Citation Nr: 18142783 Decision Date: 10/16/18 Archive Date: 10/16/18 DOCKET NO. 17-55 757 DATE: October 16, 2018 ORDER Entitlement to service connection for a psychiatric disability, to include major depressive disorder and generalized anxiety disorder, is denied. Entitlement to service connection for diabetes mellitus, to include as secondary to major depressive disorder, is denied. Entitlement to service connection for narcolepsy is denied. Entitlement to service connection for insomnia, also claimed as nightmares, is denied. FINDINGS OF FACT 1. While on entry-level status in the United States Army, the Veteran was administratively separated with an Uncharacterized Discharge. 2. The preponderance of the evidence is against a finding that major depressive disorder or generalized anxiety disorder is related to service. 3. The preponderance of the evidence is against finding that diabetes mellitus is related to service, manifested within one year following separation from service, and service-connected has not been established for major depressive disorder. 4. The preponderance of the evidence is against a finding that narcolepsy is related to service. 5. The preponderance of the evidence is against finding that insomnia, also claimed as a disability manifested by nightmares, is related to service. CONCLUSIONS OF LAW 1. The Veteran’s Uncharacterized Discharge from service while on entry level status is considered to be other than dishonorable, and is not a bar to receiving VA benefits. 38 U.S.C. § 5303; 38 C.F.R. §§ 3.12(k), 3.354. 2. The criteria for entitlement to service connection for a psychiatric disability, to include major depressive disorder and generalized anxiety disorder, have not been met. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. 3. The criteria for entitlement to service connection for diabetes mellitus, including as secondary to major depressive disorder, have not been met. 38 U.S.C. § 1110; 38 C.F.R. § 3.303, 3.310. 4. The criteria for entitlement to service connection for narcolepsy have not been met. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. 5. The criteria for entitlement to service connection for insomnia, also claimed as nightmares, have not been met. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS Veteran’s Status The Veteran served on active duty for one month, from December 1995 to January 1996. The Veteran received an uncharacterized discharge while still in entry-level status, during the initial 180 days of active duty. The Veteran subsequently attempted to upgrade that discharge, but that attempt was denied by the Army Discharge Review Board in an October 2002 decision. Nonetheless, because the Veteran’s separation occurred while on entry level status, VA regulations hold that that type of discharge “shall be considered under conditions other than dishonorable,” and thus, not a bar from receiving VA benefits. 38 C.F.R. § 3.12(k)(1). Service Connection Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). In addition, disabilities diagnosed after discharge may also be service connected if all the evidence, including pertinent service records, establishes the disability was incurred in service. 38 C.F.R. § 3.303(d); Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994). 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. Holton v. Shinseki, 557 F.3d 1363 (Fed. Cir. 2009); Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). In addition, certain chronic diseases, including diabetes mellitus and psychoses, may be presumed to have been incurred or aggravated during service if they become disabling to a compensable degree within one year of separation from active duty. 38 U.S.C. §§ 1101, 1112; 38 C.F.R. §§ 3.307, 3.309. A disability may be secondarily service connected if it is proximately due to or the result of a service connected disease or injury; or, if it is aggravated beyond its natural progress by a service connected disease or injury. 38 U.S.C. § 1110; 38 C.F.R. § 3.310(a), (b). VA is to give due consideration to all pertinent medical and lay evidence in evaluating a claim for disability benefits. 38 U.S.C. § 1154(a). Medical evidence is not always or categorically required in every instance to establish a medical diagnosis or the required nexus between the claimed disability and service. Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). Competent lay evidence means any evidence not requiring that the proponent have specialized education, training, or experience. Lay evidence is competent if it is provided by a person who has knowledge of the facts or circumstances and conveys matters that can be observed and described by a lay person. 38 C.F.R. § 3.159(a)(2). Lay testimony is competent when it regards the readily observable features or symptoms of injury or illness and may provide sufficient support for a claim of service connection. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Therefore, the Board must assess the competence and credibility of lay statements. Barr v. Nicholson, 21 Vet. App. 303 (2007). While the Board must provide reasons and bases supporting a decision, there is no need to discuss, in detail, the evidence submitted by the Veteran or on behalf of the Veteran. Gonzales v. West, 218 F.3d 1378 (Fed. Cir. 2000). The analysis below focuses on the most salient and relevant evidence of record. The Veteran should not assume that the Board has overlooked pieces of evidence that are not explicitly discussed. Timberlake v. Gober, 14 Vet. App. 122 (2000). The Board must assess the credibility and weight of all evidence, including the medical evidence, to determine its probative value, accounting for evidence that it finds to be persuasive or unpersuasive, and providing reasons for rejecting any evidence favorable to the Veteran. Equal weight is not given to each piece of evidence contained in the record. Every item of evidence does not have the same probative value. When the evidence is assembled, the Board 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 a claim, in which case the claim is denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 1. Entitlement to service connection for major depressive disorder. The Veteran has appealed a July 2016 rating decision that denied service connection for major depressive disorder. Based on a review of the evidence of record and with consideration of the Veteran’s statements, the Board finds that service connection for major depressive disorder is not warranted. The Board finds that the preponderance of the evidence is against a finding that the Veteran’s major depressive disorder began in or is etiologically related to the Veteran’s one month period of active service. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. § 3.303. A single service medical record from January 1996 shows an assessment of anxiety, but not depression. In a May 2002 statement in support of his application for enlistment in the United States Navy, the Veteran asserted that he had no health problems and was physically fit for service. A March 2016 private medical record indicated the Veteran reported increased stress at home with his family and at work. An August 2017 VA contract examination shows that the examiner conducted a thorough review of the evidence of record and considered the Veteran’s statements in determining that it was less likely than not that the Veteran’s major depressive disorder was due to his experiences in boot camp as he claimed, but rather was due to the stressors of life and his unstable childhood in the foster care system. The examiner found that the Veteran admitted to likely counseling in childhood. Because the examiner conducted an in person interview of the Veteran and reviewed the entire case file, the Board finds the examiner’s determination to be highly probative. The Board recognizes that the Veteran’s psychologist, Dr. Miller, opined that the stress of boot camp “seems as likely as not” to have had a significant impact on his life and that the Veteran’s many years of anxiety and depression, “could well have been, at least in part, and perhaps almost entirely caused by negative boot camp experience.” However, that determination is of less probative value as the psychologist did not have the benefit of reviewing the claims file. Thus, the preponderance of the evidence is against the claim. There are no in service medical records showing the development of major depressive disorder in service. The Veteran’s May 2002 statement indicates that he was fit for service. Further, the claims file does not contain medical records showing that the Veteran had been treated for depression prior to 2016. The August 2017 VA contract examiner concluded that it was less likely than not that the Veteran’s major depressive disorder was due to his experiences in boot camp. Accordingly, the claim must be denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 2. Entitlement to service connection for diabetes mellitus, including as secondary to major depressive disorder. The Veteran contends that his diabetes mellitus is a result of his major depressive disorder. The Veteran’s service medical records do not contain complaints, treatment, or diagnoses for diabetes mellitus. Further, the evidence does not show that diabetes mellitus developed to a compensable degree within one year following separation from service to qualify for the presumption of service connection. A February 2013 private medical record shows a diagnosis of diabetes mellitus many years after separation from service. There is no competent evidence of record that relates diabetes mellitus to service. There is no evidence of record suggesting that diabetes mellitus manifested to a compensable degree within one year following separation from service. The Veteran has not submitted any competent evidence relating diabetes mellitus to service and his own statements are not competent evidence because as a lay person he does not possess the training to provide that type of opinion. The Board finds that the preponderance of the evidence is against finding that the Veteran’s diabetes mellitus was incurred in service or is secondary to any service connected disability. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.303, 3.310; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). The Board has determined that the Veteran has not established entitlement to service connection for major depressive disorder. Therefore, the Veteran’s diabetes mellitus cannot be secondarily service connected as due to major depressive disorder or any other mental disorder. Secondary service connection cannot be established where the claimed primary disability is not service-connected. 38 U.S.C. § 1110; 38 C.F.R. § 3.310(a), (b). 3. Entitlement to service connection for generalized anxiety disorder. The Veteran contends that currently diagnosed generalized anxiety disorder was incurred in or related to active service. The Board finds that the preponderance of the evidence is against a finding that generalized anxiety disorder began in or is etiologically related to his one month period of active service. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. § 3.303. A single service medical record from January 1996 show an assessment of anxiety. However, there are no further in service medical records showing complaints of, treatment for, or diagnosis of an anxiety disorder. In addition, in a May 2002 statement in support of his application for enlistment in the United States Navy, the Veteran asserted that he had no health problems and was physically fit for service. A March 2016 private medical record indicated the Veteran reported increased stress at home with his family and at work. The August 2017 VA contract examiner conducted a thorough review of the evidence of record and considered the Veteran’s statements in determining that it was less likely than not that the Veteran’s generalized anxiety disorder was due to his experiences in boot camp as he claimed, but rather was due to the stressors of life and his unstable childhood in the foster care system. The examiner found that the Veteran admitted to likely counseling in childhood. Because that the examiner conducted an in person interview of the Veteran and reviewed the entire case file, the Board finds the examiner’s determination to be highly probative. The Board recognizes that the Veteran’s psychologist, Dr. Miller, opined that the stress of boot camp “seems as likely as not” to have had a significant impact on his life and that the Veteran’s many years of anxiety and depression, “could well have been, at least in part, and perhaps almost entirely caused by negative boot camp experience.” However, the opinion is of limited probative value as the psychologist did not have the benefit of reviewing the Veteran’s case file and the opinion is somewhat speculative. The Board finds that the contract examiner’s opinion is more persuasive because the examiner considered the entire record and analyzed all possible causations. Thus, the Board finds that the preponderance of the evidence is against the claim. The Veteran’s service medical records do not show that he was treated for or diagnosed with a generalized anxiety disorder in service. The Veteran’s May 2002 statement indicates that he did not have any mental problems at that time. Further, with the exception of the single January 1996 service medical record, the claims file does not contain medical records showing that the Veteran was treated for anxiety prior to 2016. The August 2017 VA contract examiner concluded that it was less likely than not that the Veteran’s generalized anxiety disorder was due to his experiences in boot camp. Based on the foregoing, the Board finds that the preponderance of the evidence is against the claim and the claim must be denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 4. Entitlement to service connection for narcolepsy. The Veteran has appealed the July 2016 rating decision that denied service connection for narcolepsy. Based on a review of the evidence of record and with consideration of the Veteran’s statements, the Board finds that service connection for narcolepsy is not warranted. The Board finds that the preponderance of the evidence is against a finding that the Veteran’s narcolepsy began in or is etiologically related to his one month period of active service. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. § 3.303. There is no evidence that the Veteran complained of, was treated for, or diagnosed with narcolepsy or any other sleep disorder in service. Further, the evidentiary record shows that the Veteran was first diagnosed with narcolepsy in May 2016, many years after active service. Thus, the Veteran has not established a connection between his one month period of active and his current diagnosis of narcolepsy. The Veteran has not submitted any competent evidence relating narcolepsy to service. The Veteran’s statements that relate narcolepsy to service are not competent evidence because as a lay person he does not have the training to provide that type of opinion. Accordingly, the Board finds that the preponderance of the evidence is against a finding that narcolepsy is related to service and the claim must be denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 5. Entitlement to service connection for insomnia, also claimed as nightmares. The Veteran has appealed the July 2016 rating decision that denied service connection for insomnia. Based on a review of the evidence of record and with consideration of the Veteran’s statements, the Board finds that service connection for insomnia is not warranted. The Veteran’s private medical records show that he has been diagnosed with obstructive sleep apnea and narcolepsy. However, the evidentiary record does not show that the Veteran has a current diagnosis of insomnia. The existence of a current disability is the cornerstone of a claim for VA disability compensation. 38 U.S.C. § 1110; Degmetich v. Brown, 104 F.3d 1328 (1997). In the absence of proof of a current disability, there can be no valid claim. Boyer v. West, 210 F.3d 1351 (Fed. Cir. 2000); Brammer v. Derwinski, 3 Vet. App. 223 (1992). The Veteran’s statements that he has insomnia are entitled to minimal probative value. Rather, the most probative evidence of record shows that the Veteran has obstructive sleep apnea, narcolepsy, generalized anxiety disorder, and major depressive disorder. The Veteran, as a lay person, may be competent to report symptoms such as sleeplessness or excessive fatigue. However, he does not have the medical expertise to diagnose a sleep disturbance or to differentiate which of his currently diagnosed conditions causes which sleep disturbance symptoms. The Veteran has not been diagnosed with insomnia. The Veteran has not submitted any competent evidence that shows that any sleep disorder, such as insomnia, is related to service or any event, injury, or disease during service. Any statements from the Veteran diagnosing insomnia or relating insomnia to service are not competent as the Veteran as a lay person is not qualified to make those types of diagnoses or etiological opinions. There are many causes for sleep disorders, so diagnosing and opining as to the etiology is a medical opinion. Because the most probative evidence of record does not establish that the Veteran has a current diagnosis of insomnia, the Board finds that the Veteran is not entitled to service connection for insomnia. 38 C.F.R. § 3.385. Accordingly, the claim must be denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Harvey P. Roberts Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Gillian A. Flynn, Associate Counsel