Citation Nr: 18142081 Decision Date: 10/15/18 Archive Date: 10/12/18 DOCKET NO. 15-15 494 DATE: October 15, 2018 ORDER Entitlement to service connection for a psychiatric disorder to include posttraumatic stress disorder (PTSD) is denied. FINDINGS OF FACT 1. The Veteran does not have PTSD. 2. Schizophrenia was not manifest in service or within one year of separation. Schizophrenia is not related to service. CONCLUSIONS OF LAW 1. PTSD was not incurred in or aggravated by service. 38 U.S.C. §1110; 38 C.F.R. §§ 3.102, 3.303, 3.304. 2. Schizophrenia was not incurred in or aggravated by service. 38 U.S.C. §§ 1101, 1110, 1112, 1113; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from June 2002 to December 2002. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a November 2014 Rating Decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge (VLJ) at a Travel Board Hearing in May 2018. A copy of the hearing transcript has been associated with the claims file. During the hearing, the VLJ clarified the issue, explained the concept of service connection, made inquiry as to the existence of evidence and left the file open for the submission of evidence. The actions of the VLJ comply with 38 C.F.R. § 3.103. SERVICE CONNECTION Service connection may be granted for disability or injury incurred in or aggravated by active military service. 38 U.S.C. §§ 1110, 1131. Generally, the evidence must show (1) the existence of a current disability; (2) the existence of the disease or injury in service; and (3) a relationship or nexus between the current disability and any injury or disease during service. See Cuevas v. Principi, 3 Vet. App. 542 (1992). For the showing of chronic disease in service there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time, as distinguished from merely isolated findings or a diagnosis including the word chronic. When the disease identity is established, there is no requirement of evidentiary showing of continuity. 38 C.F.R. § 3.303 (b). Continuity of symptomatology is required only where the condition noted during service (or in the presumptive period) is not, in fact, shown to be chronic or where the diagnosis of chronicity may be legitimately questioned. When the fact of chronicity in service is not adequately supported, then a showing of continuity after discharge is required to support the claim. Id. For certain disabilities, such as schizophrenia, service connection may be presumed when such disability is shown to a degree of 10 percent or more within one year of a veteran’s discharge from active duty. 38 C.F.R. §§ 3.307, 3.309. Such a presumption is rebuttable by affirmative evidence to the contrary. Id. 1. Entitlement to service connection for PTSD The Veteran is seeking service connection for PTSD. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to service. Service connection for PTSD requires medical evidence diagnosing the condition in accordance with 38 C.F.R. § 4.125 (a); 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) and 38 C.F.R. § 4.125 (requiring PTSD diagnoses to conform to the DSM-5). The Veteran contends that he has PTSD. The Veteran is competent to relate what he has been told. However, his lay/medical evidence is of no greater probative value than the medical evidence upon which it is based. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). An October 2014 VA examiner found that the Veteran did not have a diagnosis of PTSD. Specifically, he found that the Veteran’s symptoms did not meet the diagnostic criteria for PTSD under DSM-5 criteria. Though the Veteran told the VA examiner that he almost died while in the military when he collapsed, the VA examiner noted that the Veteran “did not endorse the experience as being significantly traumatic.” He did not report intrusive, traumatic thoughts about the in-service injury. Thus, the VA examiner noted that no traumatic stressors nor intrusive thoughts adequate to support a diagnosis of PTSD were reported. The VA examiner also noted that no stressor related to a fear of hostile military or terrorist activity was reported. Though private practitioner Howard Wing, M.D., stated in a January 2012 progress report that the Veteran had PTSD, he was evaluating the Veteran according to DSM-4, which is invalid. Since the October 2014 VA examiner evaluated the Veteran in light of DSM-5 as required by 38 C.F.R. § 4.125, the Board gives more probative weight to the October 2014 VA examiner’s findings. The preponderance of the evidence is against finding that the Veteran has a current diagnosis of PTSD. The Board concludes that the Veteran does not have PTSD. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a), (d). 2. Entitlement to service connection for schizophrenia The Veteran is seeking service connection for schizophrenia. The Veteran has been diagnosed with schizophrenia during the appeal period. The issue for the Board is whether the Veteran has a disability that began during service or is at least as likely as not related to service. While the Veteran believes his schizophrenia is related to an in-service injury, he is not competent to provide a nexus opinion in this case. This issue is also medically complex, as it requires specialized medical education. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Treatment records show that the Veteran was not diagnosed with schizophrenia until approximately 2009, approximately seven years after his separation from service. Nothing at that time suggested that manifestations dated to service or shortly thereafter. The October 2014 VA examiner acknowledged that the Veteran experienced an in-service injury, but opined that the Veteran’s schizophrenia is not at least as likely as not related to an in-service injury or disease. The VA examiner’s rationale was that the Veteran’s symptoms appeared about five years after service and are unrelated to military occurrences. In a January 2014 progress report, private practitioner Howard Wing, M.D., indicated that the Veteran’s delusions may have been the result of substance abuse damage. Here, the Veteran’s schizophrenia was not manifest in service or within one year of separation from service. The evidence shows that manifestations did not appear until approximately five years after separation from service. A psychosis was not noted during service or within one year of separation and he did not have characteristic manifestations sufficient to identify the disease entity. In addition, because there were no positive findings during the critical time frame, the concept of continuity does not apply. The preponderance of the evidence weighs against finding that the Veteran’s schizophrenia began during service or is otherwise related to service. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a), (d). H. N. SCHWARTZ Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD K. McDermott, Associate Counsel