Citation Nr: 18149951 Decision Date: 11/14/18 Archive Date: 11/14/18 DOCKET NO. 17-66 704 DATE: November 14, 2018 ORDER Service connection for adjustment disorder with mixed anxiety and depressed mood is granted. Service connection for posttraumatic stress disorder (PTSD) is denied. FINDINGS OF FACT 1. The Veteran’s diagnosed adjustment disorder with mixed anxiety and depressed mood is linked to active service. 2. A current diagnosis of PTSD is not established. CONCLUSIONS OF LAW 1. The criteria to establish service connection for adjustment disorder with mixed anxiety and depressed mood are met. 38 U.S.C. §§ 1110, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303(a) (2017). 2. The criteria to establish service connection for PTSD are not met. 38 U.S.C. §§ 1110, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303(a), 3.304(f) (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from October 2009 to October 2012. This appeal arose to the Board of Veterans’ Appeals (Board) from an August 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Columbia, South Carolina. Service Connection Service connection will generally be granted when a veteran has a current disability resulting from an injury or disease incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Establishing service connection generally requires competent evidence of the following: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship, i.e., a nexus, between the claimed in-service disease or injury and the current disability. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. When the evidence supports the claim or is in relative equipoise, the claim will be granted. Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). If the preponderance of the evidence weighs against the claim, it must be denied. Id.; Alemany v. Brown, 9 Vet. App. 518, 519 (1996). A. Adjustment Disorder with Mixed Anxiety and Depressed Mood The Veteran has been diagnosed with adjustment disorder with mixed anxiety and depressed mood. See April 2016 VA Examination Report. The service treatment records show that the Veteran’s entrance examination noted neither mental health issues nor a history of mental health issues, and he was found to be in good health. Once in service, however, he complained of psychiatric problems numerous, such as depression, anxiety, suicidal ideation and insomnia. He was diagnosed with an adjustment disorder with anxiety. In the April 2016 VA examination report, the examiner diagnosed the Veteran with adjustment disorder with mixed anxiety and depressed mood. This diagnosis is similar to diagnoses reflected in the service treatment records. The examiner noted that the Veteran’s mental health issues had been present during and since service. Accordingly, as the Veteran had an onset of psychiatric symptoms during and since service that have been diagnosed as an adjustment disorder with anxiety and depressed mood, the evidence is at least in equipoise, and service connection is established. In the April 2016 VA examination report, the examiner provided a negative nexus opinion, finding that the Veteran’s adjustment disorder was a “byproduct” of a personality disorder. This opinion does not adequately explain the Veteran’s adjustment disorder is solely a manifestation or “byproduct” of his personality disorder, rather than a discrete acquired psychiatric disorder. Accordingly, its probative weight is diminished, and it does not outweigh the evidence supporting the claim. In sum, resolving reasonable doubt in favor of the Veteran, service connection for adjustment disorder with mixed anxiety and depressed mood is granted. B. PTSD The Veteran has also claimed service connection for PTSD. The Board finds that service connection is not established. To grant service connection for PTSD, there must be a current diagnosis, among other things. See 38 C.F.R. § 3.304(f). The service treatment records and VA treatment record show that the Veteran has reported having PTSD. The possibility of the diagnosis was noted in the service treatment records as “r/o [i.e. rule out] noncombat PTSD,” but there was never a definitive diagnosis. The only definitive (i.e. not just noted as a possibility to be ruled out or in, but an actual finding) diagnosis rendered was adjustment disorder. Some VA treatment records note a diagnosis of PTSD based on the Veteran’s reported history, but do not reflect a diagnosis based on an actual medical assessment. They also show a positive PTSD screen, but again not an actual diagnosis. In the May 2016 VA examination report, the examiner found that the Veteran did not meet the criteria for a diagnosis of PTSD. This assessment represents the conclusion of a psychologist who examined the Veteran and reviewed the file and medical history, including his treatment records, to determine whether he had PTSD. Therefore, it is probative on the issue. This finding outweighs the service treatment records and VA treatment records, which do not show independent definitive clinical assessments based on examination of the Veteran in terms of whether he met the criteria for a PTSD diagnosis. Because the preponderance of the evidence weighs against the claim, service connection for PTSD must be denied. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert, 1 Vet. App. at 55. J. Rutkin Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD C. Ryan, Associate Counsel