Citation Nr: 1036005 Decision Date: 09/23/10 Archive Date: 09/30/10 DOCKET NO. 07-39 517 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Huntington, West Virginia THE ISSUE Entitlement to service connection for a psychiatric disorder, to include schizophrenia and schizoaffective disorder. REPRESENTATION Appellant represented by: Veterans of Foreign Wars of the United States WITNESS AT HEARING ON APPEAL The Veteran ATTORNEY FOR THE BOARD T. M. Gillett, Associate Counsel INTRODUCTION The Veteran served on active duty in the Navy from November 1972 to January 1975; and in the Army from December 1979 to March 1980. The Veteran also served in the National Guard between his period of service in the Navy and his service in the Army. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a September 2006 rating decision by the Department of Veterans Affairs (VA) "Tiger Team" at the Regional Office (RO) in Cleveland, Ohio. Due to the Veteran's place of residence, subsequent development was accomplished by the Huntington, West Virginia RO. In May 2008, the Veteran testified during a hearing before the undersigned Acting Veterans Law Judge in Washington, DC; a transcript of that hearing is of record. In September 2008, the Board remanded the issue currently on appeal to the Appeals Management Center (AMC) for further development. The record indicates that the AMC reasonably complied with the Board's requests, including the procurement of further VA treatment records and the provision of a VA medical examination. The record indicates that the AMC was unable to procure any records from the Social Security Administration (SSA), as requested by the Board. However, as the RO made reasonable attempts to locate and procure these records, the Board finds that they complied substantially with the September 2008 Remand directives. Therefore, we will proceed to render a decision on this claim. See Stegall v. West, 11 Vet. App. 268, 271 (1998) (noting the Board's duty to "insure [the RO's] compliance" with the terms of its remand orders). Moreover, throughout the pendency of this appeal, the Veteran's current application has been evaluated as a claim for service connection for schizophrenia. However, the record contains diagnoses of schizoaffective disorder. The Veteran has claimed that his psychiatric disorders arise from service. In keeping with the United States Court of Appeals for Veterans Claims' decision in Clemons v. Shinseki, 23 Vet. App. 1 (2009), the Board will adjudicate and consider all identified disorders as a single claim for service connection for a psychiatric disorder. FINDINGS OF FACT 1. The Veteran's current psychiatric disorder first manifested more than a year after the Veteran's naval service and is unrelated to the Veteran's service in the Navy. 2. Clear and unmistakable evidence establishes that the Veteran's current psychiatric disorder existed prior to the Veteran's active service in the Army. 3. Clear and unmistakable evidence establishes that the Veteran's current psychiatric disorder was not aggravated during the Veteran's active service in the Army. CONCLUSION OF LAW The Veteran's current psychiatric disorder, to include schizophrenia and schizoaffective disorder, was not incurred in or aggravated by service. 38 U.S.C.A. §§ 1110, 1111, 1131 (West 2002); 38 C.F.R. §§ 3.303, 3.304, 3.306, 3.307, 3.309 (2009). REASONS AND BASES FOR FINDINGS AND CONCLUSION I. The Veterans Claims Assistance Act of 2000 (VCAA) As provided for by the Veterans Claims Assistance Act of 2000 (VCAA), the United States Department of Veterans Affairs (VA) has a 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). a. Duty to Notify. VA has a duty to notify the appellant of any information and evidence needed to substantiate and complete a claim. 38 U.S.C.A. §§ 5102, 5103. In order to meet the requirements of 38 U.S.C.A. § 5103(a) and 38 C.F.R. § 3.159(b), VCAA notice must (1) inform the claimant about the information and evidence necessary to substantiate the claim; (2) inform the claimant about the information and evidence that the VA will seek to provide; and (3) inform the claimant about the information and evidence the claimant is expected to provide. VCAA notice should be provided to a claimant before the initial unfavorable agency of original jurisdiction (AOJ) decision on a claim. See Pelegrini v. Principi, 18 Vet. App. 112 (2004). The United States Court of Appeals for Veterans Claims (Court) held in Dingess v. Nicholson, 19 Vet. App. 473 (2006), that the VCAA notice requirements of 38 U.S.C.A. § 5103(a) and 38 C.F.R. § 3.159(b) apply to all five elements of a service connection claim. Those five elements include (1) the Veteran's status; (2) the existence of a disability; (3) a connection between the Veteran's service and the disability; (4) the degree of disability; and (5) the effective date of the disability. The Court held that upon receipt of an application for a service connection claim, 38 U.S.C.A. § 5103(a) and 38 C.F.R. § 3.159(b) require VA to review the information