Citation Nr: 18141443 Decision Date: 10/10/18 Archive Date: 10/10/18 DOCKET NO. 16-24 953A DATE: October 10, 2018 ORDER Service connection for an acquired psychiatric disorder, to include major depressive disorder, is granted. Service connection for a headache disability, to include as secondary to tinnitus or an acquired psychiatric disorder, is granted. FINDINGS OF FACT 1. Resolving reasonable doubt in the Veteran’s favor, his acquired psychiatric disorder began during active service. 2. Resolving reasonable doubt in the Veteran’s favor, his headache condition is proximately due to his service-connected tinnitus and acquired psychiatric disability. CONCLUSIONS OF LAW 1. The criteria for service connection for an acquired psychiatric disorder are met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). 2. The criteria for secondary service connection for a headache condition are met. 38 U.S.C. §§ 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.310(a). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active military service from April 1980 to March 1982. Service Connection Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. 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 (Fed. Cir. 2004). Service connection may also be established on a secondary basis for a disability which is proximately due to, or the result of, a service connected disability. 38 C.F.R. § 3.310(a). Secondary service connection may also be established for a disability which is aggravated by a service connected disability. In order to prevail on the issue of secondary service connection, the record must show (1) evidence of a current disability; (2) evidence of a service connected disability; and (3) medical nexus evidence establishing a connection between the service-connected disability and the current disability. Wallin v. West, 11 Vet. App. 509 (1998). Here, the Veteran has provided evidence of a current disability to support each of his claims. Thus, this element is not in dispute for service connection for either an acquired psychiatric disorder or a headache condition. These claims depend on whether they can be linked to some element of the Veteran’s service, or to a service-connected condition. 1. Service Connection for an Acquired Psychiatric Disorder In assessing the evidence of nexus, the Board notes that when it is evaluating the evidence of record, it must assess the credibility and probative value of the evidence, and, provided that it offers an adequate statement of reasons or bases, the Board may favor one medical opinion over another. See Owens v. Brown, 7 Vet. App. 429, 433 (1995). While the Board is not free to ignore the opinion of a treating physician, it is free to discount the credibility of that physician’s statement. See Guerrieri v. Brown, 4 Vet. App. 467, 471-73 (1993). In this case, the Board has received nexus opinions from three medical professionals, one private clinician and two VA examiners. Because these medical professionals are presumed to have appropriate medical training and experience, the Board accepts all of the opinions as competent and credible. Nevertheless, the Board must determine what evidence is the most probative. Upon review of the medical evidence of record, the Board places more probative weight on the August 2017 opinion of the private psychologist, Dr. H.H., than on the August 2017 and July 2013 VA examiner opinions. With regard to the July 2013 VA examiner’s opinion, the examiner simply stated that the Veteran reported having felt depressed for the previous year, so his depression was not related to his military service which had ended 30 years prior. However, this examiner did not support his opinion with any rationale and did not discuss how the VA treatment records he stated he reviewed showed the Veteran was screened positively for depression in the earliest VA treatment records associated with the claims file, dating back to 2011. Thus, there is evidence that the Veteran’s psychiatric symptomatology could have waxed and waned since service, as symptoms clearly existed more than a year prior to the VA examination, despite the examiner stating that the Veteran did not experience his current depression earlier than the year prior to the examination. The Board, therefore, places relatively little probative weight on the July 2013 VA examiner’s opinion, which does not appear to have considered the Veteran’s entire medical history. The August 2017 VA examiner’s opinion is also afforded little probative value. This examiner proffered a positive nexus opinion, but did so because he associated the Veteran’s acquired psychiatric disorder with a seizure disorder. The Veteran is not service-connected for a seizure disorder, so this opinion is not probative as to whether the Veteran’s psychiatric condition is related to any element of his active service. Dr. H.H. examined the Veteran in August 2017 and concluded that he suffered from major depressive disorder which more likely than not began during his military service. The opinion of Dr. H.H. is supported by a rationale that thoroughly considered the medical evidence of record, including the Veteran’s historical treatment records and relevant medical literature. Dr. H.H. also discussed and considered lay statements of record made by the Veteran and written statements by his family members discussing changes they observed in the Veteran’s psychiatric state after he separated from service. The Board finds this opinion credible and affords it great weight, as it is based on sufficient facts and data applied to reliable principles and methods. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). The Board accordingly affords greater probative weight to this opinion than to either of the VA examiners’ opinions on this matter. In light of the above, the weight of the probative evidence supports a finding that there is a medical nexus linking the Veteran’s acquired psychiatric condition to his active service. Thus, service connection for an acquired psychiatric condition is warranted. 2. Service Connection for a Headache Disability Regarding the Veteran’s claimed headache condition, the Board finds the most probative evidence to be the October 2017 private medical opinion the Veteran submitted from Dr. H.S., which stated the Veteran’s headaches were related to his service-connected tinnitus and acquired psychiatric disorder. No other medical opinion has been obtained on the etiology of the Veteran’s headache condition. Thus, there is no medical evidence to dispute the opinion of Dr. H.S. Being that the Veteran has a current headache condition which has been shown to be medically linked to service-connected disabilities, this claim is also warranted as the elements of a secondary service connection are met. Accordingly, service connection for a headache condition is allowed. MATTHEW W. BLACKWELDER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD C. Davidoski, Associate Counsel