Citation Nr: 0303172 Decision Date: 02/24/03 Archive Date: 03/05/03 DOCKET NO. 99-09 997 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Seattle, Washington THE ISSUE Entitlement to service connection for post-traumatic stress disorder (PTSD). REPRESENTATION Appellant represented by: AMVETS WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD T. Hal Smith, Counsel INTRODUCTION The veteran served on active duty from February 1974 to February 1978. The current appeal arose from a November 1996 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Seattle, Washington. FINDING OF FACT The veteran did not engage in combat with the enemy, and there is no credible evidence corroborating any of the veteran's alleged in-service stressors. CONCLUSION OF LAW PTSD was not incurred in or aggravated by the veteran's military service. 38 U.S.C.A. §§ 1110, 1131 (West 1991 & Supp. 2002); 38 C.F.R. § 3.304(f) (2002). REASONS AND BASES FOR FINDINGS AND CONCLUSION The veteran is seeking entitlement to service connection for PTSD. In the interest of clarity, the Board will summarize the relevant factual background and list the pertinent laws and regulations. The final part of this decision will be an analysis of all of the above. Factual Background Service records reflect that the veteran's military occupational specialty was motor vehicle operator. He was not awarded any citations or medals specifically indicative of combat. He participated in operation "Frequent Wind" in the contiguous waters of Vietnam on April 28 and 29, 1975. His personnel records indicate that the veteran was on unauthorized absence from April 8, 1975, to April 9, 1985, July 9, 1975, to July 25, 1975, and from September 20, 1977, to September 21, 1977. He was a prisoner on July 26, 1975, and counseled on numerous occasions, to include in July 1974, May 1975, December 1976, and October 1977. Counseling was provided in May 1975 because he was not recommended for promotion due to recent involvement resulting in nonjudicial punishment. In June 1975 he was counseled concerning the reason he was not selected for lance corporal. In December 1975 he was counseled that his frequent involvement of a discreditable nature with civil or military authorities could lead to administrative discharge under other than honorable conditions. Subsequent counseling is documented. Treatment records during these time frames do not reflect treatment for injuries. They do show that he received treatment for a fungal rash in his groin area beginning in August 1975 when he gave a history of symptoms for two months. A syphilis record dated in December 1975 showed a diagnosis of secondary syphilis with date of onset in October 1975. He received treatment for alcoholism in 1977. In February 1977 he reported that he had been drinking for 6 years and had been drinking heavily for the last 3 years. In March 1977 it was reported that he was still a private due to drinking problems and that he had been drinking throughout his active duty time. The veteran's personnel records confirm various disciplinary actions, but there is no reference to a kidnapping incident. The veteran underwent VA general medical examination in September 1996. At that time he reported that in service he dealt with refugees from Saigon and he had an NCO Mike who was in charge of the motor pool. He was essentially kidnapped by the NCO and taken to a small island in the Subic Bay. They spent 17 days there, having apparent close contact with the natives, among whom syphilis was a contractible, infectious disease. When they returned, they were placed in solitary confinement. The veteran felt the authorities recognized that the NCO was primarily responsible and therefore he received relatively light punishment. He saw a psychologist because they were accused of cannibalism and the NCO physically assaulted the veteran because he believed he had told others that he was guilty of cannibalism. He was subsequently treated for syphilis. On a social and industrial survey conducted in September 1996 the veteran reported that while on the USS Frederick, his sergeant, named Mike, was a "psycho" and threatened him repeatedly. One night at 2:00 a.m. the sergeant woke him and stuffed him under the cargo of a truck. In the morning the truck was driven eventually to land; he was forced to march for 2 days; and he was then transported by a Philippine civilian boat to a bamboo shack in a primitive village. He was held in the village for 17 days and was eventually returned by civilian boat and arrested by shore patrol. The sergeant was apparently also put in the brig but when he got out, he severely assaulted the veteran because the veteran told the story of what happened to the authorities. The kidnapping also involved the driver of the truck, another sailor, J.B., who was also a kidnap victim. After that incident the veteran was constantly in trouble with the authorities due to alcoholism. He denied any postservice inpatient or outpatient psychiatric care or treatment. On VA psychiatric examination in September 1996 the veteran reported that in service he had an NCOIC, a sergeant named Mike, who intimidated him. The sergeant ordered him to get in the back of a truck, and he was covered with ammo nets. He nearly suffocated and feared for his life. Later the trucks were driven off the ship and he was taken in small boats to an isolated island where he and a few others participated in extremely rigorous training exercises for 17 days. They returned and he was charged with missing ship's movement and unauthorized absence and was given office hours. The sergeant was also disciplined but continued in his unusual behavior. After the veteran's office hours, the sergeant also beat him severely about the head and face, resulting in 2 black eyes. The veteran did not report the incident because he feared for his life. After the incident his performance declined. He stated that his drinking escalated and he began smoking marijuana. He was seen twice by a psychiatrist but was offered no treatment. He received alcohol rehabilitation treatment in 1977. Postservice he received some counseling while homeless in 1987. Following examination, the examining physician diagnosed PTSD. The examiner added that the veteran's history appeared to be believable. At a personal hearing in March 2000, the veteran testified in support of his claim for service connection for PTSD. He added additional details as to the kidnapping incident. For example, he stated that he was stationed aboard the USS Frederick or Frederickson and also aboard the USS Duluth. He said that in early 1975 he was threatened and harassed by his NCO for a period of several months or so, and that in July 1975 that the NCO forced him and another soldier from the ship, bringing them via truck and boat to a small island in the Subic Bay. The veteran said that the NCO forced them to march for two days before being transported by a civilian boat to a bamboo shack in a primitive village where the natives lived. He said that he was in captivity in that village for approximately 17 days. The veteran provided the names of both the NCO, M.R., and the other individual with whom he was kidnapped, J.B. The veteran added that he turned himself in upon release and that he bore visible signs of abuse such as a black eye, etc. He further argued that it was traumatic returning to service duties and hearing stories about cannibalism, etc., attributed to him and his NCO. He indicated that his NCO was placed in the brig upon return to military custody. The veteran further stated that subsequent to the incident he used alcohol and his service performance declined. In February 2001, the Board remanded the case for additional evidentiary development to include additional attempt to secure the veteran's service personnel records. An attempt was to be made to further develop the veteran's contentions regarding the reported in-service kidnapping and physical abuse. Subsequent to this remand, the veteran was requested to furnish additional details and/or medical evidence, but no additional evidence or information was forthcoming. Additional service personnel records were added to the claims file in July 2001. (All service personnel records have been summarized above.) Pertinent Laws and Regulations By law, the Board's statement of reasons and bases for its findings and conclusions on all material facts and law presented on the record must be sufficient to enable the claimant to understand the precise basis for the Board's decision, as well as to facilitate review of the decision by courts of competent appellate jurisdiction. The Board must also consider all applicable statutory and regulatory law, as well as the controlling decisions of the appellate courts. See Vargas-Gonzalez v. West, 12 Vet. App. 321, 328 (1999); Gilbert v. Derwinski, 1 Vet. App. 49, 56-57 (1990); 38 U.S.C.A. § 7104(d)(1) (West 1991). Service connection - in general According to applicable law and regulations, service connection may be granted for disability resulting from a disease or injury incurred in or aggravated by military service. 38 U.S.C.A. § 1110, 1131 (West Supp. 2002); 38 C.F.R. § 3.303 (2002). The resolution of this issue must be considered on the basis of the places, types and circumstances of his service as shown by service records, the official history of each organization in which the claimant served, his medical records and all pertinent medical and lay evidence. Determinations relative to service connection will be based on review of the entire evidence of record. 38 U.S.C.A. § 7104(a) (West Supp. 2002); 38 C.F.R. § 3.303(a) (2002); see Wilson v. Derwinski, 2 Vet. App. 16, 19 (1991). Notwithstanding the lack of a diagnosis of a disability during service, service connection may still be granted if all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 U.S.C.A. § 1113(b) (West Supp. 2002); 38 C.F.R. § 3.303(d) (2002); Cosman v. Principi, 3 Vet. App. 503, 505 (1992). Service connection - 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). With regard to the second PTSD criterion, evidence of in- service stressors, the evidence necessary to establish that the claimed stressor actually occurred varies depending on whether it can be determined that the veteran "engaged in combat with the enemy." 38 U.S.C.A. § 1154(b) (West 1991); 38 C.F.R. § 3.304(d) (2002). 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 C.F.R. § 3.304(f)(1) (2002). Service department evidence that the veteran engaged in combat or that the veteran was awarded the Purple Heart, Combat Infantryman Badge, or similar combat citation will be accepted, in the absence of evidence to the contrary, as evidence of the claimed in-service combat stressor. 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. 38 C.F.R. § 3.304(f)(3) (2002). 38 U.S.C.A. § 1154 requires that the veteran have actually participated in combat with the enemy, meaning participated in events constituting an actual fight or encounter with a military foe or hostile unit or instrumentality, and does not apply to veterans who served in a general "combat area" or "combat zone" but did not themselves engage in combat with the enemy. See VAOPGCPREC 12-99 (October 18, 1999). Where a determination is made that the veteran did not "engage in combat with the enemy," or the claimed stressor is not related to combat, the veteran's lay testimony alone will not be enough to establish the occurrence of the alleged stressor. See Moreau v. Brown, 9 Vet. App. 389, 395 (1996); Dizoglio v. Brown, 9 Vet. App. 163, 166 (1996). In such cases, the record must contain service records or other corroborative evidence which substantiates or verifies the veteran's testimony or statements as to the occurrence of the claimed stressor. See West (Carlton) v. Brown, 7 Vet. App. 70, 76 (1994); Zarycki v. Brown, 6 Vet. App. 91, 98 (1993). Moreover, a medical opinion diagnosing PTSD does not suffice to verify the occurrence of the claimed in-service stressors. See Moreau v. Brown, 9 Vet. App. 389, 395-396 (1996); Cohen v. Brown, 10 Vet. App. 128, 142 (1997). The Board notes that the RO has not adjudicated the appellant's claim for PTSD under the March 1997 revised version of section 3.304(f). The Board concludes that its initial consideration of the amended regulations would not prejudice the appellant in this instance because the substance of the previous 38 C.F.R. § 3.304(f) has not been significantly altered in terms of the three basic requirements for service connection of PTSD. See 38 C.F.R. § 3.304(f) (2002); Notice, 64 Fed. Reg. 32,807-08 (June 18, 1999). Prior to March 7, 1997, 38 C.F.R. § 3.304(f) required a "clear" diagnosis of PTSD. See 38 C.F.R. § 3.304(f) (1996). Under the new regulation, the three requirements remain essentially unchanged. It still requires medical evidence of a current diagnosis, a medical link between current symptoms and an in-service stressor, and credible supporting evidence that the claimed in-service stressor occurred. See 38 C.F.R. § 3.304(f) (2002); Bernard v Brown, 4 Vet. App. 384 (1993). Furthermore, the VA regulation was changed in June 1999 to conform to the CAVC's determination in Cohen v. Brown, 10 Vet. App. 128 (1997). As the Cohen determination was in effect when the RO reviewed this case, the Board finds no prejudice to the appellant in proceeding with this case at this time. See Bernard v. Brown, supra. The Board also notes that 38 C.F.R. § 3.304(f)(3) was amended effective March 7, 2002, to provide that evidence other than service records may corroborate the occurrence of a stressor and that VA may not deny PTSD claims based on personal assault without first advising claimants that evidence from sources other than the veteran's service records may help prove the stressor occurred. 67 Fed. Reg. 10330-10332 (March 7, 2002). It appears that the RO has not reviewed the claim under the amended regulation. However, the RO did consider the veteran's claim under the provisions of M21-1, Part III, 5.14(c) which provided that alternate sources of information should be developed in personal assault claims. Substantively, the amended regulation is essentially similar to the M21-1 provisions, and the Board concludes that the RO's consideration of this claim under the M21-1 satisfies the provisions of the amended regulation. The duty to notify the veteran of potential alternate sources for corroborating his claimed stressor will be discussed below. Standard of review Once the evidence has been assembled, it is the Board's responsibility to evaluate the record on appeal. 38 U.S.C.A. § 7104 (West 1991 and Supp. 2002). When there is an approximate balance of evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C.A. § 5107(b) (West Supp. 2002); 38 C.F.R. §§ 3.102, 4.3 (2002). In Gilbert, supra, the Court stated that "a veteran need only demonstrate that there is an 'approximate balance of positive and negative evidence' in order to prevail." To deny a claim on its merits, the evidence must preponderate against the claim. Alemany v. Brown, 9 Vet. App. 518, 519 (1996), citing Gilbert, 1 Vet. App. at 54. In evaluating the evidence and rendering a decision on the merits, the Board is required to assess the credibility, and therefore the probative value, of proffered evidence in the context of the record as a whole. See Madden v. Gober, 125 F. 3d 1477, 1481 (Fed. Cir. 1997). Analysis Duty to Assist The Board initially notes that there has been a significant change in the law during the pendency of this appeal. On November 9, 2000, the President signed into law the Veterans Claims Assistance Act of 2000 (VCAA), Pub. L. 106-475, § 7(b), 114 Stat. 2096, 2099-2100 (2000), 38 U.S.C.A. §§ 5100 et seq. (West Supp. 2002). Among other things, this law eliminates the concept of a well-grounded claim and supersedes the decision of the CAVC in Morton v. West, 12 Vet. App. 477 (1999), withdrawn sub nom. Morton v. Gober, 14 Vet. App. 174 (2000) (per curiam order), which held that VA cannot assist in the development of a claim that is not well grounded. 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. VCAA, Pub. L. No. 106-475, § 7(b), 114 Stat. 2096, 2099-2100 (2000). 38 U.S.C.A. § 5107 note (Effective and Applicability Provisions); see generally Holliday v. Principi, 14 Vet. App. 280 (2001); see also Karnas v. Derwinski, 1 Vet. App. 308 (1991). On August 29, 2001, the final regulations implementing the VCAA were published in the Federal Register. The portion of these regulations pertaining to the duty to notify and the duty to assist are also effective as of the date of the enactment of the VCAA, November 9, 2000. 66 Fed. Reg. 45, 620, 45, 630-45, 632 (August 29, 2001) (codified at 38 C.F.R. § 3.159). Where the law and regulations change while a case is pending, the version more favorable to the appellant applies, absent congressional intent to the contrary. Karnas v. Derwinski, 1 Vet. App. 308, 312-313 (1991). The Board is of the opinion that the new duty to assist law has expanded VA's duty to assist (e.g., by providing specific and expanded provisions pertaining to the duty to notify), and is therefore more favorable to the veteran. Therefore, the amended duty to assist law applies. Id. In the case at hand, the Board is satisfied that the duty to notify and the duty to assist have been met under the new law. The duty to notify has been satisfied as the veteran has been provided with notice of what is required to substantiate his claim. The RO, through its issuance of its rating decisions, March 1997 statement of the case, April 1999 and July 2002 supplemental statements of the case, and associated correspondence, and more recently dated correspondence after the Board's February 2001 remand of the case, has given the veteran notice of the information and evidence necessary to substantiate his claim. That is, he was provided with notice of the regulations pertaining to service connection for the disability at issue, a rationale of the denial, and he was notified of his appellate rights. In correspondence dated in April 2001, the provisions and requirements of the VCAA of 2000 were discussed. 38 U.S.C.A. § 5103 (West Supp. 2002); 38 C.F.R. § 3.159. As is discussed elsewhere in this decision, the outcome of this issue hinges on the existence of stressors. The veteran has been given the opportunity to describe his stressors and he has indeed done so, most recently at a personal hearing in March 2000. The veteran's contentions with respect to PTSD involve the matter of alleged harassment and personal attack of the veteran by a superior. The Board notes that, in Patton v. West, 12 Vet. App. 272 (1999), the United States Court of Appeals for Veterans Claims (CAVC) held that special consideration must be given to claims for PTSD based on assault. In particular, the CAVC held that the provisions in M21-1, Part III, 5.14(c), which address PTSD claims based on personal assault are substantive rules which are the equivalent of VA regulations and must be considered. See also YR v. West, 11 Vet. App. 393, 398-99 (1998). Paragraph 5.14c states that, in cases of personal assault, development to alternate sources for information is critical. There is provided an extensive list of alternative sources competent to provide credible evidence that may support the conclusion that the event occurred, to include medical records, military or civilian police reports, reports from crisis intervention centers, testimonial statements from confidants, and copies of personal diaries or journals. See M21-1, Part III, 5.14(c)(8). With regard to notifying the veteran of the evidence Under the amended regulation, 38 C.F.R. § 3.304(f), the veteran must be notified that alternative sources of information may support his claim. By letter of March 1997 the veteran was asked to identify any sources (military or non-military) that might provide information concerning the incident and that the RO would assist him in getting information concerning knowledge of the incident if he furnished the name and address of any roommate, family member, chaplain, clergy or fellow service person in whom he confided. There was no response to this request. The Board's February 2001 remand also advised him of the alternate sources of information delineated in the M21-1 manual and listed the various examples of behavior changes that might indicate a stressor. The veteran was thereafter notified by VA in a letter in April 2001 that he could obtain alternative sources of information to support his claim, including police reports, "buddy" certificates or affidavits, and letters written during service. The Board concludes that, by virtue of the letters and its remand, the veteran has been notified that sources other than military records may be submitted to substantiate his claim and that the notification duties under the M21-1, the VCAA and the recently amended 38 C.F.R. § 3.304(f) have been satisfied. He has been given an opportunity to submit alternative sources of information, and additional development is not warranted. See Soyini, v. Derwinski, 1 Vet. App. 540, 546 (1991). The veteran, through his representative, has raised specific concerns concerning development of the PTSD claim. It has been suggested that this case again be remanded for an additional attempt to verify the veteran's stressor contentions. However, for reasons which are expressed in greater detail below, the Board concludes that there is sufficient evidence of record with which to make an informed decision. The veteran alleges inservice treatment during service by a psychologist following the alleged incident; there is no indication in the record of such an examination. However, the RO has obtained the veteran's service medical records which appear complete. The service medical records contain records of treatment in 1977 for alcoholism, but none of these records suggest substance abuse problems associated with any incident of service. With respect to any request for another VA psychiatric examination and the examiner's opinion as to the cause of his diagnosed PTSD, in the absence of corroborated stressors, referral of this case for a VA examination or opinion as to the etiology of the veteran's claimed PTSD would in essence place the examining physician in the role of a fact finder. This is the Board's responsibility. Determination as to the existence of stressors is independent of VA examination or medical opinion. In other words, unless a stressor is corroborated, any medical opinion which links the veteran's claimed PTSD to his naval service would necessarily be based solely on the veteran's uncorroborated assertions regarding stressors. The CAVC has held on a number of occasions that a medical opinion premised upon an unsubstantiated account of a claimant is of no probative value. See, e.g., Swann v. Brown, 5 Vet. App. 229, 233 (1993) [generally observing that a medical opinion premised upon an unsubstantiated account is of no probative value, and does not serve to verify the occurrences described]; Reonal v. Brown, 5 Vet. App. 458, 461 (1993) [the Board is not bound to accept a physician's opinion when it is based exclusively on the recitations of a claimant]. Further development of ship's logs has been requested. However, the RO has obtained the veteran's service records which do substantiate that he was absent without leave in July 1995. The RO requested from him specific information which might allow meaningful development through service department sources but such has not been forthcoming. In light of the discussion below, the Board does not believe that further development would be useful. Moreover, in this case, a preliminary review of the record shows that VA has made reasonable efforts to obtain evidence necessary to substantiate the veteran's claim. The Board notes that a variety of extensive records has been associated with the claims folder including SMRs and service personnel records and postservice VA treatment records. The evidence of record provides a complete basis for addressing the merits of the veteran's claim at this time. Therefore, the duty to assist has been satisfied in this case. 38 U.S.C.A. § 5103A (West Supp. 2002); see also 66 Fed. Reg. 45,620, 45,630 (August 29, 2001) (to be codified at 38 C.F.R. § 3.159). In its many correspondences with the veteran the RO has informed him of the evidence he should obtain and which evidence it would retrieve as specified. The RO has in fact augmented the evidentiary record in accordance with the veteran's directives as well as those of the Board in its 2001 remand. Finally, the statement of the case and supplemental statements of the case have informed him of the evidence obtained and considered by the RO. See Quartuccio v. Principi, 16 Vet. App. 183 (2002). As noted above, the RO has considered the veteran's claim under the new law. In light of the foregoing, the Board is satisfied that all relevant facts have been adequately developed to the extent possible; no further assistance to the appellant in developing the facts pertinent to his claim is required to comply with the duty to assist him as mandated by 38 U.S.C.A. §§ 5103, 5103A (West Supp. 2002). Having determined that the duty to assist has been satisfied, the Board turns to an evaluation of the veteran's claim on the merits. PTSD As discussed above, 38 C.F.R. 3.304(f) sets forth the three elements required to establish service connection for PTSD. For service connection to be awarded for PTSD, the record must show: (1) a current medical diagnosis of PTSD; (2) medical evidence of a causal nexus between his PTSD and the claimed in-service stressor; and (3) credible supporting evidence that the claimed in-service stressor actually occurred. There is of record a current medical diagnosis of PTSD that has been linked to the veteran's military service; accordingly, elements (1) and (2) above have arguably been satisfied. However, there is still the question of whether there is credible supporting evidence that an in-service stressor actually occurred. The Board observes that the veteran has not claimed that he participated in combat, and there is no objective evidence that the veteran specifically participated in events constituting actual combat, as opposed to serving in a combat zone. He was not awarded any medal indicative of combat. Accordingly, the Board concludes that combat status has not been demonstrated in this case. Because the veteran did not engage in combat, the law requires that stressors be corroborated. The veteran's lay testimony alone is not enough to establish the occurrence of an alleged stressor. See Moreau v. Brown, 9 Vet. App. 389, 395 (1996); Dizoglio v. Brown, 9 Vet. App. 163, 166 (1996). Although the veteran has described a very detailed history involving kidnapping and physical attack by his NCO, there is nothing in the personnel records (which appear to be complete) that might corroborate his story. In fact, they show that he was treated intermittently throughout his military service for disciplinary infractions and that he was found to have unauthorized leave on at least three occasions, to include the July 1975 period in question. There is nothing in the record, however, to suggest that this time frame was due to mistreatment by his NCO or that any difference in the severity of punishment was because he was coerced into committing the infraction. He was, in fact, imprisoned for a day on his return, and there is nothing in the record suggesting that this incident was anything other than a period when he was found to be on unauthorized leave. There is no record of any inservice examination as alleged, and there simply is no evidence in the record which would corroborate his claim as to the incidents he has described. Further, the Board notes that the examiner in September 1996 stated that the history given by the veteran appeared to be believable. However, the evidence does not corroborate the history as stated. At that time, as in his other recitations of history, the veteran stated that his performance deteriorated after the alleged kidnapping incident and his drinking escalated. However, the record shows that he was on unauthorized absence in April 1975 and was counseled in July 1974, in May 1975 because he was not recommended for promotion due to a recent nonjudicial punishment and in June 1975 because he was not selected for lance corporal. All this occurred prior to the alleged kidnapping; these incidents reflect significant performance problems prior to the period of unauthorized absence in July 1975. With regard to an escalation of drinking due to the alleged incident, on treatment for alcohol abuse in early 1977 he reported that had been drinking for the past 6 years and that his drinking escalated for the last 3 years, which would predate July 1975. The clinical records of his alcohol treatment make no reference to any traumatic incident in service, and, in particular, no reference to any kidnapping or assault. The Board concludes that the history relied upon in the September 1996 examination is contradicted by the evidence of record. Further, the medical opinion itself does not provide verification of the claimed stressor. See Cohen, at 142. In his testimony in March 2000 the veteran also stated that he was 2 weeks away from promotion to lance corporal and that he had a "pretty good" career going at the time of the incident (Transcript, p. 6). However, again, this is contradicted by the nonjudicial punishments prior to July 1975 and the counseling he had in May and June 1975, just prior to the alleged incident, when he was counseled as to why he was not being promoted. The veteran's credibility as to the facts surrounding his service and unauthorized absences is diminished by the contradictions on the record. After a review of the record, the Board concludes that there is no credible corroborating evidence of an in-service stressor, which is one of the elements required for entitlement to service connection for PTSD. In the absence of one of the required elements under 38 C.F.R. § 3.304(f) (2001), the claim is denied. ORDER Service connection for PTSD is denied Holly E. Moehlmann 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.