and the evidence presented with the claim, and to provide the claimant with notice of what information and evidence not previously provided, if any, will assist in substantiating or is necessary to substantiate the elements of the claim as reasonably contemplated by the application. Id. at 486. This notice must also inform the Veteran that a disability rating and an effective date for the award of benefits will be assigned if service connection is granted. Id. A July 2006 VCAA notice substantially satisfied the provisions of 38 U.S.C.A. § 5103(a). In this letter, the RO informed the Veteran about the information and evidence not of record that was necessary to substantiate his claim; the information and evidence that VA would seek to provide; the information and evidence the Veteran was expected to provide; and the information required by Dingess. Also, the evidence does not show, nor does the Veteran contend, that any notification deficiencies, with respect to either timing or content, have resulted in prejudice. The record raises no plausible showing of how the notice provided affected the essential fairness of the adjudication. b. Duty to Assist. The Board finds that all necessary assistance has been provided to the Veteran. The evidence of record indicates that the VA acquired the Veteran's VA, private, and service treatment records to assist the Veteran with his claims. As noted in the Introduction, the AMC attempted to procure the Veteran's SSA records. In October 2009, SSA responded to the AMC's request, stating that they did not have the Veteran's records. Therefore, because SSA has indicated that they do not have these records, the Board finds that an additional remand seeking their procurement would be futile as it would result in unnecessarily imposing additional burdens on VA with no benefit flowing to the Veteran. See Soyini v. Derwinski, 1 Vet. App. 540, 546 (1991); Sabonis v. Brown, 6 Vet. App. 426, 430 (1994). The Board also notes that the claims file does not contain many psychiatric records indicating treatment during the 1980s. The Board notes that many of these records were written by Dr. Peter Romer, who, the Veteran reports, is no longer practicing, and the Veteran has not provided any address for Dr. Romer. Accordingly, the Board finds that any attempt to locate these records would be futile. See Soyini, 1 Vet. App. at 546; Sabonis, 6 Vet. App. at 430. In compliance with the Board's remand instructions, in October 2008, the AMC issued a letter to the Veteran, requesting that he complete consent and release forms to allow the AMC to procure any additional treatment records not included in the claims file. The Veteran responded by indicating that he did not have any further information to provide. Therefore, the Board finds that VA has procured all treatment records necessary to allow for the adjudication of the Veteran's claim. The Board also notes that VA provided the Veteran with a VA medical examination that was thorough and productive of medical findings regarding the nature and etiology of the Veteran's claimed disorder. As such, there is no duty to provide an additional examination or medical opinion for this claim. 38 U.S.C.A. § 5103A(d); 38 C.F.R. § 3.159(c)(4). In view of the foregoing, the Board finds that VA has fulfilled its duty to notify and assist the Veteran in the claim under consideration. Adjudication of the claim at this juncture, without directing or accomplishing any additional notification and/or development action, poses no risk of prejudice to the Veteran. Bernard v. Brown, 4 Vet. App. 384, 394 (1993). II. Service Connection Service connection may be granted if it is shown the Veteran suffers from a disability resulting from an injury sustained or disease contracted in the line of duty, or for aggravation during service of a pre-existing condition beyond its natural progression. 38 U.S.C.A. §§ 1110, 1131, 1153; 38 C.F.R. §§ 3.303, 3.306. To establish service connection, there must be (1) a medical diagnosis of a current disability; (2) medical or, in certain cases, lay evidence of in-service occurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between an in-service injury or disease and the current disability. Hickson v. West, 12 Vet. App. 247, 252 (1999), citing Caluza v. Brown, 7 Vet. App. 498, 506 (1995), aff'd 78 F.3d 604 (Fed. Cir. 1996). A disorder also may be service connected if the evidence of record reveals the Veteran currently has a disorder that was chronic in service or, if not chronic, that was seen in service with continuity of symptomatology demonstrated thereafter. 38 C.F.R. § 3.303(b); Savage v. Gober, 10 Vet. App. 488, 494-97 (1997). A demonstration of continuity of symptomatology is an alternative method of demonstrating the second and/or third Caluza elements discussed above. Savage, 10 Vet. App. at 495- 496. Disorders diagnosed after discharge may still be service connected if all the evidence, including pertinent service records, establishes the disorder was incurred in service. 38 C.F.R. § 3.303(d); Combee v. Brown, 34 F.3d 1039, 1043 (Fed. Cir. 1994). 38 U.S.C.A. §§ 1111, 1132 set forth governing principles relating to the presumption of a Veteran's soundness of condition upon entry to service. 38 U.S.C.A. § 1111, 1132 (both entitled "Presumption of sound condition"). They provides that every Veteran shall be taken to have been in sound condition when examined, accepted, and enrolled for service, except as to defects, infirmities, or disorders noted at the time of the examination, acceptance, and enrollment, or where clear and unmistakable evidence demonstrates that the injury or disease existed before acceptance and enrollment and was not aggravated by such service. Id. The implementing regulation, 38 C.F.R. § 3.304(b), similarly provides that "[t]he Veteran will be considered to have been in sound condition when examined, accepted and enrolled for service, except as to defects, infirmities, or disorders noted at entrance into service, or where clear and unmistakable (obvious or manifest) evidence demonstrates that an injury or disease existed prior thereto and was not aggravated by such service. Only such conditions as are recorded in examination reports are to be considered as noted." 38 C.F.R. § 3.304(b). A history of preservice existence of a disease or injury recorded at the time of examination does not constitute a notation of such a malady, but instead, must be considered with all other material evidence in determinations as to inception. 38 C.F.R. § 3.304(b)(1). A Veteran thus enjoys an initial presumption of sound condition upon service entry if the enlistment records do not reflect that the Veteran has a disease or injury that subsequently becomes manifest during service. Wagner v. Principi, 370 F.3d 1089, 1096 (2004) (noting that "[w]hen no preexisting condition is noted upon entry to service, the Veteran is presumed to have been sound upon entry," but that "if a preexisting disorder is noted upon entry to service, the Veteran cannot bring a claim for service connection for that disorder"); see also 38 U.S.C.A. § 1111, 1132; 38 C.F.R. § 3.304(b). Such an initial presumption, however, is not absolute and may be rebutted. Wagner, 370 F.3d at 1092, 1096, 1097. The United States Court of Appeals for the Federal Circuit has interpreted § 1111 to "permit[] the government to overcome the presumption of soundness" upon a two-prong showing: it "must show clear and unmistakable evidence of both a preexisting condition and a lack of in-service aggravation to overcome the presumption of soundness for ... service . . . ." Id. If the government fails to demonstrate either prong, the rebuttal fails and the soundness presumption remains. See id., at 1096, 1097 (recognizing that the government's failure to rebut the soundness presumption means that "the Veteran's claim is one for service connection"); see also Kinnaman v. Principi, 4 Vet. App. 20, 27 (1993) (noting that if a Veteran's disease "was first diagnosed while in service, the burden of proof is on the government to rebut the presumption of sound condition upon induction by showing that the disorder existed prior to service and, if the government meets this requirement, by showing that the condition was not aggravated in service"). In determining whether such aggravation occurred the Board must give "[d]ue regard . . . [to] the places, types, and circumstances of service and particular consideration will be accorded combat duty and other hardships of service," and "[t]he development of symptomatic manifestations of a preexisting disease or injury during or proximately following action with the enemy . . . will establish aggravation of a disability." 38 C.F.R. § 3.306(b)(2). Where an in-service increase in severity has been shown, VA may rebut the presumption of aggravation by demonstrating that "the [in- service] increase in disability is due to the natural progress of the disease," and it must do so by offering "[c]lear and unmistakable evidence (obvious or manifest)" in this regard. 38 C.F.R. § 3.306(a), (b); Wagner, supra. A pre-existing disease or injury will be presumed to have been aggravated by service only if the evidence shows that the underlying disability underwent an increase in severity; the occurrence of symptoms, in the absence of an increase in the underlying severity, does not constitute aggravation of the disability. See Davis v. Principi, 276 F.3d 1341, 1345 (Fed. Cir. 2002); 38 C.F.R. § 3.306(a) (2007). A finding of aggravation is not appropriate in cases where the evidence specifically shows that the increase is due to the natural progress of the disease. Furthermore, temporary or intermittent flare-ups of a pre-existing disease during service are not sufficient to be considered aggravation of the disease unless the underlying condition, as contrasted to symptoms, worsens. See Jensen v. Brown, 4 Vet. App. 304, 306- 7 (1993); Hunt v. Derwinski, 1 Vet. App. 292 (1991). Although the Board has an obligation to provide reasons and bases supporting this decision, there is no need to discuss, in detail, the extensive evidence of record. Indeed, the Federal Circuit has held that the Board must review the entire record, but does not have to discuss each piece of evidence. Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000). Therefore, the Board will summarize the relevant evidence where appropriate, and the Board's analysis below will focus specifically on what the evidence shows, or fails to show, as to the Veteran's claim. The Veteran's initial set of service treatment records, indicating treatment for his term of service in the Navy, do not contain any notation indicating diagnosis or treatment for a psychiatric disorder. Service personnel records from that period indicate that the Veteran was given a general discharge for unfitness, due to frequent involvement of a discreditable nature with civil or military authorities. The personnel records, dated from May 1973 through November 1974, indicate that the Veteran was repeatedly punished for absence without leave and failing to comply with orders. Also, the records state that, at the time of discharge, the Veteran was being investigated for possible involvement with dangerous drugs after marijuana was found in his locker. In a December 1976 National Guard service entrance examination report, the examiner noted that the Veteran had no psychiatric disorders. In an August 1977 VA treatment record, the examiner noted that the Veteran's sisters and friends had brought the Veteran to the VA medical facility after he grew increasingly nervous. The Veteran denied ever being treated for a psychiatric disorder previously. The examiner noted that the Veteran touched himself inappropriately during the physical examination and indicated that the Veteran's reliability was to be questioned as he would give conflicting and contradictory answers to the same question. The examiner noted that the Veteran's memory was somewhat impaired, possibly due to a concentration defect, but his recent memory was intact. The examiner noted that the Veteran obviously experienced delusions, but no hallucinations. The diagnosis was simple schizophrenia. After two days of treatment, the Veteran signed himself out of the hospital against the medical advice of the examiners. October 1978 Army National Guard personnel records indicate that the Veteran was discharged from the National Guard and Army reserves for failure to meet enlistment standards. In a November 1979 Army enlistment medical examination report, the examiner did not note any psychiatric disorders. On a contemporaneous report of his medical history, the Veteran did not report having any depression, worry, or other nervous disorder. He also did not report being hospitalized for a mental condition. Subsequent Army personnel records indicate that the Veteran only completed three weeks of training before being pulled from the program. During this training, in January 1980, the Veteran was provided a mental status evaluation. After evaluation, the examiner found that the Veteran did not have significant mental illness and indicated that the Veteran would be able participate in any administrative actions deemed appropriate. In a service personnel record, written two days after the mental status evaluation, the Veteran's superior indicated that the Veteran was punished for failing to obey a lawful order after he refused to get out of bed. Subsequent documents indicate that the Veteran's superiors found him to be untrainable. In these accounts, the superiors describe the Veteran as being arrogant, apathetic, and lacking in military discipline. In March 1980, the Veteran was discharged after being found to lack the necessary motivation, discipline, ability, and aptitude to be a soldier. In a February 1982 court record, an examiner reported conducting a psychiatric screening of the Veteran at the cellblock of the Washington, DC Courthouse after the Veteran was accused of an assault with a dangerous weapon. The examiner noted that, although the Veteran probably had psychiatric problems, he found that the Veteran was competent to stand trial. In a December 1982 court record, an examiner noted that the Veteran, when not incarcerated, was living a nomadic street life, spending nights in a shelter house. She indicated that, while in the Washington, DC Jail, the Veteran was observed to be experiencing symptoms of a chronic mental illness. In a May 1983 private treatment record, the Veteran reported having to quit several jobs a few years prior because he was too depressed to function. He stated that there had been many deaths in his family. The diagnosis was severe depression. In an August 1991 report, written for the Veteran's probation officer, a psychiatric examiner noted that the Veteran had received psychiatric treatment in a variety of places since 1982. The examiner noted that his symptoms had included bizarre speech, loose associations, delusions, paranoid ideas, depression, and social withdrawal. The Veteran had been diagnosed with depression, schizophrenia, and substance abuse. The