Citation Nr: 1014753 Decision Date: 04/19/10 Archive Date: 04/30/10 DOCKET NO. 07-10 852 ) DATE ) ) On appeal from the Department of Veterans Affairs (VA) Regional Office (RO) in Roanoke, Virginia THE ISSUE Entitlement to service connection for a claimed psychiatric disorder. ATTORNEY FOR THE BOARD C. L. Krasinski, Counsel INTRODUCTION The Veteran served on active duty from January 1966 to August 1970, April 1971 to October 1973, and June 1985 to April 1990. This matter came to the Board of Veterans' Appeals (Board) on appeal from a rating decision dated in September 2006. The Board notes that, in April 2007, the Veteran requested a hearing at the Board. Hearings were scheduled in September 2009 and April 2010, but the Veteran failed to report to the hearings without explanation. Accordingly, the Board will proceed as if the hearing request had been withdrawn. See 38 C.F.R. § 20.704(d) (2009). The issues of service connection for schizophrenia and depression and for arthritis of the lower back, pelvis, and hands have been raised by the record, but have not been adjudicated by the Agency of Original Jurisdiction (AOJ). See the report of contacts dated in July 2006 and August 2006 and the Veteran's statement dated in April 2008. Therefore, the Board does not have jurisdiction over them, and the issues are referred to the AOJ for appropriate action. FINDINGS OF FACT The currently demonstrated generalized anxiety disorder and obsessive compulsive disorder are shown as likely as not to have had their clinical onset while the Veteran was on active duty. CONCLUSION OF LAW By extending the benefit of the doubt to the Veteran, his disability manifested by a generalized anxiety disorder and obsessive compulsive disorder is due to disease or injury that was incurred in active service. 38 U.S.C.A. §§ 1110, 1131, 5107(West 2002 & Supp. 2009); 38 C.F.R. § 3.303 (2009). REASONS AND BASES FOR FINDING AND CONCLUSION Duty to Notify and Duty to Assist The Veterans Claims Assistance Act of 2000 (VCAA) describes VA's duty to notify and assist claimants in substantiating a claim for VA benefits. 38 U.S.C.A. §§ 5100, 5102, 5103, 5103A, 5107, 5126 (West 2002 & Supp. 2009); 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326(a) (2009). 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); 38 C.F.R. § 3.159(b); Quartuccio v. Principi, 16 Vet. App. 183 (2002). To the extent that the action taken hereinbelow is fully favorable to the Veteran, further discussion of VCAA is not required at this time. Legal Criteria Service connection will be granted for disability resulting from a disease or injury incurred in or aggravated by military service. 38 U.S.C.A. §§ 1110, 1131; 38 C.F.R. § 3.303. For the showing of chronic disease in service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time, as distinguished from merely isolated findings or a diagnosis including the word "Chronic." When the disease entity is established, there is no requirement of evidentiary showing of continuity. A continuity of symptomatology is required only where the condition noted during service is not, in fact, shown to be chronic or where the diagnosis of chronicity may be legitimately questioned. When the fact of chronicity in service is not adequately supported, then a showing of continuity after discharge is required to support the claim. 38 C.F.R. § 3.303(b). Service connection may also be granted for a disease first diagnosed after discharge when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Service connection requires competent evidence showing, (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004), citing Hansen v. Principi, 16 Vet. App. 110, 111 (2002); see also Caluza v. Brown, 7 Vet. App. 498 (1995). Once the evidence has been assembled, it is the Board's responsibility to evaluate the evidence. 38 U.S.C.A. § 7104(a). The Secretary shall consider all information and lay and medical evidence of record in a case before the Secretary with respect to benefits under laws administered by the Secretary. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C.A. § 7105; 38 C.F.R. §§ 3.102, 4.3. In Gilbert v. Derwinski, 1 Vet. App. 49, 54 (1990), the Court of Appeals for Veterans Claims (Court) stated that "a veteran need only demonstrate that there is an 'approximate balance of positive and negative evidence' in order to prevail." Analysis The Veteran contends that his generalized anxiety disorder and obsessive compulsive disorder were incurred in service. There is competent medical and lay evidence that demonstrates that the Veteran had psychiatric symptoms that began in service and continued thereafter. At the March 2006 VA QTC examination, the Veteran reported having had rituals and symptoms in 1974 to 1975, while he was in service. In a May 2006 statement, the Veteran stated that he was prescribed Librium for nervousness in 1971. He stated that he took Librium for 30 days and did not go back because he would have been referred to a military psychiatrist. The Veteran stated that a psychiatrist had the power to have someone discharged and he intended to stay in service. The Veteran also reported having a psychiatric screening when he was in the Navy from 1982 to 1986, done by a corpsman not a medical doctor. The Veteran stated that the corpsman did not diagnose a psychiatric disorder. The Veteran is competent to testify as to his observable symptoms such as anxiety or ritualistic behavior such as frequently washing his hands or folding paper. See Espiritu v. Derwinski, 2 Vet. App. 492, 494-5 (1992); Grottveit v. Brown, 5 Vet. App. 91, 93 (1993). The service treatment records confirm that the Veteran was prescribed Librium in September 1971. The service treatment record indicates that the Veteran had difficulty with tension on the job and felt it occasionally interfered with his effectiveness. A service treatment record dated in September 1973 indicates that the Veteran was in a "stress situation" and was prescribed Valium. There is competent medical evidence which medically relates the current diagnoses of obsessive compulsive disorder and generalized anxiety disorder to the Veteran's period of service. The March 2006 VA QTC examination indicates that the examiner considered the Veteran's report of psychiatric symptoms in service and reviewed the claims folder. The Axis I diagnoses were those of generalized anxiety disorder and obsessive compulsive disorder. Although these disorders were not diagnosed until 2004, the examiner had no reason to doubt the Veteran's time table of symptoms which started in the 1970's. Of record is a medical opinion by the Veteran's private psychiatrist which related the current disorders to service. In a November 2005 statement, Dr. P.B. of T.C. Psychiatric Associates indicated that the Veteran had obsessive compulsive disorder and generalized anxiety disorder. The psychiatrist stated that, given the long term nature of these illnesses, he was certain that the mental disability was manifested while the Veteran was in military service. Based on this record, the Board finds the evidence to be in relative equipoise in showing that the generalized anxiety disorder and obsessive compulsive disorder as likely as not had their clinical onset while the Veteran was serving on active duty. In resolving all reasonable doubt in the Veteran's favor, service connection for generalized anxiety disorder and obsessive compulsive disorder is warranted. ORDER Service connection for generalized anxiety disorder and obsessive compulsive disorder is granted. ____________________________________________ STEPHEN L. WILKINS Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs