence that the claimed in-service stressor actually occurred; and (3) medical evidence of a link between current symptomatology and the claimed in-service stressor. 38 C.F.R. § 3.304(f) (2007); See also Cohen v. Brown, 10 Vet. App. 128 (1997). A diagnosis of PTSD must be established in accordance with 38 C.F.R. § 4.125(a), which simply mandates that, for VA purposes, all mental disorder diagnoses must conform to the fourth edition of the American Psychiatric Association's Diagnostic and Statistical Manual for Mental Disorders ("DSM- IV"). 38 C.F.R. § 3.304(f) (2007). The United States Court of Appeals for Veterans Claims ("Court") has taken judicial notice of the mental health profession's adoption of the DSM-IV as well as its more liberalizing standards to establish a diagnosis of PTSD. The Court acknowledged the change from an objective "would evoke...in almost anyone" standard in assessing whether a stressor is sufficient to trigger PTSD to a subjective standard (e.g., whether a person's exposure to a traumatic event and response involved intense fear, helplessness, or horror). Thus, as noted by the Court, a more susceptible person could have PTSD under the DSM-IV criteria given his or her exposure to a traumatic event that would not necessarily have the same effect on "almost everyone." Cohen, 10 Vet. App. 128, 140- 41 (1997). If the evidence establishes that the veteran engaged in combat with the enemy and the claimed stressor is related to that combat, in the absence of clear and convincing evidence to the contrary, and provided that the claimed stressor is consistent with the circumstances, conditions, or hardships of the veteran's service, the veteran's lay testimony alone may establish the occurrence of the claimed in-service stressor. 38 U.S.C.A. § 1154(b); 38 C.F.R. § 3.304(f)(1) (2007). The ordinary meaning of the phrase "engaged in combat with the enemy," as used in 38 U.S.C.A. § 1154(b), requires that a veteran have participated in events constituting an actual fight or encounter with a military foe or hostile unit or instrumentality. The issue of whether any particular set of circumstances constitutes engagement in combat with the enemy for purposes of section 1154(b) must be resolved on a case- by-case basis. See VAOPGCPREC 12-99 (October 18, 1999). 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 statements as to the occurrence of the claimed stressor. Doran v. Brown, 6 Vet. App. 283, 288-89 (1994). The veteran's testimony, by itself, cannot, as a matter of law, establish the occurrence of a non-combat stressor. Dizoglio v. Brown, 9 Vet. App. 163, 166 (1996). Moreover, a medical opinion diagnosing PTSD does not suffice to verify the occurrence of the claimed in-service stressor. Cohen v. Brown, 10 Vet. App. 128, 142 (1997); Moreau v. Brown, 9 Vet. App. 389, 396 (1996). Such is the case here. The veteran did not engage in combat with the enemy. He claims he was traveling home from a bar in July 1973 with a couple of friends when they encountered an individual physically beating another individual at an off-base location. The veteran claims that he and his companions witnessed the shooting of the beating victim and when they walked up to the scene, were shot at themselves. He states the soldiers ran for their lives to the safety of the military base and then went to report the incident to his Sergeant. Because he did not engage in combat with the enemy, the veteran needs independent corroboration of his statements as to the occurrence of his claimed stressors. The record contains two lay statements submitted by individuals who were with the veteran the night of the claimed beating-one who was actually there and one from the brother of an individual who has since died but relayed the story to his brother prior to his death. The statements are each identical to the veteran's in their description of the events of that night and the impact it made. The veteran testified that he began having nightmares almost immediately in 1973. He describes the inability to sleep, the inability to work; suicidal ideations; alcohol and substance abuse; as well as physical and emotional abuse in relationships with others. He has extreme feelings of anxiety and guilt over the event. He did not seek treatment, however, until approximately 2002. His statements regarding the incident are also consistent with the accounts provided in the lay statements and the Board finds them to be credible. In addition to other VA medical treatment notes of record, the veteran was afforded a VA examination in January 2007 wherein he was diagnosed as having chronic PTSD with a GAF score of 52. The medical examiner concluded that the veteran's symptoms are mild to moderate and have persisted for some time and that he believes there is a nexus between the stressor the veteran reported in the military and the currently diagnosed PTSD. The Board finds that the medical reports for the claim and the statements corroborating the claim are both probative and credible. Because there is medical diagnosis of PTSD related to the claimed in-service stressor, and credible supporting evidence of the occurrence of that stressor, applying the benefit-of-the-doubt doctrine, the Board concludes that the evidence favors the grant of service connection for PTSD. ORDER Service connection for PTSD is granted. ____________________________________________ STEVEN D. REISS Acting Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs