Citation Nr: 1032541 Decision Date: 08/30/10 Archive Date: 09/08/10 DOCKET NO. 08-19 854A ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Newark, New Jersey THE ISSUE Entitlement to service connection for a psychiatric disability, to include as secondary to service connected otitis media, bilateral hearing loss, and tinnitus. REPRESENTATION Veteran represented by: Disabled American Veterans ATTORNEY FOR THE BOARD C. C. Dale, Associate Counsel INTRODUCTION The Veteran had active duty service from February 1943 to January 1946. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a February 2008 rating decision by a Regional Office (RO) of the Department of Veterans Affairs (VA). The issue of an increased rating for service connected hearing loss was initially part of the appeal. However, in a July 2008 statement, the Veteran indicated that a subsequent rating action increasing his disability rating for hearing loss satisfied his appeal with respect to this issue, and he desired to withdraw this issue. 38 C.F.R. § 20.204. It is not presently before the Board. In August 2010, the Veteran's representative submitted a motion to advance the appeal on the docket. A Board member granted the motion. Please note this appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c) (2009). 38 U.S.C.A. § 7107(a)(2) (West 2002). FINDINGS OF FACT 1. The Board finds the Veteran credible in his reports of working under stressful conditions during his tour of duty in Greenland. 2. The record contains probative evidence showing a nexus between the reported stressors and the currently diagnosed generalized anxiety disorder (GAD). CONCLUSION OF LAW The criteria for service connection for a psychiatric disability are met. 38 U.S.C.A. §§ 1110, 5107(b) (West 2002); 38 C.F.R. §§ 3.303, 3.307, 3.309, 3.310 (2009). REASONS AND BASES FOR FINDINGS AND CONCLUSION Laws and Regulations Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C.A. § 1110; 38 C.F.R. § 3.303(a). 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); see also Caluza v. Brown, 7 Vet. App. 498 (1995). 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. If chronicity in service is not established, a showing of continuity of symptoms after discharge is required to support the claim. 38 C.F.R. § 3.303(b). Service connection may also be granted for any disease diagnosed after discharge when all of the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Regulations also provide that certain diseases, including psychosis, may be presumed to be incurred during service if manifested to a compensable degree within a specified period following service. 38 C.F.R. §§ 3.307, 3.309. Additionally, disability which is proximately due to, or results from, another disease or injury for which service connection has been granted shall be considered a part of the original condition. 38 C.F.R. § 3.310(a). Any increase in severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice-connected disease, will be service connected. 38 C.F.R. § 3.310(b); see also Allen v. Brown, 7 Vet. App. 439, 448 (1995). Evidence The Veteran's service treatment records do not reflect any psychiatric complaints or findings. Rather, the Veteran asserts experiencing intrusive recollections of his service in Greenland. During this tour, he worked in solitude for prolong periods with limited exposure to sunlight. The Veteran's separation record notes service in Greenland for approximately a year and a half. In June 2007, the Veteran sought mental health treatment at VA. He stated that he did not have any prior psychiatric history, but began experiencing sleep disturbances due to his experiences in Greenland. Mental status examination was within normal limits. The VA physician diagnosed generalized anxiety disorder (GAD). She recommended individual psychotherapy. The Veteran attended several VA individual psychotherapy sessions during 2007 and 2008. He continued to report sleep disturbance due to his memories of Greenland. He also reported negative feelings due to his hearing impairments. The VA psychiatrist maintained the GAD diagnosis and recommended relaxation techniques for anxiety relief. A VA psychiatric examination, dated November 2009, is associated with the record. The Veteran complained about intrusive recollections of his service in Greenland. These recollections started in 2007 and caused sleep disturbances. He also reported experiencing anxiety due to his hearing impairments. The examiner detailed the Veteran's in-service stressors, which consisted of working for long periods in solitude with minimal exposure to natural light. Mental status examination showed anxious and nervous mood. However, speech was normal, and there was no evidence of perceptual impairment or thought disorder. The Veteran related his anxiety to his sleep disturbances. The examiner diagnosed GAD. He expressed an opinion that GAD was related to the intrusive memories from Greenland and exacerbated by his hearing impairments. Analysis The Veteran contends that his present GAD is related to stressful experiences while stationed in Greenland or as secondary to his service connected hearing impairments. As explained below, the evidence supports the claim, and it will be granted. Service treatment records do not show psychiatric treatment. Nonetheless, the Veteran reports working in solitude for long periods with minimal light exposure during service in Greenland. He is competent to report his experiences. See Washington v. Nicholson, 19 Vet. App. 362, 368 (2005). His separation record shows that he spent approximately two winters in Greenland during 1943 and 1944. The Board finds the Veteran credible in his reports of stressful experiences in Greenland. The remaining issue is whether there is probative evidence of a nexus between his reported in-service stressor and any present psychological disorder. While the Veteran is competent to report his experience, he has not been shown to have the experience, education, or training, to report on the etiology of psychological disorders based on scientific principles. Espiritu v. Derwinski, 2 Vet. App. 492, 495 (1992); Davidson v. Shinseki, 581 Vet. App. 1313 (Fed. Cir. 2009). Thus, the Board considers the Veteran's statements regarding nexus to service as competent lay evidence. See Layno v. Brown, 6 Vet. App. 465 (1994). However, these statements are not considered competent medical evidence of a nexus. Routen v. Brown, 10 Vet. App. 183, 186 (1997); see also Bostain v. West, 11 Vet. App. 124, 127 (1998). The Board must weigh all lay and medical evidence of record in making a determination of whether a nexus exists. See Owens v. Brown, 7 Vet. App. 429 (1995); Gabrielson v. Brown, 7 Vet. App. 36 (1994). Although the Federal Circuit has held that lay evidence is one type of evidence that must be considered and competent lay evidence can be sufficient in and of itself; the Board retains the discretion to make credibility determinations and otherwise weigh the evidence submitted, including lay evidence. See Buchanan v. Nicholson, 451 F.3d 1331, 1336 (Fed. Cir. 2006). The competent medical evidence supports the claim. Competent medical evidence means evidence provided by a person who is qualified through education, training or experience to offer medical diagnoses, statements or opinions. See Duenas v. Principi, 18 Vet. App. 512, 520 (2004). VA treatment records from 2007 and 2008 reflect that the Veteran sought individual psychotherapy on several occasions to alleviate anxiety symptoms. He reported continuing sleep disturbances caused by his intrusive recollections of service. The VA psychologist maintained a GAD diagnosis during the course of treatment. The examiner conducting the November 2009 VA examination expressed a positive opinion relating the Veteran's reported in-service history to his present GAD. As the Board finds the Veteran's report of in-service stressors credible and the record includes probative lay and medical evidence relating GAD to these stressors, service connection is warranted. The claim is granted. 38 C.F.R. §§ 3.303, 3.310. Duty to Notify and Assist The Board has considered whether further development and notice under the Veterans Claims Assistance Act (VCAA) or other law should be undertaken. However, given the results favorable to the Veteran, further development under the VCAA or other law would not result in a more favorable result for the Veteran, or be of assistance to this inquiry. ORDER Service connection for GAD is granted, subject to the statutes and regulations governing the payment of monetary awards. ____________________________________________ MARY GALLAGHER Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs