Citation Nr: 18141383 Decision Date: 10/10/18 Archive Date: 10/10/18 DOCKET NO. 06-28 300A DATE: October 10, 2018 ORDER Service connection for anxiety disorder is granted. FINDING OF FACT The Veteran’s anxiety disorder manifested while in service. CONCLUSION OF LAW The criteria are met for service connection for anxiety disorder. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from March 1946 to January 1948. Service connection for anxiety disorder is granted. Service connection may be granted for any current disability that is the result of a disease contracted or an injury sustained while on active duty service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. §§ 3.303(a), 3.304. Service connection requires competent evidence showing: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and, (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). The Veteran is diagnosed with anxiety disorder. He has asserted that he had his first panic attack while in service, and that he has had regular panic attacks and anxiety since his service. He reports having anxiety prior to his service, but that it significantly increased while on active duty. The Veteran’s STRs do not show treatment of or complaints for mental health symptoms. His entrance examination does not note a psychiatric diagnosis. The Board notes that the “presumption of soundness” does not apply prior to January 1947, but the absence of findings at his entrance strongly supports that he did not have an acquired psychiatric disability at the time of his entrance. See 38 C.F.R. § 3.304(a) & (b). He has reported multiple times—initially in a November 1950 statement—that he did not seek medical treatment for his anxiety during his active duty service, but instead he spoke about his feelings with the chaplain, who advised him to do the rosary. He also reported he was reluctant to talk too much about his symptoms, as he was worried that he would be viewed in a negative light. The Board finds this credible. The record contains four “Buddy” statements from men who served with the Veteran. Each noted that he was observed to be nervous, withdrawn, and homesick while stationed on Guam, and that he acted differently from other soldiers. The earliest available medical records containing psychiatric symptoms or diagnoses are dated in June 1956, when he noted on a Report of Medical History that he was nervous. In June 1957, he reported a history of depression or excessive worry, which the examiner noted was present at his enlistment. He reported it in June 1960. At an August 1970 medical appointment, the physician noted the Veteran had a history of nervous spells and anxiety, and had been given a prescription for Valium in 1968. The Veteran reported continued anxiety and was diagnosed with affective reaction, chronic, moderately severe. At a December 1970 VA examination, he complained of anxiety. It was noted he was prescribed Serax and Vivactil, which treat anxiety and depression, but he was diagnosed with a personality disorder. The Board notes that, starting from the early 1970’s, the Veteran’s file contains records of ongoing symptoms and treatment up to the present time. He reported some treatment in the 1950’s, but those records were unavailable. He has submitted two private medical opinions that attribute his current symptoms to his service. Dr. B.R., in September 2010, opined the Veteran had anxiety disorder while still in active duty service. He noted review of the Veteran’s statements regarding his service and symptoms, as well as the available medical records, which showed complaints in the 1950’s through to the present, as discussed above. Dr. B.R. listed some of the incidents the Veteran reported that were anxiety-inducing, including being put in the ship’s brig when he failed to respect rationing rules, and he opined that these incidents would have exacerbated any existing anxiety. Because the record does not show that he entered service with a diagnosis, the Board finds this evidence to be probative as to the onset of his symptoms, and it shows a temporal relationship between the Veteran’s diagnosis and his service. Dr. R.H. also noted that the Veteran reported some symptoms prior to service, but that onset of panic symptoms did not begin until he was already in service. Dr. R.H. indicated review of the record and the Veteran’s statements, which he noted were consistent and detailed. Dr. R.H. acknowledged that the medical evidence was limited but found nothing that caused him to doubt the Veteran’s statements about the impact his active duty service had on his mental health. He, too, opined that the Veteran’s symptoms had a temporal relationship with his active service. He further opined that he found the Veteran credible, and noted that he did not detect any type of exaggeration being made for the purpose of self-gain. In particular, he did not think the Veteran was magnifying his symptoms, and instead found the Veteran’s reports to be reasonable and not beyond the reality of the reported circumstances. The August 2012 VA examiner did not diagnose any acquired psychiatric disabilities, and did not provide an opinion on whether there was a relationship to service. He opined the Veteran had a personality disorder, which is not an acquired disability, and opined it was not related to service. This medical report is inadequate as it does not address the Veteran’s anxiety diagnoses. The Veteran has made many statements regarding his symptoms over the years, which are generally internally consistent with one another. He has consistently reported having some anxiety prior to service but that he began to have panic attacks while in service. There is nothing to show that he had clinically significant anxiety prior to his service, and the Board does not find he had a preexisting disability. He has consistently reported feelings of nervousness during service, and depression. His treatment providers have opined that his symptoms likely began in service. There is no evidence that contradicts this finding, or that strongly suggests another source.   Although he did not have consistent medical treatment until years after separation, that is not the standard for establishing service connection. Service connection is available for disabilities diagnosed after service if the evidence demonstrates an as likely or not in-service cause. 38 C.F.R. § 3.303(d). His statements are credible and competent, and the Board finds them probative to the issue. Given his statements and the available medical evidence, the Board finds that his anxiety disorder is at least as likely as not related to his service, as it appears to have incepted in service and has persisted since that time. Under these circumstances, any doubt is resolved in his favor. Accordingly, service connection is granted. Nathaniel J. Doan Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Gibson