Citation Nr: 1318130 Decision Date: 06/04/13 Archive Date: 06/11/13 DOCKET NO. 07-31 029A ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Cleveland, Ohio THE ISSUE Entitlement to service connection for an acquired psychiatric disorder, to include major depressive disorder and posttraumatic stress disorder (PTSD). REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD D. Whitehead, Counsel INTRODUCTION The Veteran served on active duty from March 1977 to March 1980. He also served on active duty from May 1981 to April 1984 with a discharge under other than honorable conditions. This matter comes before the Board of Veterans' Appeals (Board) on appeal from January 2008 and May 2008 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO) in Seattle, Washington and Cleveland, Ohio, respectively. Jurisdiction now resides at the Cleveland RO. The case was most recently before the Board in August 2012, at which time the Board remanded the case to the RO via the Appeals Management Center (AMC) for additional development and adjudicative action. In a February 2013, the AMC continued the denial of the claim. The case has now been returned to the Board for appellate review. FINDING OF FACT An acquired psychiatric disorder is not related to the Veteran's period of military service from March 1977 to March 1980 and was not caused or aggravated by a service-connected disability. CONCLUSION OF LAW The criteria for service connection for an acquired psychiatric disorder are not met. 38 U.S.C.A. §§ 1112, 1131, 5107 (West 2002 & Supp. 2012); 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309, 3.310 (2012). REASONS AND BASES FOR FINDING AND CONCLUSION VA's Duty to Notify and Assist The Veterans Claims Assistance Act of 2000 (VCAA), codified in pertinent part at 38 U.S.C.A. §§ 5103, 5103A (West 2002 & Supp. 2012), and the pertinent implementing regulation, codified at 38 C.F.R. § 3.159 (2012), provide that VA will assist a claimant in obtaining evidence necessary to substantiate a claim but is not required to provide assistance to a claimant if there is no reasonable possibility that such assistance would aid in substantiating the claim. They also require VA to notify the claimant and the claimant's representative, if any, of any information, and any medical or lay evidence, not previously provided to the Secretary that is necessary to substantiate the claim. As part of the notice, VA is to specifically inform the claimant and the claimant's representative, if any, of which portion, if any, of the evidence is to be provided by the claimant and which part, if any, VA will attempt to obtain on behalf of the claimant. The Board also notes the United States Court of Appeals for Veterans Claims (Court) has held that the plain language of 38 U.S.C.A. § 5103(a) requires that notice to a claimant pursuant to the VCAA be provided "at the time" that or "immediately after" VA receives a complete or substantially complete application for VA-administered benefits. Pelegrini v. Principi, 18 Vet. App. 112, 119 (2004). The timing requirement enunciated in Pelegrini applies equally to the initial-disability-rating and effective-date elements of a service-connection claim. Dingess v. Nicholson, 19 Vet. App. 473 (2006). The record reflects that the Veteran was provided all required notice in letters mailed in October 2005 and March 2008, prior to the initial adjudication of the claim. VA also has a duty to assist a Veteran in the development of his claim. This duty includes assisting him in the procurement of service treatment records and other pertinent records, and providing an examination when necessary. 38 U.S.C.A. § 5103A; 38 C.F.R. § 3.159. The RO has obtained available service treatment records and identified VA and private treatment records. Records associated with the Veteran's claim for benefits from the Social Security Administration (SSA) have also been obtained. In addition, the Veteran has submitted written statements discussing his contentions as to the claimed disorder. There is no indication of any additional evidence that has not yet been obtained. Most recently, the Board remanded the case so that the Veteran's SSA and VA treatment records could be obtained and so that the Veteran could be afforded a VA examination. As noted above, the Veteran's SSA records have been associated with the claims file. VA treatment records dated up until January 2013 have been included in the Veteran's electronic claims folder. He was afforded a VA examination in November 2012. The Board finds that the VA November 2012 examination report is thorough and adequate upon which to base a decision with regard to the Veteran's claim. The November 2012 VA examiner considered all of the pertinent evidence of record, to include service and post-military treatment records, and the statements of the Veteran, and provided a complete rationale for the opinions stated. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). As the outstanding records have been obtained and the Veteran has been provided with an adequate examination, the RO has substantially complied with the August 2012 remand directives. See D'Aires v. Peake, 22 Vet. App. 97, 105 (2008); Dyment v. West, 13 Vet. App. 141, 146-47 (1999) (holding that there was no Stegall v. West, 11 Vet. App. 268, 271 (1998) violation when the examiner made the ultimate determination required by the Board's remand). Hence, no further notice or assistance is required to fulfill VA's duty to assist in the development of the claim. Smith v. Gober, 14 Vet. App. 227 (2000), aff'd, 281 F.3d 1384 (Fed. Cir. 2002); Dela Cruz v. Principi, 15 Vet. App. 143 (2001); see also Quartuccio v. Principi, 16 Vet. App. 183 (2002). Service Connection for an Acquired Psychic Disorder Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active military service. 38 U.S.C.A. § 1131; 38 C.F.R. § 3.303. In addition, certain chronic diseases, including psychoses, may be presumed to have been incurred or aggravated during service if they become disabling to a compensable degree within one year of separation from active duty. 38 U.S.C.A. §§ 1101, 1112, 1137; 38 C.F.R. §§ 3.307, 3.309. Moreover, service connection may be established for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes the disease was incurred in service. 38 C.F.R. § 3.303(d). Generally, the evidence must show: (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, 1166-67 (Fed. Cir. 2004) (citing Hansen v. Principi, 16 Vet. App. 110, 111 (2002); Caluza v. Brown, 7 Vet. App. 498, 505 (1995), aff'd, 78 F.3d 604 (Fed. Cir. 1996) (table). Service connection for PTSD specifically requires medical evidence establishing a diagnosis of the disability, credible supporting evidence that the claimed in-service stressor actually occurred, and a link, established by medical evidence, between the current symptomatology and the claimed in-service stressor. See 38 C.F.R. § 3.304(f). Where a determination is made that a veteran did not "engage in combat with the enemy," or the claimed stressor is unrelated 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 (1995); Dizoglio v. Brown, 9 Vet. App. 163, 166 (1996). In such cases, the record must include service records or other credible evidence that supports and does not contradict the Veteran's testimony. Doran v. Brown, 6 Vet. App. 283, 289 (1994). Moreover, a medical opinion diagnosing PTSD does not suffice to verify the occurrence of the claimed in-service stressors. See Moreau, 9 Vet. App. at 395-96; Cohen v. Brown, 10 Vet. App. 128, 142 (1997). Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists and (2) that the current disability was either (a) proximately caused by or (b) proximately aggravated by a service-connected disability. 38 C.F.R. § 3.310; see also Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc). Although all the evidence has been reviewed, only the most relevant and salient evidence is discussed below. See Gonzales v. West, 218 F.3d 1378 (Fed. Cir. 2000) (holding that the Board must review the entire record but does not have to discuss each piece of evidence). Factual Background and Analysis The Veteran claims service connection for an acquired psychiatric disorder. Specifically, he attributes his current psychiatric disorders to an in-service motorcycle accident during which he sustained injuries to his left lower extremity. He claims to have experienced psychiatric symptomatology ever since the in-service accident. As an alternative argument, the Veteran contends that his current psychiatric disorders are caused or aggravated by his service-connected left femur and left knee disabilities. As noted above, the Veteran had two periods of active duty service, with the second period from May 1981 to April 1984 resulting in a discharge under other than honorable conditions. As a result of the character of his discharge from his second period of service, the Board determined in an unappealed December 1990 decision that his service from May 1981 to April 1984 was not recognized for purposes of awarding VA benefits for service connection. As such, VA benefits may not be awarded based on the Veteran's period of active service from May 1981 to April 1984, and his second period of active duty service will not be discussed further. See 38 U.S.C.A. § 5303; 38 C.F.R. § 3.203. The Veteran's service treatment records have been reviewed and are negative for a diagnosed psychiatric disorder. Included in these records is a July 1978 report of medical history wherein the Veteran checked "yes" to having nervous trouble of any sort. The examiner noted "nervousness all the time. cause ??" A July 1979 service treatment record shows that the Veteran incurred a motorcycle accident and was subsequently treated for a fractured left femur. A January 1980 separation report of medical examination shows that the psychiatric examination was normal. On the associated January 1980 separation report of medical history, the Veteran denied ever having depression or excess worry, frequent trouble sleeping, or nervous trouble of any sort. The claims file reflects the Veteran's first post-military report of psychiatric symptomatology in private treatment records dated from March to August of 1987. According to these records, the Veteran experienced anxiety and depression. He reported experiencing conflict and stress due to his family relationships, unemployability, period of incarceration during service with subsequent discharge, and trouble with finances. A May 1987 record includes the Veteran's report of feeling stressed related to an automobile accident that occurred during the previous week; he was diagnosed with anxiety of a nonspecific nature, similar to problems while in the military. He was also noted to have severe emotional stress possibly related to his bleak financial circumstances. It was noted in a June 1997 treatment record that his anxiety was inextricably linked to his family dynamics. Collectively, these records show diagnoses of chronic anxiety and probable depression. A December 1987 private psychiatric examination report associated with his claim for SSA benefits documents the Veteran's report of a long history of severe distress dating back to his childhood. Although he reported that he served in the military, he made no specific report of his in-service motorcycle accident or left femur fracture. He reported being involved in several automobile accidents and the examiner noted that his medical records indicated possible focal brain damage. The clinical examination revealed relevant diagnoses of generalized anxiety disorder, and dysthymia. The Veteran underwent an additional private psychiatric examination in January 1988 in connection with his SSA claim. He identified his primary concern as chest pain that he had experienced for two years. The Veteran also described a two year history of experiencing anxiety, and he reported additional psychiatric symptoms to include nightmares. While he reported being involved in multiple motor vehicle accidents, to include the in-service motorcycle accident, he did not specifically attribute any of his psychiatric symptoms to these incidents. The Veteran essentially reported that his "dishonorable" discharge from his second period of active service negatively affected his life and he had been unable to recover from the incident. The clinical examination revealed relevant diagnoses of panic disorder, generalized anxiety disorder by history, dysthymia, a dream anxiety disorder, provisional, and a personality disorder, not otherwise specified. A June 1989 private psychiatric examination report documents the Veteran's report that his "emotional problems" began during his second period of military service. He also reported feeling depressed for the previous four years. A mental status examination revealed diagnoses of panic disorder, dysthymic disorder, and mixed personality disorder. A January 2002 private mental health assessment revealed a diagnosis of dysthymic disorder. VA treatment records dated from 1996 show treatment for the Veteran's psychiatric diagnoses and his varying reports of the onset and nature of his symptomatology. Treatment records dated from December 1996 to November 2003 collectively show reports and diagnoses of depression, anxiety, dysthymia, and a panic disorder; these records document his reports of stress related to his work, financial pressure, unemployment, homelessness, marital problems, and social issues. Treatment records dated in September 1999 show that he sustained a clavicle fracture in July 1999 due to a motorcycle accident. He reported that he was unable to work since that time and felt stressed due to his financial status. In November 2003, he reported feeling discouraged because he had been off work for two weeks due to falls he sustained as a result of his service-connected left lower extremity disability. Additional VA treatment records include the Veteran's report of chronic pain. A December 2003 VA treatment record reflects the Veteran's report of chronic left knee pain since his 1978 in-service motorcycle accident. He reported having difficulty sleeping in August 2004 due to left knee pain. In November 2004, he reported having residual leg pain following an automobile accident and passive suicidal thoughts. An October 2005 VA treatment record documents the Veteran report of groin pain and suicidal thoughts; he received in-patient treatment and was diagnosed with single episode major depression, cannabis abuse, rule out major depressive disorder, and rule out malingering. Treatment records dated in November 2006 show assessments of a substance induced mood disorder, dysesthesia, polysubstance dependence, and depression with suicidal ideations. A December 2006 treatment record includes the Veteran's report of experiencing nightmares for years about a motorcycle accident. An August 2009 VA treatment record includes his report of having intrusive thoughts or nightmares regarding his automobile accidents; he was diagnosed with depression, not otherwise specified. During a January 2007 VA mental health consultation, the Veteran reported having nightmares about his in-service motorcycle accident; this record shows a diagnosis of depression and possible PTSD from a motorcycle accident. He continued his report of having nightmares about his motorcycle accident during VA and private mental health consultations between March and May of 2007. A May 2007 private treatment records shows a diagnosis of PTSD. In a December 2008 letter, a VA clinical relayed that the Veteran was receiving treatment for PTSD and was enrolled in a VA PTSD program. An April 2010 VA PTSD examination report includes the Veteran's report of experiencing nightmares and flashbacks of his in-service motorcycle accident. He also reported experiencing anxiety and