Citation Nr: 18142715
Decision Date: 10/16/18	Archive Date: 10/16/18

DOCKET NO. 15-22 010
DATE:	October 16, 2018
ORDER
Entitlement to service connection for an acquired psychiatric disability, including unspecified schizophrenia spectrum, other psychotic disorder, generalized anxiety disorder, major depression and schizophreniform disorder, is granted.
FINDING OF FACT
It is at least as likely as not that the Veteran’s acquired psychiatric disability had its onset during her active duty service.
CONCLUSION OF LAW
The criteria for service connection for an acquired psychiatric disability have been met. 38 U.S.C. §§ 1101, 1110, 1111, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304 (2017).
REASONS AND BASES FOR FINDING AND CONCLUSION
The Veteran served on active duty from May 2000 to June 2000.
Service Connection for an Acquired Psychiatric Disability
Direct service connection generally requires credible and 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. Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009).
The Veteran has submitted evidence of a diagnosis of an acquired psychiatric disability, including schizophreniform disorder and unspecified schizophrenia spectrum. See March 2015 VA Examination, p. 1.  Accordingly, the Board finds that the first element of service connection is established. See Holton, 557 F.3d at 1366.
The Board also finds that the evidence supports a finding of an in-service injury.  Specifically, the Veteran was treated for psychiatric symptoms while in service and was discharged because of those symptoms. See December 2014 STRs, pp. 9, 12, 13.  Her in-service diagnoses were psychosis not otherwise specified and adjustment disorder.  Thus, the Board finds that the second element of service connection is established. See Holton, 557 F.3d at 1366.
Regarding nexus, the evidence is at least in equipoise.  The Veteran underwent a VA examination in March 2015.  The examiner opined that the Veteran’s condition pre-existed her active duty service and was not aggravated by her service.  However, there is not clear and unmistakable evidence that the Veteran’s psychiatric disability pre-existed her service and she is presumed to have been sound at entry. See 38 U.S.C. § 1111; 38 C.F.R. § 3.304(b); Wagner v. Principi, 370 F.3d 1089, 1096 (Fed. Cir. 2004).  Consequently, the March 2015 examination contains little probative value.
In September 2018, the Board requested a medical opinion from a Veterans’ Health Administration (VHA) psychiatrist to clarify the Veteran’s psychiatric diagnoses; address whether any diagnoses pre-existed her active duty service; and, address whether any diagnoses onset in service or were aggravated by service.  The VHA findings indicate that the Veteran’s multiple diagnoses were more likely than not “based on fluctuating and varying symptom phases manifesting at different times which can be attributable to the same diagnosis and should be considered as one diagnosis, schizophreniform disorder…”  The psychiatrist went on to state that there is no documentation indicating that the condition pre-existed the Veteran’s active duty service and concluded that the condition initially manifested during her service.  Moreover, the psychiatrist attributed the onset of the condition to a combination of medical conditions (dehydration and electrolyte imbalance) and stress from adjusting to active service.  The Board finds the VHA opinion to be probative.
The evidence regarding nexus is at least in equipoise.  When the evidence for and against a claim is in relative equipoise, the Board has an obligation to resolve all reasonable doubt in favor of the Veteran. See 38 U.S.C. §5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49 (1990).  In resolving all reasonable doubt in the Veteran’s favor, the Board finds that the third element of service connection is established. See Holton, 557 F.3d at 1366.  Thus, service connection for an acquired psychiatric disability, unspecified schizophrenia spectrum, other psychotic disorder, generalized anxiety disorder, major depression and schizophreniform disorder, is warranted.
 
A. S. CARACCIOLO
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	W.V. Walker, Associate Counsel