Citation Nr: 18145289 Decision Date: 10/26/18 Archive Date: 10/26/18 DOCKET NO. 15-45 911 DATE: October 26, 2018 ORDER Service connection for an acquired psychiatric disorder, claimed as PTSD, is granted. FINDINGS OF FACT 1. The Veteran has been diagnosed with an acquired psychiatric disorder. 2. The acquired psychiatric disorder is the result of service-connected stressors. CONCLUSION OF LAW The criteria for entitlement to service connection for an acquired psychiatric disorder have been met. 38 U.S.C. § 1110 (2012), 38 C.F.R. §§ 3.303, 3.304 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION It appears that the Veteran served on active duty in the Marine Corps from November 2000 to May 2001 and March 2003 to March 2005. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a February 2013 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). Service connection for an acquired psychiatric condition is granted. Generally, to prove service connection, a veteran must show: (1) a present disability; (2) an 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. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection for PTSD/acquired psychiatric disorders requires medical evidence establishing a diagnosis of the disability in accordance with the DSM-V for claims on or after August 4, 2014, a link, established by medical evidence, between the current symptoms and the claimed in-service stressor, and credible supporting evidence that the claimed in-service stressor actually occurred. See 38 C.F.R. § 3.304(f), 4.125(a) The Veteran’s deployment, along with an Iraq campaign medal and Global War on Terrorism medal recorded on the Veteran’s Certificate of Release or Discharge from Active Duty (DD-214), substantially supports the claim that the Veteran served in combat situations during deployment. The Veteran’s claims are consistent with the circumstances and conditions of combat service. See 38 U.S.C. 1154(b). During a VA examination, the Veteran reported several in-service events. Of significance is that he spent around six months assigned to a mortuary affairs unit in Kuwait. The Veteran also described this stressor to a VA counselor in 2014 by stating that he “worked around dead bodies” while deployed. The file includes a memo from a Navy psychologist indicating assignment to a mortuary affairs unit, and the risk of psychological issues related to the work of “collecting and receiving the remains and portions of remains & personal effects of service members.” This document is dated in 2007—well before the initial PTSD claim was filed in 2012, and provides independent corroboration of the scope of the Veteran’s job assignment during deployment. The description of working in a mortuary affairs unit was repeated by the Veteran during his VA examination, counseling he obtained through VA, and again during his examination by a private psychologist. The Veteran’s account of service in a mortuary affairs unit as a stressor is credible based on the consistency in which the Veteran reported this stressor as well as its independent corroboration by a Navy psychologist. Also during the VA examination, the Veteran reported that he avoids fireworks due to associating them with mortar fire that he was exposed to in Iraq. In a later statement on the VA Form 9, the Veteran went into more detail describing being around mortar fire throughout his tour in Fallujah. He also claims to have been a guard at the gate of the Abu Ghraib prison which required him to observe visitors arriving and “pull suspicious people out of the crowd.” In June 2012, the Veteran filed a claim for VA benefits. He asserted that he had PTSD and that it was related to his service. In November 2012, a VA examination was conducted and the examiner concluded that the Veteran did not have PTSD or any other psychiatric diagnosis. In December 2016, a private psychologist (W.R.), diagnosed the Veteran with PTSD and referenced DSM-V code 309.89 which is “Other Specified Trauma and Stressor-Related Disorder.” The diagnosis was based on four hours of clinical interviews and a review of prior treatment records. The examiner, as a doctoral-level psychologist, is competent to make such a diagnosis and his opinion, using DSM-V criteria, a review of records, and clinical interviews, is considered credible. As a result of the 2016 examination, W.R. concluded that “PTSD symptoms are clearly present and it is probable that they have been in existence since [Veteran] served in Iraq and Kuwait.” When the Veteran sought counseling in 2013, he expressed concerns regarding PTSD with symptoms of anger, anxiety, and isolation. During counseling, the Veteran stated that upon returning from deployment, he did not tell anyone he had returned for at least one week in order to “decompress.” During his VA examination, he reported that shortly after returning from his 2004 deployment he “punched a headboard and broke his hand.” Although not probative on their own, these events support the contention that at least some symptoms began almost immediately upon returning from deployment. The Veteran has a current diagnosis of PTSD/Stressor-Related Disorder. It is noted that there is some ambiguity in the 2016 diagnosis from W.R. in which he states that the Veteran has PTSD, but cites the DSM-V code for “Other Specified Trauma and Stressor-Related Disorder.” Despite the ambiguity in the precise diagnosis, the record supports a finding that at the time of the examination, the Veteran had an acquired psychiatric condition. Although there are competing medial opinions regarding a formal diagnosis, it is also noted that the Veteran was diagnosed with depression in August 2005, which was only a few months after returning from deployment. VA did not diagnose the Veteran with PTSD or any other condition in the 2012 examination, but the Veteran received counseling through VA beginning in 2013. The counselor providing treatment reported the following: “Veteran has experienced some traumatic experiences which most likely have caused the anger, hypervigilance, and anxiety. I see [the] Veteran benefitting from Therapeutic Services with the Vet Center.” Counseling records also use the following description for the treatment “Psycho-social focus: PTSD.” Although this is not considered to be a formal diagnosis, it does indicate at least the presence of symptoms well before the 2016 diagnosis made by W.R. The VA examiner did not diagnose the Veteran with PTSD, but the examiner acknowledged that the stressors described by the Veteran meet criteria adequate to support a PTSD diagnosis and that the stressors were related to the Veteran’s fear of hostile military or terrorist activity. These conclusions establish a link between the current symptoms and the in-service stressors. 38 C.F.R. § 3.304(f)(3). The link between the Veteran’s current symptoms and in-service stressors is further supported by the findings of W.R. in 2016. W.R. stated that “qualifying stressors are direct exposure to death and threatened death in combat situations and also the personal witnessing of body parts in the process of identification while assigned…to a Mortuary Affairs unit in Kuwait.” Service connection for an acquired psychiatric condition, variously diagnosed, is granted. H.M. WALKER Veterans Law Judge Board of Veterans’ Appeals J. Jack, Law Clerk Department of Veterans Affairs