Citation Nr: 0810422 Decision Date: 03/28/08 Archive Date: 04/09/08 DOCKET NO. 03-24 783 ) DATE ) ) On appeal from the Department of Veterans Affairs (VA) Regional Office (RO) in Winston-Salem, North Carolina THE ISSUES 1. Entitlement to service connection for post-traumatic stress disorder (PTSD). 2. Entitlement to service connection for an acquired psychiatric disorder other than PTSD, to include major depressive disorder. REPRESENTATION Appellant represented by: North Carolina Division of Veterans Affairs ATTORNEY FOR THE BOARD L. A. Rein, Associate Counsel INTRODUCTION The veteran had active service from April 1969 to May 1970. This appeal to the Board of Veterans Appeals (Board) arises from a September 2002 rating action that denied service connection for an acquired psychiatric disorder, to include PTSD. A Notice of Disagreement (NOD) was received in December 2002, and a Statement of the Case (SOC) was issued in July 2003. A Substantive Appeal was received in August 2003 (via a VA Form 9, Appeal to Board of Veterans' Appeals). In August 2004, the Board recharacterized the appeal s encompassing two separate issues (as reflected on the title page of this decision) and remanded these matters to the RO for additional evidentiary development. After accomplishing the requested action, the RO continued the denial of the claims (as reflected in the May 2007 SSOC)) and returned these matters to the Board for further appellate consideration. As a final preliminary matter, the Board notes that, after certification of the veteran's appeal to the Board, the Board received copies of additional VA inpatient records from the veteran reflecting psychiatric treatment for suicidal and homicidal ideations (but no specific diagnosed disability). A review of these documents reflects that they do not contain information pertinent to the matters on which these claims turn, as discussed in more detail below. Therefore, even though the veteran has not waived consideration of this evidence by the RO, a remand of these matters for RO consideration of this evidence in connection with these claims, in the first instance, is unnecessary. See 38 C.F.R. § 20.1304 (2007). FINDINGS OF FACT 1. All notification and development action needed to fairly adjudicate each claim on appeal has been accomplished. 2. While the veteran has been diagnosed with PTSD, there is no evidence or allegation that he engaged in combat with the enemy, nor are there service records or other supporting evidence corroborating the occurrence of any alleged in- service stressful experience, the record also presents no basis for further RO development in this regard. 3. Persuasive medical opinion relates the current PTSD to post-service chemical exposure during the course of the veteran's post-service employment in July 1994 4. No acquired psychiatric disorder other than PTSD was present in service, and the weight of the probative medical evidence indicates that the veteran does not currently suffer from a chronic psychiatric disability that is medically related to his military service. CONCLUSION OF LAW 1. The criteria for service connection for PTSD are not met. 38 U.S.C.A. §§ 1110, 1131, 5103, 5103A, 5107 (West 2002); 38 C.F.R. §§ 3.102, 3.159, 3.304(f), 4.125(a) (2007). 2. The criteria for service connection for an acquired psychiatric disorder, other than PTSD (to include major depressive disorder) are not met. 38 U.S.C.A. §§ 1110, 1131, 5103, 5103A, 5107 (West 2002); 38 C.F.R. §§ 3.102, 3.159, 3.303 (2007). REASONS AND BASES FOR FINDINGS AND CONCLUSION I. Duties to Notify and Assist VA's duties to notify and assist claimants in substantiating a claim for VA benefits are found at 38 U.S.C.A. §§ 5100, 5102, 5103, 5103A, 5107, 5126 (West 2002 & Supp. 2007); 38 C.F.R. §§ 3.102, 3.156(a), 3.159 and 3.326(a) (2007). Upon receipt of a complete or substantially complete application for benefits, VA is required to notify the claimant and his or her representative, if any, of any information, and any medical or lay evidence, that is necessary to substantiate the claim. 38 U.S.C.A. § 5103(a) (West 2002 & Supp. 2007); 38 C.F.R. § 3.159(b) (2007); Quartuccio v. Principi, 16 Vet. App. 183 (2002). Proper notice must inform the claimant of any information and evidence not of record (1) that is necessary to substantiate the claim; (2) that VA will seek to provide; (3) that the claimant is expected to provide; and (4) must ask the claimant to provide any evidence in her or his possession that pertains to the claim in accordance with 38 C.F.R. § 3.159(b)(1). The notice requirements of 38 U.S.C. § 5103(a) and 38 C.F.R. § 3.159(b) apply to all five elements of a "service connection" claim, defined to include: (1) veteran status; (2) existence of a disability; (3) a connection between the veteran's service and the disability; (4) degree of disability; and (5) effective date of the disability. See Dingess/Hartman. Nicholson, 19 Vet. App. 473 (2006). VCAA-compliant notice must be provided to a claimant before the initial unfavorable decision on a claim for VA benefits by the agency of original jurisdiction (in this