Citation Nr: 18149509 Decision Date: 11/09/18 Archive Date: 11/09/18 DOCKET NO. 16-44 337 DATE: November 9, 2018 ORDER Service connection for an acquired psychiatric disorder, to include anxiety, is denied. FINDING OF FACT There is no probative medical evidence that indicates the Veteran’s current anxiety and alcohol abuse disorders were incurred in service. CONCLUSION OF LAW The criteria for service connection for an acquired psychiatric disorder, to include anxiety, have not been satisfied. 38 U.S.C. §§ 1110, 5107 (b) (West 2014); 38 C.F.R. §§ 3.102, 3.303, 3.304 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from June 1969 to March 1970. The Board has re-characterized the issue of entitlement to service connection for anxiety to more broadly encompass entitlement to service connection for an acquired psychiatric disorder, to include anxiety, pursuant to Clemons v. Shinseki, 23 Vet. App. 1 (2009) (holding that when a claimant makes a claim, he is seeking service connection for symptoms, regardless of how those symptoms are diagnosed or labeled). The claim is analyzed on its merits below. Entitlement to service connection for an acquired psychiatric disorder, to include anxiety Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by service. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303 (a). “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. 2010) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Disorders diagnosed after discharge will still be service connected if all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d); see Combee v. Brown, 34 F.3d 1039, 1043 (Fed. Cir. 1994). In deciding an appeal, the Board must analyze the credibility and probative value of the evidence, account for the evidence which it finds to be persuasive or unpersuasive, and provide the reasons for its rejection of any material favorable to the claimant. Gabrielson v. Brown, 7 Vet. App. 36, 39-40 (1994); Gilbert v. Derwinski, 1 Vet. App. 49, 57 (1990). Competency is a legal concept determining whether testimony may be heard and considered by the trier of fact, while credibility is a factual determination about the probative value of the evidence to be made after the evidence has been admitted. Rucker v. Brown, 10 Vet. App. 67, 74 (1997); Layno v. Brown, 6 Vet. App. 465, 469 (1994). When considering whether lay evidence is competent, the Board must determine, on a case-by-case basis, whether a veteran’s disability is the type of disability for which lay evidence may be competent. Kahana v. Shinseki, 24 Vet. App. 428 (2011); see also Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). A veteran is competent to report symptoms because this requires only personal knowledge, not medical expertise, as it comes to him through his senses. See Layno, 6 Vet. App. 465, 469. Lay testimony is competent to establish the presence of observable symptomatology, where the determination is not medical in nature and is capable of lay observation. Barr v. Nicholson, 21 Vet. App. 303 (2007). Lay evidence may establish a diagnosis of a simple medical condition, a contemporaneous medical diagnosis, or symptoms that later support a diagnosis by a medical professional. Jandreau, 492 F.3d 1372, 1377. In deciding claims, it is the Board’s responsibility to evaluate the entire record on appeal. See 38 U.S.C. § 7104 (a). When all the evidence is assembled, the Board is then responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether the preponderance of the evidence is against the claim, in which case the claim is denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). VA treatment records indicate the Veteran was diagnosed with generalized anxiety disorder and alcohol dependency in May 2014 and prescribed sertraline. Prior treatment included taking the anti-anxiety medication clonazepam in conjunction with other health issues for less than one year in the mid- to late-2000s. The Veteran’s March 1969 report of medical history at induction indicates the Veteran denied nervous trouble, depression and excessive worry. His clinical psychiatric examination was normal. In December 1969, the Veteran was admitted to the hospital for psychiatric evaluation after admitting thoughts and intentions of self-harm. Psychiatric testing indicated “severe schizoid personality,” although the examiner noted there were no symptoms “to sufficiently justify a formal psychiatric diagnosis.” The examiner opined the Veteran demonstrated difficulties adjusting to military demands indicative of “constricted emotional development” not commensurate with the Veteran’s chronological age or physical growth. The February 1970 report of medical examination at discharge indicates the Veteran noted nervous trouble, trouble sleeping, depression, and excessive worry. His clinical psychiatric evaluation was noted as “abnormal,” with a notation indicating chronic schizoid personality. The Veteran was administratively discharged for having a character and behavior disorder. At the August 2015 VA medical examination, the Veteran reported loneliness, less depressed mood since starting sertraline, reduced problems with temper, and concerns about health problems stemming from his increased alcohol abuse. The examiner diagnosed the Veteran with unspecified anxiety disorder with depressive features and alcohol use disorder. The examiner opined the Veteran’s current psychiatric diagnoses were not related to the Veteran’s in-service psychiatric hospitalization because he was not diagnosed with anxiety during service. The examiner noted the Veteran’s in-service symptoms of dysphoric mood, thoughts of self-harm, and withdrawn behavior stemmed from situational stress, and that treatment records indicate the Veteran’s current anxiety started after his last divorce and has been exacerbated by the Veteran’s health concerns surrounding his increased alcohol use. The examiner stated that “a clear nexus cannot be established” between the Veteran’s in-service symptoms and his current diagnoses. The preponderance of the evidence is against finding service connection for an acquired psychiatric disability. There is no probative medical evidence that indicates the Veteran’s current anxiety and alcohol abuse disorders were incurred in service. The Veteran has continuously asserted throughout the appeal that his current psychiatric disabilities are a result of his service. The Veteran is competent to report observable symptomatology of his condition and to relate a contemporaneous medical diagnosis. See Layno, 6 Vet. App. 465, 469; see also Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). However, while the Veteran has attempted to establish a nexus through his own lay assertions, the Veteran is not competent to offer opinions as to the etiology of his current psychiatric disabilities. See Jandreau, 492 F.3d 1372, 1377 n.4; Woehlaert v. Nicholson, 21 Vet. App. 456, 462 (2007). Anxiety and alcohol disorders require specialized training for determinations as to diagnosis and causation, and is therefore not susceptible to lay opinions on etiology. Thus, the Veteran is not competent to render such a nexus opinion or attempt to present lay assertions to establish a nexus between his current diagnoses and their relationship to service. Since the Veteran’s current psychiatric diagnoses were not incurred in service, the claim for service connection is denied. As the preponderance of the evidence is against the claim, the benefit-of-the-doubt doctrine is not applicable. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990). Vito A. Clementi Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S. Anwar, Associate Counsel