depression over the years. The examiner stated that the claims file was reviewed in conjunction with the examination. The clinical examination revealed a diagnosis of depressive disorder, not otherwise specified. The examiner opined that the Veteran's depressive disorder was not felt to be caused by or a result of his military service and that the Veteran did not meet the criteria for a PTD diagnosis at that time. The April 2010 examiner failed to provide any rationale for his opinions, and thus, the Board finds these opinions to be inadequate with which to decide the Veteran's claim. Stefl v. Nicholson, 120, 124 (2007) ( "[A]medical opinion ... must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions."). As directed by the August 2012 Remand, the Veteran underwent a VA examination in November 2012 to determine the nature and etiology of his claimed disorder. The examiner detailed an extensive review of the claims file, to include service treatment records documenting the Veteran's July 1978 report of nervous trouble and the June 1979 motorcycle accident. Although the Veteran denied receiving any psychiatric treatment while on active duty, he reported being "bothered" ever since the in-service accident. Significantly, the examiner also highlighted that the record did not show treatment for mental health issues until 1987, several years after the Veteran's second discharge from service. The examiner also noted the Veteran's reports of chronic pain, as well as reports of post-service motor vehicle and motorcycle accidents documented in his VA treatment records. Based on the results of the clinical examination, examiner rendered a diagnosis of major depressive disorder. The examiner opined that the Veteran's major depressive disorder was less likely as not causally related to his military service, to include the June 1979 motorcycle accident. The examiner highlighted that there were no complaints of depressive symptoms or psychiatric diagnoses in service or within a year of discharge. Thus, she concluded that the weight of the evidence did not support a chronic depressive disorder from the time of service to the present. The examiner highlighted the Veteran's strong family history of depression, and she also noted his numerous other psychosocial stressors previously reported to be the cause of his depression, which were documented as including homelessness, financial strain, and relationship issues. In addition, the November 2012 VA examination revealed a diagnosis of PTSD. The examiner identified the stressors adequate to support the PTSD diagnosis as the in-service motorcycle accident, childhood sexual abuse noted in the Veteran's records, and at least one other motorcycle accident and numerous car accidents causing injury. The examiner opined, however, that the Veteran's PTSD was less likely as not causally related to the Veteran's military service, including his June 1979 motorcycle accident. She then discussed inconsistencies in the Veteran's report of personal history with that of reports he previously made to past treatment providers, noting that his report of personal history varied between treatment providers. Specifically, the examiner highlighted that the Veteran gave varying accounts of his substance abuse history, history of child sexual trauma, and the nature of his discharge from the military; she noted Veteran's report of being "pushed out" of the military after the in-service motorcycle accident even though he had a subsequent period of service and was later incarcerated and discharged for selling diet pills. She essentially concluded that the Veteran was attempting to answer questions in a way that he believed would increase his chances of being awarded service-connected compensation; she essentially questioned the credibility of the Veteran's answers to questions in light of his attempt to obtain service connection compensation. The examiner acknowledged the Veteran's report that his PTSD began immediately after his 1979 motorcycle accident. She emphasized, however, that there was no discussion of the motorcycle accident being related to his mental health condition during the Veteran's history of psychiatric treatment and diagnoses dating back to 1987. Given this, the examiner concluded that the Veteran's PTSD diagnosis was based on childhood sexual trauma and numerous post-military motorcycle/motor vehicle accidents. Regarding the claim for secondary service connection, the examiner opined that the Veteran's major depressive disorder and PTSD were less likely as not caused by or a result of the Veteran's service-connected left femur fracture and left knee disability. The examiner noted that the Veteran's treatment records reflected numerous areas of chronic pain primarily involving the back, neck, penis, bilateral foot, chest, and ankle. She again noted the Veteran's strong family history of depression and numerous other psychosocial stressors, which she opined were more likely the cause of his major depressive disorder. The examiner ultimately concluded that the weight of the evidence did not support that pain or residuals of the Veteran's left femur fracture and left knee disability were the cause of his major depressive disorder. As for PTSD, the examiner stated that PTSD, by