Veteran admitted abusing alcohol, cocaine, amphetamines, and phencyclidine at various times from 1976 through 1990. The Veteran reported being unemployed since 1976. The examiner noted that the Veteran had been arrested for simple assault, drug act violations, forgery, conspiracy, and attempted petit larceny. The examiner also indicated that the Veteran had been incarcerated in the Washington, DC Jail. The examiner diagnosed mild depression, mild anxiety, and occasional indistinct auditory hallucinations. In a March 1992 VA medical examination report, the Veteran indicated being unable to sleep or concentrate. He reported experiencing constant depression and severe headaches. He also noted that he was hearing voices that scared him to the "point of nausea." He indicated that he was unmotivated and had not worked since 1979. He reported that, during his term of service in the Army, he was in "some sort of difficulty" and was discharged. He stated that he had used cocaine once or twice a week for the past year. However, he reported that he had never been in jail. The Veteran stated that he had experienced a head injury as a child. The diagnosis was schizoaffective disorder, depressed type. In a June 1992 VA medical examination report, the Veteran indicated that he was discharged from the Navy for reasons that he did not know. He stated that he went to the hospital once during this term of service because he was feeling depressed, but was turned away without treatment. He indicated that, during this period, he heard voices talking in his head. He indicated that, after his initial discharge, he had worked a few times performing janitorial services. When describing his term of service in the Army, the Veteran stated that he was discharged after three months because his superiors did not like him in the service. He indicated his belief that there was a conspiracy against him during both terms of service. He stated that he had heard voices in his head for a number of years. Usually, he heard his dead mother and sisters telling him what to do, such as to do the right thing. He recalled spending a year in prison for being involved in a drug operation and getting out of prison about a year prior to the examination. The diagnosis was chronic schizophrenia, undifferentiated type. In a March 1996 VA PTSD examination report, the Veteran reported experiencing depression since 1974, manifesting during his term of service in the Navy. He recalled that, while serving in the Navy, he was "shot" by unexpected gun firing which knocked him out unconscious. Since that time, he had experienced similar blackouts about 20 times. He recalled serving in the Army for three months in 1979 and being discharged due to his depressive disorder. He stated that he was unable to keep a job after discharge due to his depression. He admitted that he had used both cocaine and marijuana, but indicated that he had stopped using all illicit drugs in the summer of 1995. He stated that he used to hear auditory hallucinations during the period he was on drugs, but that these experiences had stopped since he quit using illicit substances. The diagnosis was moderate dysthymia. A December 2005 VA social work assessment notes that the Veteran recalled that his mother died while he was in the Navy and he was granted an early discharge to return home as he was her only son. He admitted drinking beer while in the Navy, but denied drug usage of any kind during that period. The Veteran reported that he first drank alcohol when he was eight or nine years old and drank with regularity after he turned 21. He also started to use illicit drugs with regularity when he turned 21. He admitted using crack cocaine a year prior to the interview. He stated that he had been clean and sober for a month. In a January 2006 VA treatment record, the examiner diagnosed the Veteran as having schizoaffective disorder vs. schizophrenia. In a March 2006 VA treatment record, the Veteran reported experiencing chronic recurrent depression since his discharge from the Navy. In an additional March 2006 VA treatment record, the examiner diagnosed the Veteran as having schizoaffective disorder and cocaine dependence. In a subsequent March 2006 VA treatment record, the examiner diagnosed the Veteran as having schizoaffective disorder versus schizophrenia, and substance abuse in recovery. In an October 2006 statement, the Veteran stated that he developed a depressive disorder when his mother passed away while he was in the Navy. He recalled that the depressive disorder worsened until he had to ask for a discharge. At the May 2008 Board hearing, the Veteran testified that, while serving in the Navy, he went home for his mother's funeral. He stated that, when he returned, he could not concentrate as well as he did before he left. He stated that "everything just went into a blur after that." He indicated that he had drifted ever since that time. (Hearing Transcript, page 4). When asked why no symptoms of a psychiatric disorder were listed on his Army entrance examination report, the Veteran stated that he was trying to get away from the depression he was in after a few of his relatives had passed away. He indicated that he "wanted to be alone" so he thought that the only way he could do this would be to try another tour of service. However, he recalled that it did not work out. (Hearing Transcript, page 7). He stated that, during his service in the Navy, he was scared when his ship fired its guns because he was afraid "they were going to start firing back." (Hearing Transcript, page 8). In an April 2008 VA treatment record, the examiner diagnosed the Veteran as having mild schizoaffective disorder. In an April 2009 VA treatment record, the examiner diagnosed the Veteran as having schizoaffective disorder. In an April 2010 VA medical examination report, the Veteran reported that his sister was given psychiatric treatment and hospitalized, but he did not know the reason for the hospitalization. He also stated that his mother needed psychiatric treatment, but could not afford it. He indicated that, after enlisting in the Navy, he was performing well at radio school. However, after he attended his mother's funeral in 1974, he "lost all concern." Upon returning to the Navy after a week at home, he developed headaches, could not concentrate, and believed that nothing was important anymore. Therefore, he dropped out of radio school. He stated that he asked to be discharged and was given one in 1975. Then, he started drinking and using marijuana. He stated that he joined the National Guard to clean himself up because of his drug habit. He recalled joining the Army because he was trying to pull himself out of depression. He stated that he asked for a discharge from the Army and was discharged for poor attitude and behavior. During the 1980s, the Veteran remembered using drugs and alcohol because of the "pressures of society" he felt living in Washington, DC. He stated that he worked for his landlady, but did not seek treatment for his psychiatric disorders. He remembered first hearing voices while living in a homeless shelter after his first term of service. He stopped working at his last job five or six months prior to the examination because it caused "too much stress," having to walk a half-mile to work each day. In reviewing the Veteran's records, the examiner noted that the Veteran was treated for depression and schizophrenia in 1977, prior to his entrance into the Army. The examiner also reported that the Veteran had difficulty remembering dates and the sequence of events in the past. After examination, the diagnosis was schizoaffective disorder. In her report, the examiner noted that the Veteran stated that he was depressed when his mother died while he was serving in the Navy. The examiner stated that depression was an expectable reaction to the death of one's mother, but there was no indication that this depression was clinically significant. Also, there was no indication that symptoms of psychosis developed at that time. The examiner noted that there was evidence of a mental disorder prior to the Veteran's term of service in the Army. Specifically, in the September 1977 VA treatment record, an examiner diagnosed the Veteran as having simple schizophrenia. The examiner stated that clearly this diagnosis occurred before the Veteran entered the Army. Having examined the Veteran and reviewed the claims file, the examiner stated that there was no indication that this disorder was aggravated by service beyond its normal progression. In concluding, the examiner stated that the Veteran's current schizoaffective disorder existed before the Veteran's service in the Army, but she did not see any evidence indicating that it was aggravated beyond its normal progression during or as a result of service. The examiner did not see any evidence indicating that the Veteran's current disability was related to the Veteran's service. Having reviewed the evidence of record, the Board finds that the criteria for service connection for a psychiatric disorder have not been met. The record clearly shows that the Veteran's current psychiatric disorder developed more than a year after discharge from the Veteran's first period of service (Navy) and is unrelated to that service. Furthermore, as explained below, there is clear and unmistakable evidence that the Veteran's current psychiatric disorder developed prior to the Veteran's second period of active service (Army) and clear and unmistakable evidence that this disorder was not aggravated by the Veteran's Army service. The Board notes that the only objective medical opinion of record regarding the nature and etiology of the Veteran's current mental disorder is found in the April 2010 VA medical examination report. In this report, having interviewed the Veteran, diagnosed his current disorder, and reviewed the evidence of record, the examiner noted that the Veteran's schizoaffective disorder was not related to the depression the Veteran experienced immediately after the death of his mother. The examiner explained that depressed feelings naturally followed the death of a loved one, but the records did not contain any indication of a psychiatric disorder existing during the Veteran's service in the Navy. In reviewing the evidence, the examiner noted that the August 1977 VA treatment record, written prior to the Veteran' entrance into Army service, diagnosed the Veteran as having simple schizophrenia. Therefore, she concluded that the Veteran's current disorder, being a manifestation of the diagnosed schizophrenia, clearly existed prior to the Veteran's service in the Army. Having reviewed the evidence, the examiner found that the Veteran's pre-existing disorder was not aggravated by the Veteran's brief term of service in the Army. Considering the review of the claims file, the thoroughness of the examination, and the depth of the analysis, the Board finds that the April 2010 VA medical examiner's opinion has great probative value in this matter. See Prejean v. West, 13 Vet. 444, 448 (2000). The Veteran has contended recently that his psychiatric disorder, currently diagnosed as schizoaffective disorder, manifested itself during his service in the Navy. He specifically claims that he first experienced this disorder after the death of his mother in 1974 and that it had been chronic since service. In determining whether statements submitted by a Veteran are credible, the Board may consider internal consistency, facial plausibility, consistency with other evidence, and statements made during treatment. Caluza v. Brown, 7 Vet. App. 498 (1995). In this instance, the Veteran has claimed that he requested treatment for depression during service, but was denied. However, the Veteran's service treatment records contain no record of any such requests for treatment. Moreover, the Veteran stated that he was performing well in the Navy prior to his mother's death in 1974. However, Navy personnel records indicate that the Veteran was being admonished for service infractions starting in May 1973. Also, although the Veteran experienced two days of hospitalization in August 1977 for schizophrenia, he failed to report this experience upon his November 1979 Army entrance report of this medical history. Moreover, the Board notes that treating examiners throughout the record have commented that the Veteran is unreliable in his accounts of the past. The Board notes that the Veteran has indicated that he was discharged from the Navy due to the death of his mother, when, in actuality, he was discharged due to unsuitability. The Veteran has also told various stories on when he started to hear auditory hallucinations, in some instances indicated that they started in the Navy, while at other times saying they began when he was living in a homeless shelter. Finally, the Board notes that he Veteran has shown a tendency to make statements that entirely lack in credibility. For example, the evidence clearly shows that the Veteran was incarcerated after his final discharge from service. Yet, in a March 1992 VA medical examination report, the Veteran stated that he had never been in jail. Considering the inconsistency of the Veteran's statements with other evidence of record, the examiners' comments regarding his reliability as a historian, and the Veteran's tendency to state clear falsehoods, the Board finds that the Veteran's accounts regarding the chronicity of his disorder lack credibility in this matter. Id. The Board also notes that the evidence does not show, nor has the Veteran ever contended, that the Veteran's schizophrenia is related to his service in the National Guard. The record clearly indicates that the Veteran was hospitalized in August 1977 after an incident at home and not during any active or inactive duty for training exercise. Considering the evidence of record, especially the April 2010 VA examiner's report, the Board finds that the Veteran's current psychiatric disorder is unrelated to the Veteran's service. To the contrary, clear and unmistakable evidence, specifically the VA treatment record indicating that the Veteran's schizophrenia disorder was first diagnosed in August 1977 and the April 2010 VA medical opinion, shows that the Veteran's current psychiatric disability preexisted the Veteran's Army service. Furthermore, clear and unmistakable evidence, specifically the Veteran's Army records which contain no diagnosis of a psychiatric disorder, and the April 2010 VA medical opinion, shows that the Veteran's current psychiatric disability was not aggravated by his Army service. As shown above, the presumption of soundness has been rebutted. VAOPGCPREC 3-2003; Wagner, supra. Accordingly, service connection a psychiatric disorder, to include schizophrenia and schizoaffective disorder is not warranted. (CONTINUED ON NEXT PAGE) ORDER Entitlement to service connection for a psychiatric disorder, to include schizophrenia and schizoaffective disorder, is denied. ____________________________________________ Robert E. P. Jones Acting Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs