Citation Nr: 18142197 Decision Date: 10/15/18 Archive Date: 10/12/18 DOCKET NO. 14-12 653 DATE: October 15, 2018 ORDER Entitlement to service connection for post-traumatic stress disorder (PTSD) is denied. FINDING OF FACT A probative diagnosis of PTSD is not demonstrated by the evidence of record. CONCLUSION OF LAW The criteria for service connection for PTSD have not been met. 38 U.S.C. §§ 1101, 1112, 1113, 1131, 1137, 5107 (2012); 38 C.F.R. §§ 3.303, 3.304, 3.307, 3.309, 3.310 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from October 1972 to October 1975. This case is before the Board of Veterans’ Appeals (Board) on appeal from a February 2013 rating decision from the Department of Veterans Affairs (VA) Regional Office (RO) in Togus, Maine. In July 2015, the Veteran testified before the undersigned Veterans Law Judge at a videoconference hearing. A transcript of the hearing has been associated with the record. In September 2016, the Board remanded the issues of service connection for PTSD and an acquired psychiatric disorder, other than PTSD, for further development. In a December 2016 rating decision, the RO granted service connection for chronic adjustment disorder with anxious mood, and assigned a 70 percent disability rating, effective February 7, 2012. As the Veteran has not expressed disagreement with the assigned rating or effective date, the issue is no longer in appellate status and is no longer before the Board. See Grantham v. Brown, 114 F.3d 1156 (Fed. Cir. 1977) (explaining that where a claim is granted during the pendency of an appeal, a second notice of disagreement must thereafter be timely filed to initiate appellate review concerning the assigned rating or effective date). 1. Entitlement to service connection for PTSD is denied. Under the relevant laws and regulations, service connection may be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred or aggravated in active military service. 38 U.S.C. §§ 1110, 1131 (2012); 38 C.F.R. § 3.303 (a) (2017). In general, 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). There are particular requirements for establishing service connection for PTSD in 38 C.F.R. § 3.304 (f), which take precedence over the general requirements for establishing service connection in 38 C.F.R. § 3.303. See Arzio v. Shinseki, 602 F.3d 1343, 1347 (Fed. Cir. 2010). Establishment of service connection for PTSD requires: (1) medical evidence diagnosing PTSD; (2) credible supporting evidence that the claimed in-service stressor actually occurred; and (3) medical evidence of a link between current symptomatology and the claimed in-service stressor. 38 C.F.R. § 3.304 (f). Additionally, where symptoms are capable of lay observation, a lay witness is competent to testify to a lack of symptoms prior to service, continuity of symptoms after in-service injury or disease, and receipt of medical treatment for such symptoms. Charles v. Principi, 16 Vet. App 370, 374 (2002). When considering whether lay evidence is competent, the Board must determine, on a case by case basis, whether the Veteran’s particular disability is the type of disability for which lay evidence may be competent. Kahana v. Shinseki, 24 Vet. App. 428 (2011). However, although the Veteran is competent in certain situations to provide a diagnosis of a simple condition such as a headache, varicose veins, or tinnitus, the Veteran is not competent to provide evidence as to more complex medical questions, such as the etiology of psychiatric, respiratory, or orthopedic disorders. See Woehlaert v. Nicholson, 21 Vet. App. 456 (2007). Furthermore, in determining whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of matter, the benefit of the doubt will be given to the Veteran. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. The Board finds that the preponderance of the evidence is against a finding that the Veteran currently meets the criteria for a diagnosis of PTSD. The Board notes that post-service VA treatment records are inconsistent in determining whether the Veteran has a diagnosis of PTSD. Although some records noted a positive screening for PTSD, others indicated that he did not meet the criteria for PTSD. See October 13, 2010 and October 17, 2012 VA Treatment Records. The Board acknowledges the notation by Dr. D. L., which indicated that the Veteran had been diagnosed with PTSD by a VA treatment provider. See Private Treatment Record dated May 11, 2012. However, VA treatment records are silent regarding a diagnosis of PTSD in accordance with the DSM-IV or the DSM-V. Furthermore, to the extent that any PTSD diagnosis has been rendered in a VA treatment record, such determinations have not been shown to have been based on a review of the Veteran’s claims file or any other detailed and reliable medical history. Additionally, these treatment records warrant less probative weight than the other medical evidence of record (which indicates that the Veteran does not have PTSD) as they do not contain an analysis or discussion as to whether or not all of the criteria for PTSD were met. See Madden v. Gober, 125 F.3d 1477, 1481 (Fed. Cir. 1997) (recognizing the Board’s “authority to discount the weight and probity of evidence in light of its own inherent characteristics and its relationship to other items of evidence”). Simply stated, a great deal of medical evidence has been associated with the claims file that renders the diagnosis provided in certain VA treatment records less probative. In January 2013 and December 2016, the Veteran was afforded VA examinations for PTSD. The examiners determined that the Veteran did not meet the diagnostic criteria for PTSD under both the DSM-IV and DSM-V criteria. The Board finds these opinions to be highly probative, as they were based on a thorough review of the claims file and provided a detailed report to support their conclusions. See Bloom v. West, 12 Vet. App. 185, 187 (1999). The examiners also conducted complete interviews of the Veteran and reviewed the account of his experiences and reported stressors during service. For these reasons, the VA medical opinions are afforded greater probative value than the inconsistent diagnosis of PTSD found in the post-service VA treatment records. In addition, the available service treatment records contain no complaints, symptoms, or diagnoses of PTSD. Service connection is limited to those cases where disease or injury has resulted in a disability. In the absence of proof of a present disability for which service connection is sought, there is no valid claim of service connection. See Brammer v. Derwinski, 3 Vet. App. 223 (1992). Here, the greater weight of the evidence is against the conclusion the Veteran has PTSD. Accordingly, the claim for service connection for PTSD must be denied. In making this decision, the Board has also considered the lay evidence indicating that the Veteran has PTSD. The Veteran is competent to testify as to his observations. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007. In addition, lay witnesses may, in some circumstances, opine on questions of diagnosis and etiology. See Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009). However, unlike disorders that may be observable as to both their incurrence and their cause, the cause of a psychiatric disability is not readily apparent to lay observation, and the Court has held that psychiatric diagnoses are generally the province of medical professionals. See Clemons v. Shinseki, 23 Vet. App. 1 (2009) (“It is generally the province of medical professionals to diagnose or label a mental condition, not the claimant”). Moreover, even if credible and competent, the general lay assertions are outweighed by the specific and reasoned conclusion of the health care professional who diagnosed a psychiatric disability other than PTSD. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). As explained above, the most persuasive and probative evidence of record does not reflect that the Veteran has a diagnosis of PTSD. See Hayes v. Brown, 5 Vet. App. 60, 69-70 (1993). The lay statements of the Veteran, as well as the post-service VA treatment records were considered, but are found to be less probative than the VA examination reports of record. The Board finds it significant that these reports contain no diagnosis of PTSD, which further supports the finding that this disorder does not presently exist in this case. Thus, given the lack of probative and persuasive value of evidence demonstrating a current disability of PTSD, the evidence in this case is not so evenly balanced to allow application of the benefit-of-the-doubt rule as required by law and regulation. See Gilbert, supra; 38 C.F.R. § 3.102. Accordingly, for the reasons and bases discussed above, the Board concludes that the preponderance of the evidence is against a finding that there is a PTSD diagnosis in this case. See, e.g., Cohen v. Brown, 10 Vet. App. 128, 153 (1997) (Chief Judge Nebeker, concurring) (VA adjudicators may reject the claim upon a finding that the preponderance of the evidence is against a PTSD diagnosis). Therefore, service connection for PTSD is denied. MICHAEL E. KILCOYNE Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Erin J. Trojanowski, Associate Counsel