Citation Nr: 1319281 Decision Date: 06/13/13 Archive Date: 06/21/13 DOCKET NO. 10-01 582 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUE Entitlement to service connection for an acquired psychiatric disability, to include posttraumatic stress disorder (PTSD). REPRESENTATION Appellant represented by: The American Legion WITNESSES AT HEARING ON APPEAL The Veteran, his spouse, daughter and son ATTORNEY FOR THE BOARD M. J. In, Associate Counsel INTRODUCTION The Veteran served on active duty from June 1966 to June 1968. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a January 2008 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida. In June 2011, the Veteran, his spouse, daughter and son testified before the undersigned sitting at the RO. Transcript of that hearing is of record. The case was previously remanded by the Board in February 2012 for further evidentiary development. For the reasons discussed below, the Board finds that its directives were substantially complied with. See Stegall v. West, 11 Vet. App. 268, 271 (1998). This appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c) (2012). 38 U.S.C.A. § 7107(a)(2) (West 2002). FINDINGS OF FACT 1. A valid diagnosis of PTSD related to military service is not of record. 2. An acquired psychiatric disability, to include dementia secondary to Pick's disease, major depression with psychotic features, anxiety disorder, psychotic disorder, and delusions disorder, is not shown by the competent and credible evidence of record to be related to the Veteran's military service. CONCLUSION OF LAW The criteria for service connection for an acquired psychiatric disability are not met. 38 U.S.C.A. §§ 1110, 5013A, 5107 (West 2002); 38 C.F.R. § 3.303 (2012). REASONS AND BASES FOR FINDINGS AND CONCLUSION VA has met all statutory and regulatory notice and duty to assist provisions. See 38 U.S.C.A. §§ 5100, 5102, 5103, 5103A, 5107, 5126 (West 2002); 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326 (2012). An August 2007 letter satisfied the duty to notify provisions, to include notifying the Veteran of regulations pertinent to the establishment of an effective date and of the disability rating. 38 U.S.C.A. § 5103(a); 38 C.F.R. § 3.159(b) (1); Quartuccio v. Principi, 16 Vet. App. 183, 187 (2002); Dingess/Hartman v. Nicholson, 19 Vet. App. 473 (2006). The Veteran's service treatment and personnel records were obtained and associated with his claims folder. The Veteran's VA medical treatment records and the available private treatment records, as well as his records from the Social Security Administration have been obtained. 38 U.S.C.A. § 5103A, 38 C.F.R. § 3.159. In compliance with the Board's February 2012 remand, the RO obtained the Veteran's complete service personnel file and verified the Veteran's unit and service dates in Korea. Based on this information, in April 2012, the RO requested the Joint Services Records Research Center (JSRRC) to verify the Veteran's claimed stressor in service. However, the JSRRC response was negative, and the RO made a formal finding in May 2012 that the Veteran's stressor cannot be verified due to insufficient information. Additionally, VA medical opinions were obtained in June and November 2011 to ascertain the nature and etiology of the Veteran's current psychiatric disability; the record does not reflect that these opinions were inadequate for VA purposes. 38 C.F.R. § 3.159(c) (4); Barr v. Nicholson, 21 Vet. App. 303, 307 (2007). The VA examiners conducted a complete and thorough review of the Veteran's claims file and provided an opinion that was supported by a reason for finding that the Veteran did not have a PTSD diagnosis or a psychiatric diagnosis relating to his military service. Thus, the Board finds that they were adequate. Barr, 21 Vet. App. at 311. Based on the foregoing, the Board concludes that there has been substantial compliance with its February 2012 remand. See Stegall v. West, 11 Vet. App. 268 (1998); Dyment v. West, 13 Vet. App. 141, 146-47 (1999). There is no indication in the record that any additional evidence, relevant to the issue decided herein, is available and not part of the claims file. See Pelegrini v. Principi, 18 Vet. App. 112 (2004). As there is no indication that any failure on the part of VA to provide additional notice or assistance reasonably affects the outcome of the case, the Board finds that any such failure is harmless. See Mayfield v. Nicholson, 20 Vet. App. 537 (2006); see also Dingess/Hartman, 19 Vet. App. at 486; Shinseki v. Sanders, 129 S. Ct. 1696 (2009). In Bryant v. Shinseki, 23 Vet. App. 488 (2010), the United States Court of Appeals for Veterans Claims (Court) recently held that 38 C.F.R. § 3.103(c)(2) (2012) requires that the Veterans Law Judge who conducts a hearing fulfill two duties to comply with the above the regulation. These duties consist of (1) the duty to fully explain the issues and (2) the duty to suggest the submission of evidence that may have been overlooked. Here, during the Board personal hearing, the undersigned noted the elements of the claim that were lacking to substantiate the claim for service