case, the RO). Pelegrini, 18 Vet. App. at 112. See also Disabled American Veterans v. Secretary of Veterans Affairs, 327 F.3d 1339 (Fed. Cir. 2003). However, the VCAA notice requirements may, nonetheless, be satisfied if any errors in the timing or content of such notice are not prejudicial to the claimant. Id. In this appeal, the RO sent notice letters to the veteran in February 2002, March 2002, August 2002, August 2004, and May 2007. In these notice letters, the RO advised the veteran of VA's responsibilities to notify and assist the veteran in his claim, to specifically include the information and evidence necessary to substantiate his claims for service connection. The letters asked him to submit certain information, and informed him of VA's responsibility concerning obtaining evidence to substantiate his claim. In addition, the letters explained that VA would make reasonable efforts to help him get evidence such as medical records, but that he was responsible for providing sufficient information and authorization for VA to request such records not previously obtained. In addition, the August 2004 letter asked the veteran to send to VA any information in his possession pertaining to his claim and the May 2007 letter was compliant with Dingess/Harman. The Board notes that the veteran was not requested to submit all evidence in his possession pertinent to his claim and he did not receive notice of the disability and effective date elements of a claim for service connection, pursuant to DingessHartman, until after the September 2002 rating decision on appeal. Pursuant to Sanders v. Nicholson, 487 F.3d 881 (Fed. Cir. 2007), any error in section 5103(a) notification should be presumed prejudicial, and VA has the burden of rebutting this presumption. A notice error requires reversal unless VA can show the error did not affect the essential fairness of the adjudication. Id. The Federal Circuit explained that in order to overcome this presumption, VA must persuade the reviewing court that the purpose of the notice was not frustrated, e.g., by demonstrating: (1) that any defect was cured by actual knowledge on the part of the claimant, (2) that a reasonable person could be expected to understand from the notice what was needed, or (3) that a benefit could not have been awarded as a matter of law. Id. In this appeal, the required notice was provided to the veteran in the August 2004 and May 2007 letters. Thereafter, the veteran and his representative were afforded ample opportunity to respond and the claim was fully developed prior to readjudication (as reflected in the May 2007 supplemental statement of the case) and certification of the claim. Under these circumstances, the Board finds the veteran was afforded "a meaningful opportunity to participate effectively in the processing of his claim by VA," and thus, "essentially cured the error in the timing of notice". See Pelegrini, 18 Vet. App. at 122- 24. See Mayfield v. Nicholson, 20 Vet. App. 537, 543 (2006); see also Prickett v. Nicholson, 20 Vet. App. 370, 376 (2006) (the issuance of a fully compliant notification followed by readjudication of the claim, such as an SOC or SSOC, is sufficient to cure a timing defect). Hence, the Board concludes that any defect in the timing of the notice constitutes harmless error. See generally, Conway v. Principi, 353 F.3d 1369 (Fed. Cir. 2004). Furthermore, the veteran has not been prejudiced from this error because the denial of the claims in this appeal renders moot any question as to the appropriate disability rating or effective date to be assigned. See Sanders, supra. VA also has a duty to assist claimants in obtaining evidence needed to substantiate a claim. 38 U.S.C.A. § 5103A (West 2002); 38 C.F.R. § 3.159 (2007). This duty has also been met, as the veteran's service medical records, VA medical records, and private medical records have been associated with the claims file. In addition, the veteran was afforded an appropriate examination in connection with his claim in April 2006; the report of which is of record. Moreover, neither the veteran nor his representative has identified any existing pertinent records that need to be obtained. The record also presents no basis for further developing the record to create any additional evidence to be considered in connection with the claim decided herein.. As all notification has been given and all relevant available evidence has been obtained, the Board concludes that any error or deficiency in compliance with the VCAA has not prejudiced the appellant and is, thus, harmless. See Mayfield, 20 Vet. App. at 543 (rejecting the argument that the Board is without authority to consider harmless error). See also ATD Corp. v. Lydall, Inc., 159 F.3d 534, 549 (Fed. Cir. 1998). II. Factual Background Service treatment records reflect no complaints, findings or a diagnosis of a psychiatric disorder. An April 1970 separation examination report indicates that there was no psychiatric disability. April 1970 service personnel records reflect that the veteran desired to be discharged from the Navy with no reports of racial harassment, and his record of discharge shows he was discharged at the convenience of the Government, Under Honorable Conditions. An April 1976 VA examination report is negative for complaints, findings, or a diagnosis of a psychiatric disorder. Private medical records dated in September 1994 from Doctors Urgent Care Centre reflect that in July of the same year the veteran sustained chemical exposure during the course of his employment. The veteran reported he was taken to "Glaxo" clinic with complaints of burning throat and headaches. Shortly thereafter he had sharp pains all over his body, increased fatigue, and nausea and had not been able to work as hard. In a November 1994 private medical record, T. B. Hart, M.D., noted that the veteran had reported he had been in good health all of his life until he had two exposures to benzalkonium chloride in July 1994. The veteran stated that he had been sick ever since the exposure with insomnia, headaches, dizziness, and complaints of physical pain and burning. The veteran stated he has been unable to work all this time. The doctor prescribed the veteran medication to help with the discomfort and to improve the veteran's sleep. In May 1995 letters, S. Chase, M.D., noted that he had evaluated the veteran, and that his symptoms were compatible with major depressive disorder, single, and PTSD. He opined that the veteran was unable to work because of these problems. In a long detailed letter, Dr. Chase noted that, in July 1994, the veteran reported he was exposed to chemical fumes during the course of his employment, which choked him. Later that same night, the veteran stated he had a burning sensation of the throat and eyes and diarrhea. Later in July 1994, the veteran again was exposure to strong fumes during his employment and was taken to the medical clinic at the Glaxo Imperial Center. He has had numerous somatic symptoms. He complained of episodic pain in the head, chest, and upper and lower extremities. He stated that heat activities lightheadedness so he can not go out in the sun and can not exercise the way he used to. He complained of soreness in the right cheek area. The veteran stated that when this first happened he cried, and had thoughts of suicide by shooting himself. He then denied further thoughts of suicide or homicide. The veteran reported that the chemicals he was exposed to included formaldehyde, methanol, chlorine, and ammonia. He does not go to the grocery store. He believes he will dies from this. He has dreams of being sick, and has had nightmares in the past, but not at present. The veteran reported that his marriage has its ups and downs. In 1975, he stated that while working as a custodian he hurt his right lower back. The veteran stated that while in the Navy he scored low on a written examination and was told he was not petty officer material. He stated he was involved in one fight and experienced racism. On mental status examination, the veteran had no past or present symptoms of hypomania, he gave symptoms compatible with major depressive disorder, single. There were no previous depressions. He is suspicious, although not delusional about his previous employer and their insurance company and wonders if they conspired against him. He feels that he was put in dangerous situation. The veteran also stated that in June 1994 another employee pulled a knife on him. He loaded his shotgun and drove to the office, got out of the car, but without his gun. Dr. Chase noted, that as described above, the veteran gave symptoms of PTSD. Dr. Chase reported a diagnostic impression of major depressive disorder, single, and noted that he would have to rule out psychotic features. The physician also noted that the veteran's symptoms were also compatible with PTSD. Dr. Chase opined that since the veteran had not experienced symptoms of major depressive disorder, single, or PTSD previously, it was his conclusion that they are the result of the veteran's exposure to the formaldehyde in July 1994. He noted that he did not know if it was a direct toxic effect and/or resultant psychological effect. In a February 1997 psychological evaluation report, J.S. Ward, Ed, D., reiterates the veteran history of chemical exposure and the prior objective medical findings. During the evaluation, the veteran also reiterated his history of chemical exposure, and that he felt he was not believed by the doctors who examined him that he had residual physical disabilities. He stated that his life was quite normal prior to this situation in 1994. The examiner found that the veteran's ideations are now often paranoid and he obsesses ad perseverates upon his problems almost exclusively. The examiner furthers that what began as traumatic stress, is moving towards psychotic syndrome. The examiner also noted that the veteran was very preoccupied with a personal problem/attack that happened a short time prior to the exposure and that must be factored into his problem also. A June 2000 medical record from Cumberland County Mental Health shows that the veteran reported being exposed to toxic chemicals in 1994 and that changed his life. He became depressed, had problems with sleep, social withdrawal, flashbacks, and nightmares about it. A May 2001 VA emergency room note reflects that the veteran reported being exposed to toxic chemical fumes in 1994 and that he was receiving Social Security disability due to the exposure with depression and PTSD. On August 2001 VA mental health assessment , the veteran reported no combat duty and no military trauma other than racism. He then complained of nightmares, sleep problems, and feeling angry about being exposed to toxic chemical and not being supported with appropriated follow-up. A December 2001 private psychiatric examination report authored by J. S. Howard, M.D., shows that the veteran reported that, during boot camp, he was told by a white supply clerk that "we can't find shoes to fit you. You-alls feet ain't like ours," which he took as a racial slur. After boot camp he was assigned to a destroyer, where he stated that his bunk was used to dump unsorted laundry despite orders to keep bunks clear. Subsequently, someone else's pants were left on his bunk, and his own pants disappeared. His supervisor then wrote him up for stealing a pair of pans and he was transferred to another ship without an investigation. The veteran stated that he served on the second ship without incident until his grandmother died and he was then granted emergency leave to return home for the funeral. He asserted s that he requested and was granted a 7 day extension; however, when he reported back, he was accused of being absent without leave and was held. He also stated that, during that time, he was sent to a naval psychiatrist twice because he "looked depressed" and was advised by the psychiatrist to "get of the Navy with benefits." The veteran reported that he was then put out of the Navy, whereby he left, traumatized and depressed by the way he had been treated. He contended that his self concept and self esteem were adversely affected and he felt caught in a thirty year mental time warp of false accusations, unfair treatment and racial abuse by the Navy. He also contended that he heard racist comments made directly at him while on duty and he was threatened in boot camp by white servicemen who taunted him with KKK innuendoes. The veteran reported that he was employed in various jobs post-service until 1994, when he became unable to work because of chronic mental health problems associated with military service. The veteran reported that his only major medical illness is service-connected mental health problems. The veteran related his symptoms of chronic sleep disturbances, nightmares, social withdrawal, lack of trust, intrusive thoughts, being in a "vague or grey" state of mind, and being hyperirritable, to his obsession with being a failure and his negative experiences in service. Dr. Howard diagnosed PTSD, chronic, continuous and severe, U.S. military service-connected and major depression, by history, subsequent to military service. The doctor opined that the veteran most likely did suffer substantial emotional and mental health injury during his military service which has become worse to the point of impairing his ability to seek or hold employment. An April 2006 VA mental health examination report reflects that the examiner reviewed the veteran's claims file, noting review of his service records and post service records. In addition, to a clinical interview, psychological testing was performed. The veteran reported that he began to experience problems in boot camp and was uncomfortable with comments about his race. The veteran stated that following successful completion of boot camp, he returned home on leave and married. He then learned that his wife's family was not happy with the marriage and she was being physically abused while pregnant. Then his grandmother died and he was given emergency leave to return home where his wife pleaded with him to stay and protect her so he extended his leave. He stated that he intended to inform his supervisors in the Navy about problems at home, but was accused of being AWOL which led to more stress and irritability. He again went AWOL. He eventually accepted the option to be discharged because he stated that he felt trapped and wanted to escape the prison he felt that he was living in . He denied that the abuse he felt he experienced in the military ever approached the level that he feared for his life. He state that he feared for his wife's and child's life, and the examiner stated that this could be considered to meet Criterion A of PTSD. The veteran stated that he did not tell anyone in the military about the stress he was under and did not receive any counseling or mental health treatment prior to discharge. The veteran reported that after service he worked, but felt remorse for missing his opportunity for a career in the military. He was in a state of depression for about 10 years but never sought help. He stated that his depression eventually lifted when he found employment as a long-distance truck driver because he enjoyed the solitude. The veteran reiterated the history of his chemical exposure in 1994, and in addition stated that he was very bothered by the behavior of some workmates who he felt were laughing at him while he lay on the ground gasping at air. After that he never returned to work. He related his current suspiciousness of others to this incident and that following this event, he experienced a second cycle of depression that is only beginning to resolve. The examiner diagnosed PTSD , secondary to gas exposure, and adjustment disorder with mixed disturbance of emotions and conduct problems. III. Analysis Service connection may be established for disability resulting from personal injury or disease contracted in line of duty, or for aggravation of a pre-existing injury suffered or disease contracted in line of duty. 38 U.S.C.A. § 1110; 38 C.F.R. § 3.303. Service connection may be granted for any disease diagnosed after discharge from service when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). 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 in-service stressor occurred. 38 C.F.R. § 3.304(f) (2007). Initially, the Board notes that the veteran has been diagnosed with PTSD, most recently during an April 2006 VA examination. That diagnosis notwithstanding, after carefully considering the evidence of record in light of the above- noted legal authority, the Board finds that there is no credible supporting evidence that the veteran's claimed in- service personal assault (racism and racial harassment)-his only alleged in-service stressor-actually occurred. The evidence necessary to establish the occurrence of a recognizable stressor during service to support a diagnosis of PTSD will vary depending upon whether the veteran engaged in "combat with the enemy." In this case, the veteran's alleged stressor is not related to combat; Hence, the veteran's lay testimony, in and of itself, is not sufficient to establish the occurrence of the alleged stressor. Instead, the record must contain evidence that corroborates his testimony or statements. See Cohen v. Brown, 10 Vet. App. 128, 147 (1997); Moreau v. Brown, 9 Vet. App. 389, 395 (1996). See also Zarycki v. Brown, 6 Vet. App. 91, 98 (1993); Doran v. Brown, 6 Vet. App. 283, 289-290 (1994). The Board recognizes that the present case falls within the category of situations, to include allegations of racism and racial harassment, in which it is not unusual for there to be an absence of service records documenting the events of which the veteran complains. See, e.g., Patton v. West, 12 Vet. App. 272, 281 (1999). The provisions of § 3.304(f) reflect a recognition that service records may not contain evidence of personal assault, and that alternative sources, including testimonial statements from confidants such as family members, roommates, fellow service members, or clergy, may provide credible evidence of an in-service stressor premised on personal assault. See YR v. West, 11 Vet. App. 393, 399 (1998). See also VA Adjudication Manual, M21-1MR, Part IV, Subpart ii, Chapter 1, Section D, Topic 17, Developing Claims for Service Connection for PTSD Based on Personal Trauma (Dec. 13, 2005). Specifically, under 38 C.F.R. § 3.304(f)(3) (2007), if a PTSD claim is based on an 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. 38 C.F.R. § 3.304(f)(3) (2007). Service treatment records reflect no complaints, findings or a diagnosis of any psychiatric problems or complaints of any comment as to racial discrimination or harassment. The April 1970 separation examination report indicates that there were no findings of psychiatric problems or disability. Moreover, April 1970 service personnel records reflects that the veteran desired to be discharged from the Navy with no reports of racial harassment, and his record of discharge shows he was discharged at the convenience of the Government, Under Honorable Conditions. The Board has considered the claim in view of 38 C.F.R. § 3.304(f)(3) and the relevant provisions of VA's Adjudication Manual as regards regarding . However, no additional credible supporting evidence pertaining to the veteran's claimed in-service stressor has been submitted. Aside from the veteran's own statements, the only other pertinent evidence are his wife's statements that the veteran's mood changed after his discharge from service; however, this does not corroborate the occurrence of the alleged racial harassment in service. Moreover, Dr. Howard's December 2001 report simply recites history as reported by the veteran many years after the alleged incident. The Board further notes that the mere fact that has a diagnosis of PTSD-apparently, in part, on the basis of the examiner's acceptance of the veteran's self- reported history-does not establish the that that history, in fact occurred. Credible supporting evidence of the actual occurrence of an in-service stressor cannot consist solely of after-the-fact medical nexus evidence. See Moreau, 9 Vet. App. at 396. The Board further notes that the April 2006 VA examiner specifically concluded that the veteran did not meet the criteria for PTSD until he was diagnosed after his chemical exposure as the necessary avoidance criteria had not yet been met; the examiner diagnosed PTSD as secondary to such exposure. The examiner's comments and diagnosis are consistent with VA medical and additional private medical records also indicating that the veteran's PTSD is related to, or had its onset from, post-service chemical exposure. The Board accords great probative value to the August 2004 VA examiner's opinion, and finds it to be dispositive of the question of whether the veteran, in fact, suffers from PTSD. Clearly, the reviewing physician reached his conclusions only after examination of the veteran, and review of the extensive service and post-service records. Hence, the Board finds that the most persuasive medical evidence that specifically addresses the question of whether the veteran has PTSD related to service militates against the claim. See Hayes v. Brown, 5 Vet. App. 60, 69-70 (1993) (it is the responsibility of the Board to assess the credibility and weight to be given the evidence) (citing Wood v. Derwinski, 1 Vet. App. 190, 192-93 (1992)). See also Guerrieri v. Brown, 4 Vet. App. 467, 470-471 (1993) (the probative value of medical evidence is based on the physician's knowledge and skill in analyzing the data, and the medical conclusion he reaches; as is true of any evidence, the credibility and weight to be attached to medical opinions are within the province of the Board). The Board also finds that the record does not provide a basis for establishing service connection for any acquired psychiatric disability other than PTSD, to include claimed major depressive disorder. The weight of the competent medical evidence of record-in particular, the April 2006 VA examiner's opinion-establishes that the veteran currently suffers from an adjustment disorder with mixed disturbance of emotions and history of conduct problems that leads to depressive symptoms and a sense of hopelessness and worthlessness. While that examiner did include in his report some comments indicating that the veteran's "problems" seem to have begun in connection with incidents in and contemporaneous to his time in service (such as the veteran's family allegedly being threatened, the death of the veteran's grandmother, and the veteran's perception that he had no support from the military), significantly, the diagnosed adjustment is not considered a disease or injury for compensation purposes, and, thus, is not considered a disability for which service connection can be established. See 38 C.F.R. §§ 3.303(c), 4.9, 4.127 (2000); Winn v. Brown, 8 Vet. App. 510, 516 (1996) (holding that 38 C.F.R. § 3.303(c), as it pertains to personality disorder, is a valid regulation). While service connection may be granted, in limited circumstances, for disability due to aggravation of a constitutional or developmental abnormality by superimposed disease or injury (see VAOPGCPREC 82-90, 55 Fed. Reg. 45,711 (1990); Carpenter v. Brown, 8 Vet. App. 240, 245 (1995); Monroe v. Brown, 4 Vet. App. 513, 514-15 (1993), there is no competent evidence whatsoever to even suggest that such has occurred in this case. In this regard, the Board points out that the record simply does not establish a current, chronic psychiatric disability other than PTSD upon which to predicate a grant of service connection. In adjudicating these claims, the Board has, in addition to the medical evidence, considered assertions of the veteran, as well as those advanced by his family members and by his representative, on his behalf. the veteran and his family's written assertions; however, none of this evidence provides a basis for allowance of either claim. Matters of diagnosis and etiology are within the province of trained medical professionals. See Jones v. Brown, 7 Vet. App. 134, 137-38 (1994). As none of the identified individuals is shown to be other than a layperson without appropriate medical training and expertise, none is competent to render a probative (persuasive) opinion on a medical matte such as diagnosis or etiology. See, e.g., Bostain v. West , 11 Vet. App. 124, 127 (1998), citing Espiritu v. Derwinski, 2 Vet. App. 492 (1992). See also Routen v. Brown, 10 Vet. App. 183, 186 (1997) ("a layperson is generally not capable of opining on matters requiring medical knowledge"). Hence, the lay assertions in this regard have no probative value. Under these circumstances, the Board finds that the claims for service connection for PTSD, and for an acquired psychiatric disorder other than PTSD, to include major depressive disorder, must be denied. In reaching these conclusions, the Board has considered the applicability of the benefit-of- the-doubt doctrine. However, as the preponderance of the competent, probative evidence is against each claim, that doctrine is not applicable. See 38 U.S.C.A. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990). ORDER Service connection for PTSD is denied. Service connection for an acquired psychiatric disorder other than PTSD, to include major depressive disorder, is denied. ____________________________________________ JACQUELINE E. MONROE Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs