Citation Nr: 18149373 Decision Date: 11/09/18 Archive Date: 11/09/18 DOCKET NO. 16-26 381 DATE: November 9, 2018 ORDER Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD), is denied. FINDING OF FACT The Veteran’s acquired psychiatric disorder is not related to his period of service. CONCLUSION OF LAW The criteria for service connection for the Veteran’s acquired psychiatric disorder are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from February 2006 to June 2006, and from June 2007 to April 2008, which included a deployment to Iraq. This matter is before the Board of Veterans’ Appeals (Board) on appeal of a June 2014 rating decision by the Department of Veterans Affairs Regional Office in San Diego, California. The Board notes that the Veteran claimed service connection for PTSD. The record reflects a diagnosis of depression. Accordingly, the Board has reclassified the issue of service connection for an acquired psychiatric disorder, to include unspecified depressive disorder. Clemons v. Shinseki, 23 Vet. App. 1 (2009). Service connection for posttraumatic stress disorder. Service connection may be granted where the evidence of record establishes that a particular injury or disease resulting in disability was incurred in or aggravated by active military service. See 38 U.S.C. § 1131; 38 C.F.R. § 3.303. “To establish a right to compensation for a present disability, a veteran must show: ‘(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’--the so-called ‘nexus’ requirement.” Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Service connection for PTSD requires (1) medical evidence diagnosing the condition in accordance with 38 C.F.R. § 4.125(a); (2) credible supporting evidence that a claimed in-service stressor occurred; and (3) a link, established by medical evidence, between current symptoms and the in-service stressor. 38 C.F.R. §§ 3.304(f) and 4.125. The Veteran contends that he has PTSD, and that his PTSD is related to service. During the Veteran’s service, the Veteran was deployed to Iraq where the Veteran’s base was subjected to rocket and mortar attacks. The Veteran witnessed a soldier die in one such attack. The question for the Board is whether the Veteran has a current disability that began during service, or is at least as likely as not related to an in-service injury, event, or disease. The Veteran’s November 2015 compensation and pension examination establishes that the Veteran has a current disability, specifically unspecified depressive disorder. See Nov. 2015 Initial PTSD Disability Benefits Questionnaire. The Board also recognizes that the Veteran has a verified in-service stressor and/or event. The Veteran has verified combat service during his deployment to Iraq. The ultimate question, then, is whether the Veteran’s current psychological disorder is related to his active service. In this regard, the Veteran was afforded VA psychiatric examinations in May 2014 and October 2015. The May 2014 examination noted combat history; however, the examiner determined that there were no clinically significant psychiatric symptoms to warrant a mental health diagnosis under DSM-IV or DSM-V. The November 2015 examination and medical opinion did not find that the Veteran had a diagnosis of PTSD that conforms to DSM-V criteria. The November 2015 medical opinion did report that the Veteran’s diagnosis of depressive disorder had reached clinical significance in the past year. See Nov. 2015 Medical Opinion. As to the diagnosed depressive disorder, the November 2015 VA examining clinician provided an addendum opinion in April 2016, in which he stated that the Veteran’s previous medical records are consistent that there was no notation of a clinical level of psychiatric symptoms until October 2015, where the Veteran mentioned nightmares and depression. The examiner found that the Veteran has insufficient symptoms to diagnose PTSD. The examiner found that it is more likely than not that the Veteran has a depression presenting PTSD-like symptoms, which are associated with the Veteran’s occupation as a truck driver, where the Veteran is alone for long periods, in addition to financial and relationship stressors, rather than being related to service. See Apr. 2016 Medical Opinion. This opinion was based on his examination of the Veteran, review of all treatment and service records, and is supported by sufficient rationale. Therefore, this opinion is highly probative. Further, the Veteran received PTSD screening tests in 2008, 2011, 2012 and 2013, all of which were negative. A compensation and pension examination in May 2014 also found that the Veteran does not have diagnosable PTSD. See May 2014 Initial PTSD Disability Benefits Questionnaire. The Veteran did receive a diagnosis of PTSD in a February 2016 VA telemental health intake note. However, there is no indication that the February 2016 diagnosis was based on an adequate review of the claims file or an evaluation of the necessary criteria for a diagnosis of PTSD. Therefore, the Board assigns lower probative weight to this diagnosis and instead assigns a greater probative value to the November 2015 and the April 2016 compensation and pension examinations. While the Board acknowledges the Veteran’s assessment that his PTSD was caused by an in-service stressor, the Veteran is not competent to provide such an opinion in this case. The issue is medically complex, as it requires specialized medical education to determine diagnosis and etiology of an acquired psychiatric disorder. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Therefore, service connection must be denied. In reaching this decision, the Board has considered the doctrine of reasonable doubt; however, as the preponderance of the evidence is against the Veteran’s claim, the doctrine is not for application. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). JENNIFER HWA Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Benjamin Voight, Associate Counsel