Citation Nr: 18144390 Decision Date: 10/25/18 Archive Date: 10/24/18 DOCKET NO. 16-38 419 DATE: October 25, 2018 ORDER Entitlement to service connection for posttraumatic stress disorder (PTSD) is denied. FINDING OF FACT The Veteran does not have PTSD. CONCLUSION OF LAW The criteria for service connection for posttraumatic stress disorder have not been met. 38 U.S.C. §§ 1110, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303(a), 3.304(f), 4.125(a) (2018). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from January 2001 to May 2001 and September 2003 to September 2008. The Veteran served in Iraq and earned the Combat Action Ribbon. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a February 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Phoenix, Arizona. Under applicable law, VA has a duty to notify and assist claimants in substantiating a claim for VA benefits. 38 U.S.C. §§ 5103, 5103A (2012); 38 C.F.R. § 3.159 (2018). The Veteran’s claims stem from a fully developed claim submitted in December 2015. The Veteran’s signature on his claim, submitted via VA Form 21-526EZ, indicates that he received VCAA notice. See 38 U.S.C. § 5103; 38 C.F.R. § 3.159(b). Regarding the duty to assist, the Veteran’s service treatment records (STRs) are associated with the claim file. The Veteran was afforded a VA medical examination appropriate for the issue decided in this case, in December 2016. The Veteran contends that his VA examination was inadequate because the examiner seemingly rushed through his examination and did not ask for details regarding his deployment experiences. However, the Board finds the examination was adequate, as it was conducted by a qualified medical professional and predicated on a full reading of all available records. Although a nexus opinion was not provided addressing the Veteran’s experienced stressor during his deployment in Iraq, the Board finds that such is unnecessary because there is no disability demonstrated in service or current disability shown to be otherwise related to service. To the extent the Veteran feels his examination was rushed, he has not provided a basis for comparison. Mere dissatisfaction with the conduct of an examination does not render the examination inadequate, and the Veteran has not otherwise pointed to any relevant deficiency in the examination. Accordingly, the Board finds that VA’s duty to assist, including with respect to obtaining a VA examination or opinion, has been met. 38 C.F.R. § 3.159(C)(4) (2018). Entitlement to service connection for posttraumatic stress disorder Service connection is established on a direct basis when there is competent, credible evidence of (1) a current disability; (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury. 38 U.S.C. §§ 1110, 1131; Holton v Shineski, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a), (d). Service connection for PTSD specifically requires: (1) a medical diagnosis of PTSD utilizing the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders criteria, in accordance with 38 C.F.R. § 4.125(a); (2) credible supporting evidence that the claimed in-service stressor actually occurred; and (3) medical evidence of a causal nexus between current symptomatology and the specific claimed in-service stressor. See 38 C.F.R. § 3.304(f); Cohen v. Brown, 10 Vet. App. 128, 138 (1997). The Board must assess the credibility and weight of all the evidence, including the medical evidence, to determine its probative value, accounting for evidence which it finds to be persuasive or unpersuasive, and providing reasons for rejecting any evidence favorable to the claimant. Masors v. Derwinski, 2 Vet. App. 181 (1992); Wilson v. Derwinski, 2 Vet. App. 614 (1992); Hatlestad v. Derwinski, 1 Vet. App. 164 (1991); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Equal weight is not accorded to each piece of evidence contained in the record; every item of evidence does not have the same probative value. The Board must determine whether the evidence supports the claim or is in relative equipoise, with the appellant prevailing in either case, or whether the preponderance of the evidence is against the claim, in which case, service connection must be denied. Gilbert, 1 Vet. App. at 49. The Veteran claims that he acquired PTSD as a result of his deployment to Iraq in November 2004. Specifically, the Veteran was a rifleman in Fallujah, Iraq, and his squad experienced enemy fire, including from rocket propelled grenades (RPGs), resulting in the death of one of his team leaders and another being injured. A review of the Veteran’s STRs revealed one document labeled as a military version of a PTSD checklist, which notes that the Veteran experienced repeated disturbing memories thoughts or images of a stressful military experience; felt very upset when something reminded him of a stressful military experience; avoided thinking or talking about a stressful military experience or avoided having feelings related to it; and was “super alert” or watchful on guard. This record also noted that others had indicated that he had changed since the stressful military experience. This particular document did not provide a diagnosis of PTSD. A review of the rest of the Veteran’s STRs, including his post-deployment questionnaires and separation examination are silent for any complaints, treatment, or diagnosis related to PTSD or any other psychiatric disorder. In December 2016, the Veteran was afforded a VA examination in which the examiner determined that the Veteran did not have a mental disorder. The VA examiner considered the Veteran’s background, social behaviors, and reported stressor. The Veteran indicated that he had difficulty sleeping. Specifically, he reported that he averaged about four hours of sleep a night because waking up at 4:00 in the morning was his routine in the military. The Veteran indicated that he was able to complete his day without difficulty, but he found himself becoming more irritated with others at times and felt like he was yelling more recently; he denied any physical confrontations or police involvement. The examiner noted that the Veteran neither endorsed symptoms that would elicit a diagnosis at this time, nor did he endorse symptoms that would meet the criteria for PTSD. The Veteran’s exposure to combat is verified, and his claimed stressors are therefore conceded. However, he was not diagnosed in service with PTSD, and there is no medical evidence following service establishing PTSD. The Veteran indicates that he kept his mental health symptoms and disability to himself, accounting for the lack of treatment evidence. However, the existence of a current disability is the cornerstone of a claim for VA disability compensation. See Degmetich v. Brown, 104 F. 3d 1328 (1997); see also Gilpin v. West, 155 F.3d 1353 (Fed. Cir. 1998); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992); Rabideau v. Derwinski, 2 Vet. App. 141, 144 (1992); Romanowsky v. Shinseki, 26 Vet. App. 289 (2013). The Board emphasizes that Congress has specifically limited entitlement to service connection for disease or injury to cases where such incidents have resulted in disability. See 38 U.S.C. § 1101. Thus, evidence of a current disability is a fundamental requirement for a grant of service connection. See McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). The Veteran is competent to report his symptoms; however, to the extent that such assertions purport to establish a current disability or the etiology of any such disability, such assertions do not provide persuasive support for the claim, as the Veteran is not shown to possess the medical training to render competent opinions about such complex medical matters. See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F. 3d 1372 (Fed. Cir. 2007); Buchanan v. Nicholson, 451 F. 3d 1331 (Fed. Cir. 2006). This is particularly true with respect to mental disorders, which are not directly observable, and which tend to alter the claimant’s perceptions. Even if the Veteran were competent to diagnose PTSD, the probative value of his opinion is outweighed by that of the examiner, who clearly does have the education, experience and training to diagnose psychiatric disorders. That examiner found that the Veteran did not have any mental disorders, including PTSD. The December 2016 VA examination in particular provides highly probative evidence against this claim. As such, the Board concludes that the Veteran does not have PTSD and has not had a psychiatric disorder at any time during the pendency of the claim. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain, 21 Vet. App. at 321; 38 C.F.R. § 3.303(a), (d). In the absence of a current disability that accounts for the Veteran’s claimed PTSD symptoms, further analysis is not necessary. See Brammer, 3 Vet. App. at 225. The Board finds that the preponderance of the evidence is against the claim for a service connection for PTSD. Accordingly, the benefit-of-the-doubt rule does not apply, and the claim is denied. See 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102; 4.3; Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990). THOMAS H. O'SHAY Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD D. Hite, Associate Counsel