Citation NR: 9607996 Decision Date: 03/26/96 Archive Date: 04/10/96 DOCKET NO. 91-38 623 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Boise, Idaho THE ISSUE Entitlement to service connection for alcoholism secondary to a service-connected disorder. Entitlement to dependency and indemnity compensation under 38 U.S.C.A. § 1318(b) (West 1991). REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD Michael Martin, Counsel INTRODUCTION The veteran had active service from April 1941 to November 1945, from April 1946 to August 1953, and from November 1953 to April 1957. He died on August [redacted], 1986. This matter came before the Board of Veteran’s Appeals (Board) on appeal from a decision of December 1990 by the Department of Veterans Affairs (VA) Boise, Idaho, Regional Office (RO). The appellant is the veteran’s surviving spouse. She seeks entitlement to dependency and indemnity compensation under 38 U.S.C.A. § 1318(b) (West 1991) on the basis of the veteran having been continuously rated as totally disabled for a period of 10 years or more immediately preceding death. The Board notes that the issues which were certified for appellate review were different from those set forth on the cover page of this decision. In light of the resolution of the a claim for dependency and indemnity compensation in favor of the appellant which is explained below, the Board finds that the issues which were originally certified for appellate review have become moot. CONTENTIONS OF APPELLANT ON APPEAL The appellant contends that the RO made a mistake by denying her claim for dependency and indemnity compensation. She asserts that the veteran should have been rated as totally disabling for at least 10 years preceding his death. DECISION OF THE BOARD The Board, in accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991 & Supp. 1995), has reviewed and considered all of the evidence and material of record in the veteran's claims file. Based on its review of the relevant evidence in this matter, and for the following reasons and bases, it is the decision of the Board that the evidence supports entitlement to service connection for alcoholism as being secondary to a service-connected anxiety reaction, and that the evidence supports entitlement to dependency and indemnity compensation. FINDINGS OF FACT 1. The veteran’s alcoholism was caused by his anxiety reaction. 2. The veteran was totally disabled for a period of 10 or more years immediately preceding his death. CONCLUSIONS OF LAW 1. The veteran’s alcoholism was proximately due to or the result of a service-connected disorder. 38 C.F.R. § 3.310 (1994). 2. The criteria for entitlement to dependency and indemnity compensation are met. 38 U.S.C.A. § 1318(b) (West 1991). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS Many of the facts in this case are not in dispute. As was noted above, the veteran died on August [redacted], 1986. During his lifetime, he established service connection for anxiety reaction. The veteran was assigned a temporary total disability rating pursuant to 38 C.F.R. § 4.29 effective from August 10, 1976, to January 1, 1977; a total rating based on individual unemployability effective from January 1, 1977, to January 1983, and a total rating under the schedular criteria from January 1983 until his death on August [redacted], 1986. Thus, the veteran died only a few days before the total disability rating would have been in effect for 10 years and, therefore, would have entitled the appellant to dependency and indemnity compensation under 38 U.S.C.A. § 1318(b) (West 1991). The record also shows that the veteran was frequently rated as totally disabled under 38 C.F.R. § 4.29 during periods prior to August 10, 1976. For example, in a rating decision of August 11, 1976, the RO assigned a total rating under 38 C.F.R. § 4.29 for the period from December 29, 1975, to July 1, 1976. A VA hospital discharge summary from the hospitalization upon which the that total rating was based shows that the veteran was admitted to the Sheridan, Wyoming, VA hospital on December 29, 1975, and was discharged on June 2, 1976. The record shows that the veteran came in primarily for treatment of nervousness and depression. He also complained of back problems and stated that he recently had been told that he had some crushed vertebrae. Alcoholism also reportedly had been a problem, and the veteran had been drinking up to a short time prior to admission. The veteran was described as being quite shaky. During the course of that hospitalization, the veteran reportedly was cooperative and attended to his detail. On June 2, 1976, it was determined that the veteran had received maximum hospital benefits. It was noted that the veteran planned to return to the Spokane, Washington, area. He was advised to receive medications and follow up care in the Spokane area if possible. The discharge diagnoses were (1) depression with anxiety with secondary alcoholism; (2) wedge and compression deformities of the spine associated with osteoporosis; and (3) a right hydrocele. Upon discharge on June 2, 1976, the veteran was described as being competent, but unemployable. The veteran was readmitted to the VA hospital in Sheridan on August 10, 1976. The summary shows that at the time of admission, the veteran described himself as being depressed and tense. He was not discharged until December 2, 1976. Upon discharge he was described as being marginally employable. The veteran was granted a total rating under 38 C.F.R. § 4.29 for both of these periods of hospitalization between December 1975 and December 1976. As previously noted, the total rating continued in one form or another from the time of the August 10, 1976, admission until his death. During the period between the two hospitalizations, the veteran was rated as 30 percent disabled, effective from July 1, 1976, to August 10, 1976. The Board finds that the diagnosis of “depression with anxiety with secondary alcoholism” included on the June 1976 VA hospital discharge summary gave rise to an informal claim for secondary service connection for alcoholism which has been pending and unresolved until now. The Board notes that service connection may be granted for disability shown to be proximately due to or the result of a service-connected disorder. See 38 C.F.R. § 3.310 (1994). This regulation has also been construed by to allow service connection for a disorder which is either caused or aggravated by a service- connected disorder. See Allen v. Brown, 7 Vet.App. 439 (1995). In order to resolve this secondary service connection issue, the Board referred the case to an independent medical expert for a medical opinion regarding the issue. A written medical opinion dated in August 1995 from Richard C. Shelton, M.D., an associate professor of psychiatry and pharmacology at Vanderbilt University, includes the following comments: In summary, [the veteran’s] service was 4/17/41 - 11/6/45; 4/25/46 - 8/25/46 - 8/20/53; and 11/5/53 - 4/17/57. He was in the army air corps. He was involved in several air accidents and apparently developed anxiety symptoms secondary to these events. He had multiple hospitalizations in a variety of veteran administration medical centers for anxiety and subsequent alcohol dependence. After a careful review of the medical record, I have determined that [the veteran] probably did not suffer from post-traumatic stress disorder. Rather, he had onset of severe anxiety during his period of service. This anxiety was consistent with either a generalized anxiety disorder or panic disorder. The documentation does not clarify this distinction adequately. In addition, [the veteran] experienced major depressive episodes. These occurred on more than one occasion. These depressions may have been exacerbated or precipitated by his co-existing alcohol abuse. The alcohol abuse dates back to 1945 and extended for a long period thereafter. After his discharge from the service, [the veteran] worked only briefly as a warehouseman and was otherwise unemployed. On different occasions in his medical record, it was noted that his alcohol abuse was secondary to his anxiety, with which I concur, and that he was unemployable. This unemployability was related to his underlying anxiety disorder primarily and not to the alcohol abuse. The latter was primarily in response to the anxiety and was an attempt at self medication. The medical management available to him through his life was not sufficient to reduce his symptoms adequately to allow him to return to full-time employment. I conclude with a reasonable degree of medical certainty that the evidence of record supports a medical conclusion that the veteran’s alcohol abuse was caused by his service-connected anxiety disorder. In addition, I believe that he was disabled from his anxiety from at least 1960 onward. Based on the foregoing evidence, the Board finds that the veteran’s alcoholism was caused by his anxiety reaction. Accordingly, the Board concludes that the veteran’s alcoholism was proximately due to or the result of a service- connected disorder. Taking into account the impairment attributable to the veteran’s alcoholism, along with the impairment attributable to his anxiety reaction, it is clear that the veteran was totally disabled by service-connected disorders for a period of 10 or more years immediately preceding his death. Again, the Board notes that the veteran was described as being unemployable upon discharge from the VA hospital in June 1976. In light of this, considering the pending claim for secondary service connection for alcoholism, a 100 percent rating, rather than a 30 percent rating, was warranted for the period from July 1, 1976, to August 10, 1976. Accordingly, the Board concludes that the criteria for entitlement to dependency and indemnity compensation under 38 U.S.C.A. § 1318(b) (West 1991) are met. ORDER Service connection for alcoholism, claimed as secondary to a service connected anxiety reaction, is granted. Dependency and indemnity compensation under 38 U.S.C.A. § 1318(b)(West 1991) is granted. CHARLES E. HOGEBOOM Member, Board of Veterans' Appeals The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, 741 (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West 1991 & Supp. 1995), a decision of the Board of Veterans' Appeals granting less than the complete benefit, or benefits, sought on appeal is appealable to the United States Court of Veterans Appeals within 120 days from the date of mailing of notice of the decision, provided that a Notice of Disagreement concerning an issue which was before the Board was filed with the agency of original jurisdiction on or after November 18, 1988. Veterans' Judicial Review Act, Pub. L. No. 100-687, § 402, 102 Stat. 4105, 4122 (1988). The date which appears on the face of this decision constitutes the date of mailing and the copy of this decision which you have received is your notice of the action taken on your appeal by the Board of Veterans' Appeals. - 9 -