Citation Nr: 18146175 Decision Date: 10/30/18 Archive Date: 10/30/18 DOCKET NO. 16-36 184 DATE: October 30, 2018 ORDER Service connection for posttraumatic stress disorder (PTSD), major depression, and anxiety is granted. FINDING OF FACT Resolving all doubt in the Veteran’s favor, he has current diagnoses of PTSD, major depression, and anxiety related to his combat service in Vietnam. CONCLUSION OF LAW The criteria for service connection for of PTSD, major depression, and anxiety have been met. 38 U.S.C. §§ 1110, 1154(b), 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from June 1970 to June 1972. He is the recipient of numerous awards and decorations, to include the Combat Action Ribbon. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a rating decision issued in January 2016 by a Department of Veterans Affairs (VA) Regional Office. Entitlement to service connection for an acquired psychiatric disorder, to include PTSD. The Veteran asserts he currently has an acquired psychiatric disorder, to include PTSD, related to his combat service in Vietnam. In this regard, he reported that he was inserted by helicopter into the middle of a conflict area for search and destroy missions. In between such missions, he would volunteer for night ambushes or downed pilot recovery missions. The Veteran further claims that he has experienced psychiatric symptomatology related to such experiences. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service or when evidence establishes a disease diagnosed after discharge was incurred in service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Direct service connection may not be granted without evidence of a current disability; in-service incurrence or aggravation of a disease or injury; and a nexus between the claimed in-service disease or injury and the present disease or injury. Id.; see also Caluza v. Brown, 7 Vet. App. 498, 506 (1995) aff’d, 78 F.3d 604 (Fed. Cir. 1996). For PTSD, service connection requires medical evidence diagnosing the condition in accordance with 38 C.F.R. § 4.125(a), a link, established by medical evidence between current symptoms and an in-service stressor, and credible supporting evidence that the claimed in-service stressor occurred. 38 C.F.R. § 3.304(f). If the evidence establishes that the veteran engaged in combat with the enemy and the claimed stressor is related to that combat, in the absence of clear and convincing evidence to the contrary, and provided that the claimed stressor is consistent with the circumstances, conditions, or hardships of the veteran’s service, the veteran’s lay testimony alone may establish the occurrence of the claimed in-service stressor. 38 U.S.C. § 1154(b); 38 C.F.R. § 3.304(f). In this regard, the record reflects that the Veteran is in receipt of the Combat Action Badge. As such, his reported stressors related to such combat service may be established by his testimony alone. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). In the instant case, the medical evidence contains contrary opinions concerning whether the Veteran has a current diagnosis of PTSD, or another acquired psychiatric disorder, related to his combat service. In this regard, an October 2014 VA treatment record shows an assessment of “possible PTSD” in light of the Veteran’s report of insomnia and nightmares for the prior 30-plus years, and a March 2015 VA psychiatry consultation report indicates initial diagnoses of chronic insomnia, nightmares related to military experiences, and PTSD. However, at a July 2015 VA examination, the examiner found that the Veteran did not meet the criteria for a diagnosis of PTSD. Rather, he determined that the Veteran had a diagnosis of alcohol use disorder that was less likely than not related to his service. In this regard, the examiner found that such was due to a maladaptive pattern of behavior. Thereafter, an addendum opinion was obtained from a different VA examiner in June 2016. At such time, the VA examiner opined that it was less likely as not that the Veteran has a diagnosis of PTSD that is caused by or incurred in his military service. In this regard, he found that the previous diagnosis of PTSD was conferred in a clinical context where different diagnostic guidelines apply, appeared to have been based predominantly on the Veteran’s subjectively reported symptoms, with no objective assessment of response style, and was therefore inapplicable to the current examination. As such, he opined the validity of the previous diagnosis of PTSD had not been adequately assessed and therefore was unknown. The examiner further opined that the Veteran’s alcohol use disorder was less likely than not related to service as such was willful misconduct. In contrast to the VA examiners’ findings, Dr. L.B. completed a neuro-psychological examination in which she noted that she had reviewed the Veteran’s records, interviewed him, and conducted diagnostic testing. Thereafter, she diagnosed PTSD, major depression, and anxiety, and opined that such were caused by or a result of his military service. With specific regard to PTSD, Dr. L.B. found that such was related to the Veteran’s service in Vietnam and the constant fear of his life. After a careful review of the record, the Board finds that the evidence of record is at least in equipoise as to whether the Veteran has an acquired psychiatric disorder related to his military service. Specifically, the July 2015 and June 2016 VA examiners and Dr. L.B. are all competent medical professionals who considered all relevant facts and accepted medical principles. Consequently, all of their opinions are entitled to equal probative weight. Therefore, the Board resolves all doubt in the Veteran’s favor and finds that he has current diagnoses of PTSD, major depression, and anxiety related to his combat service in Vietnam. Thus, service connection for such disorder is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert, supra. A. JAEGER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. M. Celli, Counsel