connection, and the hearing focused on the elements necessary to substantiate the claim. The Veteran and his family were assisted at the hearing by an accredited representative from the American Legion, and they were asked questions to ascertain the onset of symptoms, the extent of any in-service event and any nexus between service and a current disability. They also asked questions to draw out the current state of the Veteran's disability. No pertinent evidence that might have been overlooked and that might substantiate the claim was identified by the Veteran or the representative. The hearing focused on the elements necessary to substantiate the claim, and the Veteran, through his family's testimony, demonstrated that he had actual knowledge of the elements necessary to substantiate his claim for service connection. Neither the representative nor the Veteran has suggested any deficiency in the conduct of the hearing. Therefore, the Board finds that, consistent with Bryant, the undersigned complied with the duties set forth in 38 C.F.R. § 3.103(c)(2). Initially, the Board notes that the Veteran was diagnosed with dementia at approximately the same time he filed his service connection claim. In a January 2009 rating decision, he has been deemed not competent to handle disbursement of funds. His spouse is speaking on his behalf. His family members and friends also presented lay testimony in support of his claim. The Veteran contends, as described by his spouse, that he has PTSD that is related to his military service. He contends that he had "traumatic experiences while stationed at the DMZ [(demilitarized zone)] in South Korea." It is argued that the beginning of the Veteran's fear of hostile forces took place after the USS Pueblo was attacked in January 1968 by the North Koreans. In a July 2011 statement, J.W. indicated that after the seizure of the USS Pueblo, the Veteran's unit was put on alert and he and the Veteran were flown to the DMZ where they laid in the grass with weapons pointed toward North Korea. See also, the internet article titled "the Pueblo Incident." Entitlement to service connection for PTSD requires medical evidence diagnosing PTSD in accordance with the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-IV); a link, established by medical evidence, between current symptoms and an in-service stressor; and credible supporting evidence that the claimed in-service stressor occurred. 38 C.F.R. §§ 3.304(f); 4.125(a). Where the claimed stressor is not related to combat, the veteran's lay testimony, by itself, will not be enough to establish the occurrence of the alleged stressor. Instead, the record must contain evidence that corroborates the veteran's account as to the occurrence of the claimed stressor. See 38 U.S.C.A. § 1154(b); 38 C.F.R. § 3.304(d), (f) (2012); Cohen v. Brown, 10 Vet. App. 128 (1997). Evidence denoting participation in combat includes award of decorations such as the Combat Action Ribbon, Combat Infantryman Badge (CIB), Purple Heart Medal, and decorations such as the Bronze Star Medal that have been awarded with a Combat "V" device. A review of the Veteran's DD-214 reflects that he is not currently shown to have received commendations or awards that warrant the conclusion that he participated in combat. See VAOPGCPREC 2-99 at 12; 65 Fed. Reg. 6256 -6258 (2000); VBA's Adjudication Procedure Manual, M21-1MR (hereinafter "M21- 1MR"), Part III.iv.4.H.29.b, c.; see also Veteran's discharge (DD Form 214). As it is not shown the Veteran engaged in combat, his assertion of a service stressor is not sufficient to establish the occurrence of such an event. Rather, his alleged service stressor must be established by official service records or other credible supporting evidence. 38 C.F.R. § 3.304(f) (2012); Pentecost v. Principi, 16 Vet. App. 124 (2002); see also M21-1MR, Part III.iv.4.H.29.a, i. Where VA determines that the veteran did not engage in combat with the enemy, or that the veteran did engage in combat with the enemy but the claimed stressor is not related to such combat, the veteran's lay testimony, by itself, will not be enough to establish the occurrence of the alleged stressor. Instead, the record must contain evidence that corroborates the veteran's account as to the occurrence of the claimed stressor. See 38 U.S.C.A. § 1154(b); 38 C.F.R. § 3.304(d), (f); Cohen v. Brown, 10 Vet. App. 128 (1997). In April 2012, the RO requested the JSRRC to verify the Veteran's claimed stressor in service. However, the JSRRC responded that after researching the available records and coordinating their research with the National Archives and Records Administration (NARA) and the U.S. Army Center for Military History, it was confirmed that there was a USA Camp Carroll Depot located at Waegan, Korea; however, they were unable to locate documentation to substantiate the Veteran's claim that his unit was placed on alert. The JSRRC further reported that the chronology did not provide any information pertaining to any units being placed on alert and flown to the DMZ. Nevertheless, with regards to the corroboration of stressors, the Board observes the recent amendment to 38 C.F.R. § 3.304 concerning stressors based on a veteran's "fear of hostile military or terrorist activity." Specifically, the amendment provides that, if a stressor claimed by a veteran is related to the veteran's "fear of hostile military or terrorist activity" and a VA or VA-contracted psychiatrist or psychologist confirms that the claimed stressor is adequate to support a diagnosis of PTSD, the veteran's lay testimony alone may establish the occurrence of the claimed in-service stressor so long as there is not clear and convincing evidence to the contrary, and provided that the claimed stressor is consistent with the circumstances, conditions, or hardships of the veteran's service. Stressor Determinations for Posttraumatic Stress Disorder, 75 Fed. Reg. 39,843, 39,852 (July 13, 2010) (to be codified at 38 C.F.R. § 3.304(f)(3)); 75 Fed. Reg. 41,092 (July 14, 2010) (correcting the effective date of the rule published on July 13, 2010). For purposes of this section, "fear of hostile military or terrorist activity" means that "a veteran experienced, witnessed, or was confronted with an event or circumstance that involved actual or threatened death or serious injury, or a threat to the physical integrity of the veteran or others, . . . and the veteran's response to the event or circumstance involved a psychological or psycho-physiological state of fear, helplessness, or horror." 75 Fed. Reg. at 39,852. In the instant case, however, it is found that this amendment does not apply. While the Veteran has alleged that is stressor is directly related to his "fear of hostile military or terrorist activity," there is clear and convincing evidence that the claimed inservice stressor had not occurred. The JSRRC, in conjunction with NARA and the US Army Center for Military History, were not able to corroborate the claims stressor, finding no evidence that the Veteran's unit had been placed on alert and flown to the DMZ. Since there is "clear and convincing evidence to the contrary," the Veteran's lay statements concerning the alleged stressor are not sufficient to establish its occurrence. An October 2006 VA psychology note reflects that the Veteran had mild memory problems and difficulty with abstract thinking. The Veteran's wife reported his moodiness. The assessment was cognitive disorder, not otherwise specified. A June 2007 VA psychiatry report reflects that the Veteran complained that "Well, I don't forget anything about telephone, but I forget people's name that I haven't seen for a while." His wife reported that she noticed that the Veteran, for the last several months, was irritable. He denied any violence in the past. Concerning family and social history, the Veteran reported serving in Korea for one and a half years, which was not combat-related. He had been married to his current wife for 30 years with five children. He ran his own telephone services business since 1990 and reported that the business was doing well. On mental status examination, the Veteran seemed to minimize his depressive symptoms but his wife reported that he seemed depressed. There was no evidence of psychosis and his thought process was goal-directed, but he had problems recalling three objects in three to five minutes. His attention and calculation were adequate and his judgment and insight were good. He had the capacity to give informed consent for treatment. The diagnoses were pseudodementia versus dementia, Alzheimer; and rule out depressive disorder, not otherwise specified. On a July 2007 VA mental health clinic visit, the Veteran was seen for reevaluation/medication management with a history of pseudodementia versus dementia, Alzheimer's type; and depressive disorder, not otherwise specified. The Veteran's wife reported that the Veteran was still feeling depressed; however, she reported that he had no problem with his memory except that he had difficulty remembering names. Although the Veteran denied being depressed, the examiner noted that he had blunted affect. An October 2007 VA mental health note stated that the Veteran did not respond to anything except when asked, responding with "yes" or "no." He stated that he was doing fine and denied feeling depressed. His wife was concerned about him being withdrawn and working "very little," and reported isolated episodes of disruptive behaviors in a public setting. On mental status examination, the Veteran did not initiate conversation and his affect was flat. He had no problem with comprehension, attention and calculation. No delusions or paranoia, hallucinations were shown. The Axis I diagnoses were depressive disorder, not otherwise specified; consider mood disorder due to general medical condition; and mild dementia. A January 2008 VA mental health note stated that the Veteran still did not respond to anything except when asked, responding with "yes" or "no." His wife was very concerned of his mental status, which she stated that slowly deteriorating since 2002. The examiner noted that it was difficult to elicit a history from the Veteran. His wife noticed that he could not manage his own business. The Veteran reported being