definition, was caused by a history of trauma and not pain or physical conditions. The examiner further opined that the diagnosed psychiatric disorders were not aggravated by the Veteran's service-connected left lower extremity disabilities. The examiner acknowledged the Veteran's lengthy history of reports of pain in numerous areas. She concluded, however, that the record did not establish a relationship between pain or residuals specific to the leg and/or knee and his mental condition. Instead, the examiner highlighted numerous treatment records documenting his report of pain without specific mention of his femur fracture or knee disability. As a final note, the examiner highlighted that the Veteran did not mention pain of any type as a contributor to his mental health symptoms during the examination. Having reviewed the foregoing, the Board finds that the preponderance of the evidence is against the claim for service connection for an acquired psychiatric disorder other than PTSD. Although the medical evidence of record dated since the Veteran filed his present claim in September 2005 reflects current diagnoses of PTSD and major depressive disorder, the preponderance of the evidence does not indicate that these diagnoses were caused or aggravated by the Veteran's military service or his service-connected disabilities. Accordingly, the claim for service connection is denied. The Veteran has essentially claimed that his current major depressive disorder and PTSD had their onset or are otherwise related to his military service, specifically his 1979 in-service motorcycle accident. In Barr v. Nicholson, 21 Vet. App. 303 (2007), the Court, citing Layno v. Brown, 6 Vet. App. 465, 467-69 (1994), emphasized that lay testimony is competent if it is limited to matters that the witness has actually observed and is within the realm of the witnesses personal knowledge. See also 38 C.F.R. §3.159(a)(2). In this case, the Veteran's service treatment records include his July 1978 affirmative response to the question of nervousness. These records also show that he sustained injuries due to a June 1979 motorcycle accident; thus, the in-service stressor he attributes to his PTSD diagnosis is verified by the service treatment records. As such, the Veteran's account of the in-service motorcycle accident (his claimed in-service stressor) and his report of in-service psychiatric symptoms (at least of an acute and transitory nature) are considered competent and credible . See Layno v. Brown, 6 Vet. App. 465, 469 (1994). The evidence, however, does not show that the Veteran has a chronic psychiatric disorder that began during service or that he experienced psychiatric symptoms immediately after his 1979 motorcycle accident. Here, the Board highlights that the Veteran's January 1980 separation report of medical examination, completed approximately two month prior to separation, is entirely negative for reports of psychiatric symptomatology or a diagnosed psychiatric disorder. The January 1980 separation physical examination report is entirely negative for any clinical findings relevant to or a diagnosis of a psychiatric disorder and therefore weighs heavily against the claim. See Caluza v. Brown, 7 Vet. App. 498, 511 (1995) (noting that credibility may be impeached by a showing of inconsistent statements, consistency with other evidence), aff'd, 78 F.3d 604 (Fed. Cir. 1996). Thus, the service medical records support a conclusion that any psychiatric symptoms reported during service were acute and transitory, as the January 1980 report of physical examination does not show a diagnosed psychiatric disorder prior to his discharge. Moreover, the Veteran's reports of a continuity of psychiatric symptoms since service are not credible given the Veteran's own inconsistent statements and the contradictory evidence of record. Notably, the first post-service reports of psychiatric symptomatology are documented in treatment records dated from 1987. These records, dated years after his first separation from the military, do not show any reports that his psychiatric symptoms began during his first period of active duty service or after his in-service motorcycle accident. Indeed, while the Veteran made general reports of his in-service motorcycle accident in the years after his discharge, he did not report any psychiatric symptoms related to this in-service incident until 2006, over two decades after discharge from his first period of active service and nearly two decades after his earliest documentation of post-military psychiatric treatment. Instead, the evidence dated prior to 2006 reflects the Veteran's reports of psychiatric symptoms due to post-military stressors, to include difficulty with employment and finances. In light of the lack of any record of treatment for or reports of psychiatric symptoms for many years after his first period of service and the internal inconsistency of his accounts of the onset of his symptoms, the Board finds any of the Veteran's reports of continuity of psychiatric symptomatology since service are not credible, and thus of no probative value. See Dalton v. Nicholson, 21 Vet. App. 23, 38 (2007); Caluza, 7 Vet. App. at 511. See also Maxson v. Gober, 230 F.3d 1330, 1333 (2000) (Evidence of a prolonged period without medical complaint and the amount of time that elapsed since active duty service can be considered as evidence against a claim.). The Board also highlights that the medical evidence does not include a probative opinion that attributes the Veteran's current psychiatric diagnoses to his military service, including his in-service motorcycle accident. The Board is not free to substitute its own judgment for that of an expert. Colvin v. Derwinski, 1 Vet. App. 171, 175 (1995). In this regard, the Board acknowledges that the January 2007 VA mental health record shows a diagnosis of depression and possible PTSD from a motorcycle accident. However, the Board notes that the notation of "possible" PTSD related to a motorcycle accident is speculative and does not constitute a definitive diagnosis. See generally, Bostain v. West, 11 Vet. App. 124, 127-28 (1998), quoting Obert v. Brown, 5 Vet. App. 30, 33 (1993) (medical opinion expressed in terms of "may" also implies "may or may not" and is too speculative to establish medical nexus). See also Warren v. Brown, 6 Vet. App. 4, 6 (193) (doctor's statement framed in terms such as "could have been" is not probative). The only definitive medical evidence of record assessing the relationship between the Veteran's current psychiatric disorders and service are the November 2012 VA examiner's opinions. Even considering the Veteran's assertions of a continuity of psychiatric symptoms since the in-service accident, and based on a review of the claims file and clinical examination of the Veteran, the November 2012 VA examiner provided opinions against the claim for service connection. The Board finds these VA medical opinions to be highly probative and compelling evidence against the Veteran's claim that his current psychiatric disorders are related to his military service. See Nieves-Rodriguez, 22 Vet. App. 295, 299- 301 (2008); see also Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). The Veteran has not provided any competent medical evidence to rebut the opinions against his claim or otherwise diminish their probative weight. See Wray v. Brown, 7 Vet. App. 488, 492-93 (1995). Additionally, the Board finds that the preponderance of the evidence does not show that the Veteran's psychiatric diagnoses are etiologically related to his service-connected left femur and left knee disabilities. See 38 C.F.R. § 3.310; Allen, 7 Vet. App. 439. In this regard, the Board again finds the November 2012 VA examiner's opinion to be highly probative. The November 2012 VA examiner concluded that the Veteran's major depressive disorder and PTSD were not caused or aggravated by his service-connected left lower extremity disabilities. This conclusion is considered highly probative as it is definitive and based upon a complete review of the Veteran's entire claims file and clinical examination of the Veteran. The conclusion is found to carry significant probative weight, as there is no objective medical evidence to rebut the opinion against the claim. See Nieves-Rodriguez, 22 Vet. App. at 299-301; see also Wray, 7 Vet. App. at 492-93. The Board acknowledges that the Veteran attributes his current major depression and PTSD disorder to his military service, specifically the motorcycle accident he incurred during his first period of active duty service. He also attributes his psychiatric condition to his service-connected left femur and left knee disabilities. He is certainly competent to report his in-service experiences and his in-service and post-service psychiatric symptomatology. However, the Veteran's statements as to the etiology of his current psychiatric disorders are not competent evidence to establish service connection. Whether the Veteran's current psychiatric conditions are related to or was caused by his military service, or whether such conditions are caused or aggravated by his service-connected disabilities, does not lie within the range of common experience or common knowledge, but requires special experience or special knowledge. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007); see also Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009). It is not shown that the Veteran possesses the ability, knowledge, or experience to provide a competent etiological opinion that these disorders are the result of his military service or any of his service-connected disabilities. See Jandreau, 492 F.3d at 1376-77; see also Woehlaert v. Nicholson, 21 Vet. App. 456 (2007); Barr v. Nicholson, 21 Vet. App. 303 (2007). Accordingly, the Board finds that the Veteran's lay statements as to medical causation are not competent evidence to establish service connection for an acquired psychiatric disorder. Id. In summary, the Board finds that the preponderance of the evidence is against the Veteran's claim of entitlement to service connection for an acquired psychiatric disorder on both a direct and secondary basis. Because the evidence preponderates against the claim, the benefit-of-the-doubt rule does not apply. Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). ORDER Entitlement to service connection for an acquired psychiatric disorder is denied. ______________________________________________ L. M. BARNARD Acting Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs