Citation Nr: 0206409 Decision Date: 06/17/02 Archive Date: 06/27/02 DOCKET NO. 92-02 084 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Detroit, Michigan THE ISSUE 1. Entitlement to service connection for an acquired psychiatric disorder. 2. Entitlement to service connection for post-traumatic stress disorder (PTSD). REPRESENTATION Appellant represented by: Daniel G. Krasnegor, Attorney at Law ATTORNEY FOR THE BOARD S. J. Janec, Counsel INTRODUCTION The appellant performed active duty for training from December 1976 to July 1977. This matter originally came before the Board of Veterans' Appeals (Board) from a June 1990 rating decision of the Detroit, Michigan, Regional Office (RO) of the Department of Veterans Affairs (VA) that found that new and material evidence had not been submitted to reopen a claim for service connection for an acquired psychiatric disorder. In an October 1990 rating decision, the RO reopened the claim and denied service connection for an acquired psychiatric disorder on the merits. The appellant appealed this decision to the Board. In May 1992, the Board remanded the case for further development. After the requested development was accomplished, the RO continued the denial in a December 1993 rating decision. Subsequently, the veteran raised the issue of entitlement to service connection for PTSD. In August 1994, the Board again remanded the case to the RO for development of that issue. In July 1998, the RO denied service connection for an acquired psychiatric disorder, including PTSD. The case was then returned to the Board. In a May 1999 decision, the Board reopened the claim for service connection for an acquired psychiatric disorder, and then denied service connection for an acquired psychiatric disorder and PTSD. The appellant appealed this determination to the United States Court of Appeals for Veterans Claims (Court). While the case was pending, the parties filed a Joint Motion requesting that the Court vacate the part of the Board's decision that denied service connection for an acquired psychiatric disorder and PTSD, and remand the claim for further development and readjudication. In February 2000, the Court issued an Order that vacated the Board's May 1999 decision and remanded the case to the Board. In August 2000, the Board remanded the case to the RO for further action. The requested development has been accomplished and the case has been returned to the Board for appellate review. In letter dated February 28, 2002, the appellant's representative requested that the case be reviewed by a Decision Review Officer before it was referred to the Board. However, the Board points out that the February 15, 2002 Supplemental Statement of the Case was produced and signed by a Decision Review Officer. Consequently, further review is not required. Although PTSD is an acquired psychiatric disorder, the Board's reference to an acquired psychiatric disorder excludes PTSD, as a separate determination is being made herein regarding the claim to establish service connection for PTSD FINDINGS OF FACT 1. All relevant evidence necessary for an equitable disposition of the appellant's appeal has been obtained and the duty to assist has been met. 2. The appellant did not serve on active duty; he only served on active duty for training. 3. The appellant has not established service connection for a disability, and he has not achieved veteran status for the purpose of VA benefits. 4. The appellant was not disabled from a disease or injury incurred or aggravated in line of duty during his period of active duty for training. 5. The preponderance of the evidence is against a finding that the appellant was sexually harassed and/or assaulted during his period of active duty for training; he did not engage in combat with the enemy. 6. The appellant has not been diagnosed with PTSD based on a verified stressor. CONCLUSIONS OF LAW 1. An acquired psychiatric disorder was not incurred or aggravated in the line of duty during the appellant's active duty for training. 38 U.S.C.A. §§ 101, 1131, 5103A, 5107 (West 1991 & Supp. 2001); 38 C.F.R. § 3.303 (2001). 2. PTSD was not incurred or aggravated in the line of duty during the appellant's active duty for training. 38 U.S.C.A. §§ 101, 1131, 5103A, 5107 (West 1991 & Supp. 2001); 38 C.F.R. §§ 3.102, 3.304(f) (2001); 67 Fed. Reg. 10330-10332 (March 7, 2002) (to be codified at 38 C.F.R. § 3.304(f)(3)). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS I. Factual Background The appellant's service medical records include enlistment and separation examination reports, dated in December 1976 and July 1977, respectively, which show that he was clinically evaluated as psychiatrically normal. The remainder of the service medical records are silent as to complaints, treatment or a diagnosis involving a psychiatric disorder. He was seen for complaints of a cough and other cold-related symptoms. Medical evidence dated after the appellant's active duty for training period includes reports, dated in March 1978, which show that he was treated for complaints of depression that he reported began during his active duty for training after he was harassed, was the victim of a group conspiracy to kill him, and was approached to participate in homosexual activities. He asserted that upon his return home he had become withdrawn, slept poorly and would not bathe or groom himself. He further stated that he had tried to commit suicide, and that he had lost 20 pounds since his basic training. The provisional diagnosis included paranoid reaction and acute anxiety reaction, stress of separation from home and family. A June 1979 VA psychiatric examination report indicates that the appellant began receiving treatment at the mental hygiene clinic in February 1978, and that he was treated at three- month intervals. This treatment followed a nervous breakdown in January 1978, at which time he lost his job. The appellant reported that he was currently working at Detroit Steel. The examiner stated that the appellant's only current complaints involved nervousness. The diagnosis was schizophrenic reaction, chronic, in remission with chemotherapy. The claims file contains reports from Northville Regional Psychiatric Hospital (NRPH), dated between February 1981 and September 1988; the Detroit Receiving Hospital, dated in February 1981; Calhoun County Community Mental Health, dated in January 1993; and VA outpatient records, dated between April 1982 and March 1995. All these records show treatment for schizophrenia. However, the Calhoun County records include an October 1992 report which shows an Axis I diagnosis of PTSD with dissociative disorder and polysubstance abuse. The Axis IV diagnosis noted sexual abuse. The Calhoun County report shows that the appellant asserted that he had repeatedly been raped during his active duty for training. In a letter dated in August 1997, a VA physician stated that the appellant had been receiving treatment for a chronic schizophrenic illness since 1993. The physician related that the appellant had been sexually traumatized during service, and concluded that it was "almost impossible to determine at this point which came first, his mental illness or sexual trauma." He opined that the appellant's illness started when he was in service. An October 1997 VA mental disorders examination report shows that the examiner noted that the appellant's symptoms included complete auditory hallucinations and delusions of persecution. The Axis I diagnosis was schizophrenia, paranoid type. The examiner stated that the appellant did not meet the criteria for PTSD, explaining that PTSD was an anxiety disorder and that the appellant did not display hyperarousal. Records from the Social Security Administration (SSA), show that the appellant was determined to have been disabled as of February 1981 due to schizophrenia. The claims file includes several lay statements from the appellant's mother, dated between 1980 and 1997, as well as the lay statements of the appellant's family (in a joint letter), a co-worker, a neighbor and a long-time friend. These statements generally assert that the appellant's behavior changed upon his return from active duty for training, to include becoming shy and withdrawn. The appellant's mother, and the joint letter from the appellant's family, essentially allege that the appellant's schizophrenia and/or PTSD began during his active duty for training, and that they were the result of sexual assaults by homosexuals. In particular, in a March 1993 letter, the appellant's mother argued that that appellant was "repeatedly raped by homosexuals while he was stationed at Camp Pendleton." In September 2000, the RO wrote to the appellant requesting information regarding his claimed sexual harassment stressors in service in accordance with the Board's August 2000 remand. Another letter, sent in May 2001, included a copy of a form requesting information in support of a claim for service connection for PTSD asserted as secondary to personal assault. In a January 2002 letter, the appellant's representative related that the veteran was raped by other service members while on active duty for training. At the time, he was stationed at Camp Pendleton, California with H & S Co., 1st Tank Battalion, United States Marine Corps. Furthermore, the appellant did not have any additional evidence to support his contention regarding the rape. The representative also remarked that not all of the appellant's service medical records or personnel records were included in the file. However, the Board notes that, a response in February 2001 from the National Personnel Records Center (NPRC) indicated that the available records were retired and included with the appellant's file. A March 1978 consultation sheet shows a notation that there were "no other medical records on nerves" in the appellant's health records. II. Analysis A. Veterans Claims Assistance Act Initially, the Board notes that on November 9, 2000, the President signed into law the Veterans Claims Assistance Act of 2000 (VCAA), Pub. L. No. 106-475, 114 Stat. 2096, et seq. (2000) (codified at 38 U.S.C.A. §§ 5100, 5102, 5103, 5103A, 5106, 5107, 5126) (West Supp. 2001). Among other things, this law eliminated the concept of a well-grounded claim, and redefined the obligations of VA with respect to the duties to inform and assist. This change in the law is applicable to all claims filed on or after the date of enactment of the VCAA, or filed before the date of enactment and not yet final as of that date. 38 U.S.C.A. § 5107 note (West Supp. 2001); see also Holliday v. Principi, 14 Vet. App. 280 (2001). VA has issued regulations to implement the VCAA. See 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 newly enacted laws and regulations are more favorable to the appellant. See Karnas v. Derwinski, 1 Vet. App. 308, 313 (1991) (when a law or regulation changes after a claim has been filed or reopened but before the administrative or judicial appeal process has been concluded, the version more favorable to the appellant will apply). According to the VCAA, VA shall make reasonable efforts to assist a claimant in obtaining evidence necessary to substantiate the claim. In the case of a claim for disability compensation, the duty to assist also includes providing a medical examination or obtaining a medical opinion. 38 U.S.C.A. § 5103A(d)(1) (West Supp. 2001). Such an examination is necessary if there is competent medical evidence of a current disability and evidence that the disability may be associated with the claimant's active duty, but the record does not contain sufficient medical evidence for the Secretary to make a decision on the claim. 38 U.S.C.A. § 5103A(d)(2) (West Supp. 2001); 66 Fed. Reg. 45,620, 45,626 (Aug. 29, 2001) (to be codified at 38 C.F.R. § 3.159(c)(4)(i)). After reviewing the claims file, the Board finds that there has been substantial and sufficient compliance with the notice/assistance provisions of the new statute with regard to the issues before the Board. The evidence of record includes the appellant's service medical records, his post- service VA medical reports, reports of VA and private examinations, and statements from the appellant, members of his family, friends, and his representative. He was afforded a VA psychiatric examination in October 1997, and the Board finds that the record contains sufficient medical evidence upon which to make a decision on the claim. Furthermore, in a January 2002 letter, the appellant's representative stated that there was no additional evidence available. Accordingly, the Board finds that the record as it stands is complete and adequate for appellate review. Additionally, the appellant and his representative have been adequately notified of the applicable laws and regulations which set forth the criteria for entitlement to the benefits sought. The Board concludes that the discussions in the rating decisions, statement of the case, supplemental statements of the case, prior Board remands and decisions, and the RO's letters to the appellant throughout the process have informed him and his representative of the information and evidence necessary to warrant entitlement to the benefits sought. Hence, there has been compliance with VA's notification requirements under the VCAA. Under the circumstances of this case, a remand would serve no useful purpose. See Soyini v. Derwinski, 1 Vet. App. 540, 546 (l99l) (strict adherence to requirements in the law does not dictate an unquestioning, blind adherence in the face of overwhelming evidence in support of the result in a particular case; such adherence would result in unnecessarily imposing additional burdens on VA with no benefit flowing to the claimant); Sabonis v. Brown, 6 Vet. App. 426, 430 (1994) (remands which would only result in unnecessarily imposing additional burdens on VA with no benefit flowing to the claimant are to be avoided). B. Service Connection Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active military service. 38 U.S.C.A. § 1131 (West Supp. 2001); 38 C.F.R. § 3.303(a) (2001). If a condition noted during service is not shown to be chronic, then generally a showing of continuity of symptoms after service is required for service connection. 38 C.F.R. § 3.303(b) (2001). Service connection may also be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d) (2001). To establish service connection for a disability, a claimant must submit (1) medical evidence of a current disability, (2) medical evidence, or in certain circumstances lay testimony, of in-service incurrence or aggravation of an injury or disease, and (3) medical evidence of a nexus between the current disability and the in-service disease or injury. Pond v. West, 12 Vet. App. 341, 346 (1999). Where the determinative issue involves a medical diagnosis, competent medical evidence is required. This burden may not be met by lay testimony because lay persons are not competent to offer medical opinions. Espiritu v. Derwinski, 2 Vet. App. 492, 494-95 (1992). The Board is charged with the duty to assess the credibility and weight given to the evidence. Evans v. West, 12 Vet. App. 22, 30 (1998); Wood v. Derwinski, 1 Vet. App. 190, 193 (1991). The probative value of a physician's statement is dependent, in part, upon the extent to which it reflects "clinical data or other rationale to support his opinion." Bloom v. West, 12 Vet. App. 185, 187 (1999). If all the evidence is in relative equipoise, the benefit of the doubt should be resolved in the appellant's favor, and the claim should be granted. 38 U.S.C.A. § 5107(b) (West 1991 & Supp. 2001); 38 C.F.R. § 3.102 (2001). However, if the preponderance of the evidence is against the claim, the claim must be denied. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Acquired Psychiatric Disorder The appellant was first diagnosed with acute anxiety disorder with paranoid reaction in March 1978. When a veteran has active service for 90 days or more during a period of war or after December 31, 1946, and certain chronic diseases, including schizophrenia, are manifest to a compensable degree within one year after the veteran's discharge from such service, service incurrence for that disease will be presumed. 38 U.S.C.A. §§ 1101, 1112, 1137 (West 1991); 38 C.F.R. § 3.309(a) (2001). The applicability of this presumption is determined by three distinct criteria: whether the claimant is a veteran; whether the claimant served in the active military, naval, or air service; and whether such service was for ninety days or more during a period of war or after December 31, 1946. Biggins v. Derwinski, 1 Vet. App. 474, 477 (1991). The term "veteran" means a person who served in the active military, naval, or air service, and who was discharged or released therefrom under conditions other than dishonorable. 38 U.S.C.A. § 101(2) (West 1991); 38 C.F.R. § 3.1(d) (2001). The term "active military, naval, or air service" includes active duty, any period of active duty for training during which the individual concerned was disabled or died from a disease or injury incurred or aggravated in line of duty, and any period of inactive duty training during which the individual concerned was disabled or died from an injury incurred or aggravated in line of duty. 38 U.S.C.A. § 101(24) (West 1991); see also 38 C.F.R. § 3.6(a) (2001). Consequently, when a claim is based solely on a period of active duty for training, the appellant must establish that he was disabled from a disease or injury incurred or aggravated in the line of duty in order to establish basic eligibility for veterans benefits. 38 U.S.C.A §§ 101(2) (West 1991); Mercado-Martinez v. West, 11 Vet. App. 415, 419 (1998). See also, Paulson v. Brown, 7 Vet. App. 466, 470 (1995) ("an individual who has served only on active duty for training must establish a service-connected disability in order to achieve veteran status.") The appellant's DD Form 214 reflects that he served for more than 90 days after December 31, 1946. However, he only served on active duty for training and he was not disabled from a disease or injury incurred in or aggravated in the line of duty during that period of active duty for training. In fact, his separation examination does not document any disabling diseases or injuries that were incurred in or aggravated in the line of duty and he has not established service connection for any disability. Therefore, he has not achieved veteran status because he has not met the "active military, naval, or air service" requirement of 38 U.S.C.A. § 1137. Accordingly, he is not entitled to the benefit provided by the presumptive provisions for service connection for schizophrenia. The appellant's representative has argued that service connection for an acquired psychiatric disorder should be granted on a direct basis in accordance with 38 U.S.C.A. § 1131, and 38 C.F.R. §§ 3.303(a) and (d) based on a finding that the disorder resulted from the appellant's sexual trauma during his period of active duty for training. In support of this argument, he points to an August 1997 letter from a VA physician that acknowledges the appellant's history of sexual assault, and concludes that his psychiatric disability began when he was on active duty for training. The Board disagrees. The critical point here is that the physician accepted the appellant's allegations of sexual trauma as fact despite a lack of evidence in the record to support those assertions. The appellant has repeatedly changed significant details of his alleged sexual assaults. For example, in a March 1978 treatment report, the appellant stated that he had only been "approached" by homosexuals. In a June 1979 VA examination report, he stated that two verbal "passes" had been made at him from homosexuals, and that this had bothered him. Similar statements were made during the appellant's period of hospitalizations during the 1980's. He also believed the devil was in him and spoke to him. Subsequently, in a March 1993 letter (written on behalf of the appellant by his mother, his legal guardian), the appellant asserted that he had been "repeatedly raped by homosexuals while at Camp Pendleton." In an October 1994 letter, it was reported that the appellant was "raped and assaulted every day." Similar assertions of rape or sexual assault are found in oral histories supplied by the appellant and/or his family members in VA and non-VA medical reports. However, there is no independent evidence in the record that supports the occurrence of any of the claimed incidents. The statements from the appellant's family members reflect only a recitation of what the appellant told them. Furthermore, it is noteworthy that, in the June 1979 VA psychiatric examination report, the treating physician stated that "there was definite paranoid thinking, especially (sic) in the area of homosexual thinking." It was also reported that as the appellant described the homosexual episodes, "there [was] a definite paranoid tendency." Consequently, in light of the appellant's mental status, which is well-documented by the medical evidence, as well as the inconsistencies found in the statements made by both the appellant and his family members, the Board finds that his allegations of sexual assault and trauma during his period of active duty for training are not credible. The VA physician has not addressed the appellant's diagnosis of paranoid schizophrenia and did not attempt to lend credence to his assertions of sexual assault by discussing any factual information available that would distinguish these events from the other hallucinations and delusions expressed by the appellant that have been documented in the record. Hence, the Board finds that the probative value of the physician's opinion is outweighed by contrary evidence of record; and the opinion is insufficient to establish service connection pursuant to 38 C.F.R. § 3.303(a). See Kightly v. Brown, 6 Vet. App. 200, 205-06 (1994) (finding that presumption of credibility of evidence did not arise as to medical opinion that veteran's disability was incurred in service because it was based on an inaccurate history); Bloom, supra. More significantly, the physician's statement that "it is clear that all things started when [the appellant] was in service" is not supported by the contemporaneous evidence contained in the file. As outlined above, the service medical records do not indicate that the appellant was seen for any complaints of mental problems, and do not reflect that he was diagnosed with a psychiatric disorder during his period of active duty for training. The first medical evidence documenting treatment for an acquired psychiatric disorder was a medical record dated in March 1978 - seven months after his release from his period of active duty for training - when he was seen for complaints of depression and an acute anxiety reaction. Furthermore, his allegations regarding sexual trauma during his period of active duty for training have not been substantiated. Consequently, there is no basis in the record to support the physician's conclusion that the appellant's acquired psychiatric disorder began in, or is otherwise related to an incident that occurred during, his period of active duty for training; and it may not be concluded that the evidence, including that pertinent to service, establishes that the appellant's psychiatric disorder was incurred in service as required by 38 C.F.R. § 3.303(d). Finally, without evidence of a chronic disease in service, i.e., during the appellant's period of active duty for training, the chronicity provisions found in 38 C.F.R. § 3.303(b) are inapplicable. The appellant's representative has also argued that the appellant continued to have periods of duty with the Marine Corps after July 1977 and it is unclear from the personnel records why he was discharged at that time. The appellant's DD Form 214 clearly shows that he was released from his period of active duty for training in July 1977. Although it was noted that it was not a final discharge, his personnel records do not show that he had any further periods of active duty, inactive duty training, or active duty for training. The final entry, dated in March 1982, reflects that the appellant was deemed not physically qualified for further service due to a depressive reaction. Clearly, had the appellant been disabled during his period of active duty for training, a finding of being not physically qualified for further service would have been made much earlier than that date. Furthermore, the representative has not presented any credible evidence to support his assertion that the service personnel records are inaccurate or incomplete. As discussed above, the standard for establishing service connection for a disability based only on a period of active duty for training is more stringent that that required for service connection for a disability incurred during active duty. However, the evidence does not show that the appellant was disabled by a disease or injury during his period of active duty for training, his statements alleging sexual trauma are not credible, and he has not established service connection for any other disability that would accord him veteran status and allow him the benefit of the presumptive provisions. See Biggins v. Derwinski at 478. The Board concedes that the appellant is currently disabled from schizophrenia as found by the Social Security Administration. Although the appellant may have met his burden for being awarded Social Security disability benefits, he has not met the evidentiary burden required to be granted service connection benefits. The Board concludes that the preponderance of the evidence is against the appellant's claim, and the benefit of the doubt rule is inapplicable. Accordingly, service connection for an acquired psychiatric disorder is denied. PTSD Service connection for PTSD requires medical evidence establishing a diagnosis of the condition, credible supporting evidence that the claimed in-service stressors actually occurred, and a link, established by medical evidence, between the current symptomatology and the claimed in-service stressors. 38 C.F.R. § 3.304(f) (2001); Cohen v. Brown, 10 Vet. App. 128 (1997). The Court of Appeals for Veterans Claims has emphasized that - "eligibility for a PTSD service-connection award requires" . . . specifically, "(1) [a] current . . . medical diagnosis of PTSD . . . ; (2) credible supporting evidence that the claimed in-service stressor actually occurred; and (3) medical evidence of a causal nexus between current symptomatology and the specific claimed in-service stressor." Gaines v. West, 11 Vet. App. 353, 357 (1998), citing Cohen, supra, and Suozzi v. Brown, 10 Vet. App. 307 (1997) (emphasis in original). If the claimant did not engage in combat with the enemy, or the claimed stressors are not related to combat, then the claimant's testimony alone is not sufficient to establish the occurrence of the claimed stressors, and his testimony must be corroborated by credible supporting evidence. Cohen, supra; Moreau v. Brown, 9 Vet. App. 389 (1996); Dizoglio v. Brown, 9 Vet. App. 163 (1996); West v. Brown, 7 Vet. App. 70, 76 (1994). The question of whether the veteran was exposed to a stressor in service is a factual one, and VA adjudicators are not bound to accept uncorroborated accounts of stressors or medical opinions based upon such accounts. Wood v. Derwinski, 1 Vet. App. 190 (1991), aff'd on reconsideration, 1 Vet. App. 406 (1991); Wilson v. Derwinski, 2 Vet. App. 614 (1992). In sum, whether the evidence establishes the occurrence of stressors is a question of fact for adjudicators, and whether any stressors that occurred were of sufficient gravity to cause or to support a diagnosis of PTSD is a question of fact for medical professionals. Cohen, supra. The appellant's principal claimed stressor is that he was sexually assaulted during his period of active duty for training. In this regard, the Court has noted that in claims for service connection for PTSD based on personal assault, VA has established special procedures for evidentiary development. Patton v. West, 12 Vet. App. 272, 277 (1999). These procedures, which became effective in February 1996, take into account the fact that since personal assault is an extremely sensitive issue, many incidents of personal assault are not officially reported, and victims of this type of in- service trauma may find it difficult to produce evidence to support the occurrence of the stressor. These procedures thus acknowledge the difficulty claimants face in establishing the occurrence of the stressor through standard evidence, and the need for development of alternate sources of evidence. See VA Adjudication Procedure Manual M21-1 (hereinafter M21-1), Part III, paragraph 5.14c (Feb. 20, 1996) (substantially enlarging on the former Manual M21-1, Part III, paragraph 7.47c(2) (Oct. 11, 1995)). Alternate sources that may provide credible evidence of an in-service personal assault include medical or counseling treatment records following the incident, military or civilian police reports, reports from crisis intervention or other emergency centers, statements from confidants or family, copies of diaries or journals, or behavior changes documented or observed at the time of the incident, such as obsessive behavior at the time of the incident, pregnancy tests, increased interest in test for sexually transmitted diseases, termination of primary relationships, or alcohol and drug abuse. Evidence that documents any such behavioral changes may require interpretation by a VA neuropsychiatric physician to determine whether such evidence bears a relationship to the medical diagnoses. See M21-1, Part III, para. 5.14(c)(9). Furthermore, these provisions recognize that the standard PTSD stressor letter may be inappropriate for this type of PTSD claim, and thus state that if the claimed stressful incident is a personal assault, a stressor development letter specifically tailored for personal assault cases should be sent to such veterans. See M21-1, Part III, para. 5.14(c)(6). In addition, the Court in Patton stated that in two places M21-1, Part III, para. 5.14(c)(3) and (9), appeared improperly to require that the existence of an in-service stressor be shown by "the preponderance of the evidence" and held that any such requirement was inconsistent with the benefit of the doubt doctrine found in 38 U.S.C. § 5107(b). Therefore the evidence need only be in relative equipoise to prevail on the question of the existence of the stressor. In addition, effective March 7, 2002, VA amended the regulations concerning the evidence necessary to establish the occurrence of a stressor in claims for service connection for PTSD resulting from personal assault. These new regulations partially divided and expanded 38 C.F.R. § 3.304(f), and require that VA not deny such claims without: (1) first advising claimants that evidence from sources other than a claimant's service medical records, including evidence of behavior changes, may constitute supporting evidence of the stressor; and (2) allowing him or her the opportunity to furnish this type of evidence or advise VA of potential sources of such evidence. 67 Fed. Reg. 10330-32 (March 7, 2002) (to be codified at 38 C.F.R. § 3.304(f)(3)) . Specifically, this regulation provides the following guidance: If a post-traumatic stress disorder claim is based on in-service personal assault, evidence from sources other than the veteran's service records may corroborate the veteran's account of the stressor incident. Examples of such evidence include, but are not limited to: records from law enforcement authorities, rape crisis centers, mental health counseling centers, hospitals, or physicians; pregnancy tests or tests for sexually transmitted diseases; and statements from family members, roommates, fellow service members, or clergy. Evidence of behavior changes following the claimed assault is one type of relevant evidence that may be found in these sources. Examples of behavior changes that may constitute credible evidence of the stressor include, but are not limited to: a request for a transfer to another military duty assignment; deterioration in work performance; substance abuse; episodes of depression, panic attacks, or anxiety without an identifiable cause; or unexplained economic or social behavior changes. VA will not deny a post- traumatic stress disorder claim that is based on in-service personal assault without first advising the claimant that evidence from sources other than the veteran's service records or evidence of behavior changes may constitute credible supporting evidence of the stressor and allowing him or her the opportunity to furnish this type of evidence or advise VA of potential sources of such evidence. VA may submit any evidence that it receives to an appropriate medical or mental health professional for an opinion as to whether it indicates that a personal assault occurred. 67 Fed. Reg. 10330-32 (March 7, 2002) (to be codified at 38 C.F.R. § 3.304(f)(3)). The veteran has not contended that he engaged in combat with the enemy; his service separation form does not reflect that he had any foreign service; and the Board specifically finds herein that he did not engage in combat with the enemy. Service personnel records and service medical records do not document any evidence that supports the appellant's claimed stressors. The appellant and his representative were advised to submit corroborating evidence regarding his claimed sexual harassment and/or assaults, and he was sent the appropriate forms for reporting this information in accordance with VA provisions and current case law. The record discloses that the appellant first began to report the alleged homosexual incidents in March 1978, when he was diagnosed with paranoid reaction. As discussed above, the appellant's initial statements assert that advances or passes were made. In subsequent years, the allegations escalated and included assertions that he was gang raped and/or raped repeatedly. The appellant's mother and other family members have provided statements that reiterate his allegations. However, the medical evidence shows that the appellant was diagnosed with paranoid schizophrenia, and the allegations of sexual assault were not deemed credible at the time they were made. Again, the Board points out that the June 1979 examination report reflects that the treating physicians concluded that there was definite paranoid thinking in relation to the homosexual episodes. Furthermore, the record is void of medical or counseling records which document treatment directly related to the incident(s), military or civilian police reports, or reports from crisis intervention or other emergency centers. The Board acknowledges that the appellant's family related that his behavior changed dramatically after his period of active duty for training, and that such evidence may be accepted as corroborating a claimed assault. However, in light of the appellant's mental status, the Board finds that these statements alone without other independent evidence of the assaults, does not meet the threshold requirement to establish the occurrence of the stressor. The Board concludes that the appellant's claimed in-service sexual assault stressors may not be accepted as fact. Accordingly, any diagnoses of PTSD based on this reported history would be lacking probative value and rendered insufficient to support an award of service connection. Furthermore, upon a VA examination in October 1997, the examiner stated that the appellant did not meet the criteria for a diagnosis of PTSD. He was diagnosed with schizophrenia with auditory hallucinations and delusions of persecution. Without a diagnosis of PTSD based on a verified stressor, service connection for that disorder may not be granted. Cohen, supra. Consequently, service connection for PTSD is denied. ORDER Service connection for an acquired psychiatric disorder is denied. Service connection for PTSD is denied. BARBARA B. COPELAND 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.