depressed "because I can't do the things I used to do." The diagnoses were depressive disorder, not otherwise specified; rule out mild dementia; and rule out mood disorder due to general medical condition. The Veteran had multiple psychiatric admissions from February to May 2008. It was noted that he carried a diagnosis of schizoaffective disorder, bipolar type, and rule out dementia. The Veteran's wife and family reported his problems with confusion, bizarre and inappropriate behaviors, delusion, paranoia, and inability to take care of himself. They also reported that he had increasing episodes of aggressive, labile, and angry behaviors. The diagnoses were dementia secondary to Pick's disease; major depression with psychotic features; anxiety disorder, not otherwise specified; psychotic disorder, not otherwise specified; and delusions disorder, not otherwise specified. In a March 2008 letter, Dr. A.C. stated that the Veteran had a psychiatric admission from February to March 2008 and that he was discharged with a diagnosis of psychotic disorder due to Pick's disease. Dr. C. opined that the Veteran was no longer capable of sustaining full time employment due to his decreased ability to function, noting that he should not operate a vehicle. The Veteran underwent a private psychiatric evaluation in May 2008. The examiner stated that the Veteran was very cooperative overall; however, he displayed impaired judgment, impaired impulse control, impaired reasoning, tangentiality, and deficient emotional control. He also had poor insight and insisted that there was nothing wrong with him. After conducting a mental status examination and diagnostic tests, the provisional diagnosis was frontal lobe dementia. The examiner noted that the combination of marked memory impairment along with marked reasoning problems, perseveration, dysregulation in affect, and his engaging in inappropriate behavior all strongly suggested dementia primarily of the frontal lobe type. Lay statements submitted by the Veteran's brother and a friend, dated in January 2010, indicate that the Veteran had changed after military service. He would have mood swings and have difficulty getting along with people. An October 2011 VA mental health note stated that the Veteran was totally and permanently disabled because of his chronic dementia. In June 2012, a VA examiner, who reviewed the Veteran's claims file, opined that the Veteran less likely met the DSM-IV criteria for PTSD. In support of this opinion, the examiner stated that the traumatic stressor the Veteran had claimed he experienced during his military service was refuted by the research conducted by the government authority and his claimed stressor was not substantiated. In November 2012, another VA examiner conducted a careful review of the Veteran's claims file and listed all pertinent medical record, including the Veteran's pre-service, service, and post-service treatment reports. The examiner opined that she was unable to find that any of the included diagnoses could be linked to military service. The examiner stated that all of the diagnoses listed were found equally among the civilian and military populations and nothing in the record credibly linked the diagnoses to events or conditions peculiar to military service. The examiner further stated that symptoms of anger, forgetfulness, assaultiveness, grandiosity, and even hypervigilance were not unusual in many diagnoses and not necessarily linked to any particular life experiences, such as military service. The examiner also noted that numerous psychiatrists and psychologists evaluating the Veteran over a long history have never diagnosed PTSD or any other mental disorder caused by military service. Based on a review of the evidence, the Board concludes that service connection for an acquired psychiatric disability, to include PTSD, is not warranted. Initially, the Board finds that the evidence of record does not reflect that PTSD has been diagnosed in accordance with the pertinent criteria that detailed in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (1994) (DSM-IV). As discussed above, the Veteran has reported in-service stressor events relating to the explosion/seizure of a Navy ship by North Korea and being sent to the DMZ in Korea. Despite various attempts, there has been corroboration of the stressor event reported by the Veteran. Therefore, there is no evidence of a corroborated stressor sufficient to support a diagnosis of PTSD. Moreover, pursuant to the Board's February 2012 remand, VA medical opinions were obtained by VA psychologists in June and November 2012. Following a thorough examination of all available records, the examiners opined that the Veteran did not meet the criteria for PTSD. As noted by the examiners, the Veteran's claimed stressor could not be credibly substantiated, to support a diagnosis of PTSD, and the opinions indicate that the Veteran did not meet the criteria for a diagnosis of PTSD. In this case, no VA professional has ever provided an opinion indicating that the Veteran meets the criteria for a diagnosis of PTSD based on his claimed stressor relating to the USS Pueblo incident. Thus, the evidence fails to establish a diagnosis of PTSD due to the claimed stressor by a VA or VA-contracted psychiatrist or psychologist. Furthermore, the Veteran's PTSD screen has been negative, as reflected in February 2005, August 2006 and August 2007 VA treatment reports. He denied having any experience that was so frightening, horrible or upsetting that he had nightmares, avoidance behaviors, constant hypervigilance, exaggerated startle response, or feeling numb and detached from others. The Veteran reported feeling better with an increased dose of medication and stated that he could remember things about telephone but occasionally forgot names. The Board acknowledges the Veteran's wife's belief that the Veteran has PTSD that is related to his military service. In this regard, lay evidence can be competent and sufficient to establish a diagnosis of a condition when (1) a layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). However, the Board finds that a psychiatric disorder, including PTSD, is not the type of disorder which is susceptible to lay observation. Even if the Veteran's wife was competent to provide an opinion as to the diagnosis of PTSD which is typically confirmed by a psychiatric examination, any probative value of any such opinion is outweighed by that of the June and November 2011 VA examiners, who have education, training and experience in evaluating the etiology of a psychiatric disability. The VA examiners reviewed the Veteran's claims folder and opined that it was less likely that the Veteran met the criteria for a diagnosis of PTSD. Without evidence of a current diagnosis of PTSD related to a verified stressor, service connection for PTSD cannot be granted. 38 C.F.R. §§ 3.304(f); 4.125(a). Therefore, the Board concludes that service connection for PTSD is not warranted. As noted above, the record reflects various psychiatric disorders other than PTSD. Specifically, the Veteran was diagnosed with dementia secondary to Pick's disease; major depression with psychotic features, anxiety disorder, psychotic disorder, and delusions disorder. Service treatment records reveal that the Veteran reported depression or excessive worry on his April 1968 separation examination report; however, it does not otherwise show any treatment for, or diagnosis of, a psychiatric disorder. According to a January 2010 statement submitted by the Veteran's service comrade, E.S., the Veteran began to have mood swings and would drink excessively while stationed in Korea beginning in 1967. However, no medical professional has provided any opinion to indicate that any diagnosed post-service acquired psychiatric disorder is related to his military service. The Board remanded this issue in February 2012 to obtain a medical opinion to determine the etiology of the Veteran's current psychiatric disorder. However, the November 2012 VA examiner opined that she was unable to find any of the included diagnoses that could be linked to military service. In support of this opinion, the examiner stated that all of the diagnoses listed were found equally among the civilian and military populations and nothing in the record credibly linked the diagnoses to events or conditions peculiar to military service. The examiner further stated that symptoms of anger, forgetfulness, assaultiveness, grandiosity, and even hypervigilance were not unusual in many diagnoses and not necessarily linked to any particular life experiences, such as military service. That opinion is uncontradicted. To the extent that the Veteran's wife claims that the Veteran's current psychiatric disorder other than PTSD is related to his military service, the Board finds that her statements regarding the Veteran's psychiatric symptoms as they relate to his claimed military stressor not credible. To that effect, a lay person may be competent to report the etiology of a disability; however, competency of evidence differs from weight and credibility. Competency is a legal concept determining whether testimony may be heard and considered by the trier of fact, while credibility is a factual determination going to the probative value of the evidence to be made after the evidence has been admitted. Rucker v. Brown, 10 Vet. App. 67, 74 (1997); Layno v. Brown, 6 Vet. App. 465, 469 (1994); see also Cartright v. Derwinski, 2 Vet. App. 24, 25 (1991) ("although interest may affect the credibility of testimony, it does not affect competency to testify."); cf. Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). In the September 2007 statement, the Veteran's wife related that she asked her husband on August 30, 2007 if he could remember his service in Korea. It was noted that he remembered very well being sprayed with a substance called Agent Orange and being exposed to cold weather below 20 degrees only wearing his uniform with no jacket or warm attire. She claimed that these things contributed to his memory loss, depression, anger and anxiety. She further claimed that he mentioned the "negative stuff" started happening in February or March between 1966 and 1969. He remembered that his troops were sent because the North Koreans blew up one of the ships and their duty was to protect the South Koreans. However, at the June 2011 Board hearing, the Veteran's wife asserted that the Veteran was actually on a ship and was told to get off the ship and that he also witnessed the ship blowing up. She could not remember the name of the ship. The Veteran's spouse's description of the stressor relating to the USS Pueblo incident is not consistent with the other evidence of record. The internet article describing the incident indicates that the ship was seized but not blown up by North Korea. Additionally, USS Pueblo was a Navy ship, which was captured either in the North Korean territorial waters or the international waters at the time of the incident. However, the Veteran's service personnel records, as well as lay statements submitted by his former service comrade, indicated that at the time of the incident, the Veteran was stationed at the U.S. Army Camp Carroll Depot, located in Waegan, South Korea. Notably, in the May 2008 psychiatric evaluation report, the Veteran related that recently he was in the hospital because "someone told a lie-they said I was hurt in the Army-that's a lie." He later stated that "when I lied and said something happened to me in South Korea[,] God punished me and they put me in the hospital." Regarding military history, the Veteran reported that he served in the military from 1966 to 1968 and that while serving in South Korea, "North Korea bombed Navy ships and he was teaching communications and they had them sit on a hill." The examiner noted, however, that it was difficult to follow the Veteran's train of thought. Additionally, in her September 2007 statement, the Veteran's wife indicated that the Veteran's first symptoms with anger started in November 2002, and within the last five years, she and her family had seen a major change in the Veteran. She reported his anger problems, obsession with a particular subject matter, trouble sleeping, memory problems, and depression. Specifically, she stated "I have been married to my husband for 32 years. He has been a kind, gentle and caring husband and father for me and our five children. He's provided for them unconditionally and has taken care of me as a stay at home mom for about 14 years. I know my husband very well and so this is why I've realized over the past five years that he has changed." However, these statements concerning the onset of the Veteran's psychiatric symptoms approximately in 2002 are significantly inconsistent with her testimony at the June 2011 hearing. At the June 2011 hearing before the Board, the Veteran's wife, daughter and son testified that throughout his whole life as they knew him, the Veteran had been angry, aggressive, irritable, hypervigilant and paranoid all the time; he had displayed unpredictable volatile violent behaviors. His wife testified that she and the Veteran got married in 1976 and she had known him for two years prior to their marriage. The Veteran had a prior marriage that ended in less than year due to spousal abuse problems. The Veteran's spouse testified that since the beginning of their marriage, the Veteran experienced night sweats and disturbed sleep weekly and that he would stare at people and not like crowds. Over the years, he drank excessively and was put on rehabilitation on multiple occasions. He had worked for a telephone company for about 10 years but was let go due to anger problems. She further testified that within five years of their marriage, the Veteran had a major change in his behaviors in that he ignored his family and children. Given the fact that the Veteran was very likely a poor historian due to his dementia and the apparent inconsistencies in his spouse's description of his experience in service, as well as the onset of his psychiatric symptoms, the Board finds that her statements to be not credible. Thus, her assertions as to diagnosis and etiology of a psychiatric disability have no probative value. Without evidence of the onset of an acquired psychiatric disorder to include dementia secondary to Pick's disease; major depression with psychotic features, anxiety disorder, psychotic disorder, and delusions disorder, during active duty or competent and credible evidence of an association between an acquired psychiatric disorder, and the Veteran's military service, service connection for an acquired psychiatric disability other than PTSD is also not warranted. Because a valid diagnosis of PTSD based on military stressor is not of record, and because the evidence of record does not relate the Veteran's non-PTSD acquired psychiatric disorders to his military service, the preponderance of the evidence is against the claim for service connection. The benefit of the doubt doctrine is inapplicable, and service connection for an acquired psychiatric disability is not warranted. See 38 C.F.R. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). ORDER Entitlement to service connection for an acquired psychiatric disability is denied. ____________________________________________ L. M. BARNARD Acting Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs