Citation Nr: 18150042 Decision Date: 11/14/18 Archive Date: 11/14/18 DOCKET NO. 16-40 819A DATE: November 14, 2018 ORDER Service connection for Post-traumatic stress disorder (PTSD) is granted. FINDINGS OF FACT 1. The Veteran has been diagnosed with PTSD. 2. The preponderance of the evidence supports that the Veteran’s PTSD is etiologically linked to his active service. CONCLUSION OF LAW The criteria for service connection for PTSD have been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.303, 3.304(f)(1). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the U.S. Navy from February 1965 to February 1967. 1. Duties to Notify and Assist In light of the favorable decision to grant the Veteran’s claim of service connection for PTSD, any deficiency as to VA’s duties to notify and assist, as to this issue, pursuant to the provisions of the Veterans Claims Assistance Act of 2000 (VCAA), is rendered moot. 2. Service connection for post-traumatic stress disorder The Veteran contends that his PTSD is related to traumatic events witnessed in service. Having reviewed the record, the Board finds that service connection for PTSD is warranted. There are particular requirements for establishing service connection for PTSD. 38 C.F.R. § 3.304 (f); Arzio v. Shinseki, 602 F.3d 1343, 1347 (Fed. Cir. 2010). Service connection for PTSD requires: (1) medical evidence diagnosing the condition in accordance with 38 C.F.R. § 4.125; (2) credible supporting evidence of an in-service stressor; and (3) a link, established by medical evidence, between current symptoms and an in-service stressor. 38 C.F.R. § 3.304 (f). 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). The Veteran’s August 2013 VA treatment records reflects a current diagnosis for PTSD by a VA psychiatrist. As to an in-service stressor, the Veteran credibly reported that the stressor occurred during service when he witnessed a plane crash. He indicated that when he went over to assist after the crash, there was death and destruction. The Veteran consistently restated the events in writing and at multiple medical appointments. Moreover, in May 2016, several details of the Veteran’s claimed in-service stressor were verified by the Joint Services Records Research Center Coordinator (JSRCC). Thus, the Board concedes an in-service stressor. The remaining issue is a nexus, for which conflicting opinions have been provided. The Veteran had multiple negative PTSD screenings from 2002 to 2013. In June 2016, a VA examiner found that the Veteran’s symptoms did not warrant a diagnosis of PTSD despite the Veteran having been diagnosed by several VA and non-VA providers at that point. The examiner found that the Veteran had a diagnosable mental illness but did not link that illness to the Veteran’s service citing various other stressors including 10 years of post-military work as an EMT. As discussed below, the Board finds the June 2016 exam to be of limited probative value. The Veteran provided competent lay testimony of persistent symptoms spanning over 40 years. The Veteran described violent nightmares, avoiding barbecue restaurants, depression, hypervigilance, waking up to the sound of plane engines and other symptoms consistent with the described trauma. It does not appear from the record that the Veteran sought treatment for these symptoms before the early 2000s. However, the Board may not reject as not credible any uncorroborated statement merely because contemporaneous medical evidence is silent as to complaints or treatment for relevant condition or symptoms. See Barr v. Nicholson, 21 Vet. App. 303, 310 (2007). As noted above, the Veteran was consistent in his account of the trauma and his symptoms were documented in multiple treatment records. Thus, the Board finds the Veteran’s testimony to be credible and of some probative value. VA psychiatrist, Dr. K.S., diagnosed the Veteran with PTSD in March 2013. The United States Court of Appeals for Veterans Claims has held that mental health professionals are experts and are presumed to know the DSM requirements applicable to their practice and to have taken them into account in providing a PTSD diagnosis. See Cohen v. Brown, 10 Vet. App. 128, 140 (1997). Dr. K.S. continued to treat the Veteran through June 2016. She indicated that the Veteran’s stressor was an accident that occurred while the Veteran was on active military duty. She documented triggers including the smell of barbecue as it mimicked burning flesh and the sound of airplane engines. The Veteran also underwent prolonged exposure therapy from August 2013 to October 2013. As part of this treatment, VA psychologist, Dr. T. H., identified the plane crash as the Veteran’s index trauma. He noted no intrusive symptoms from other traumas including childhood abuse, the death of the Veteran’s father or witnessing the aftermath of motor vehicle accidents. This lengthy assessment of the Veteran’s symptoms directly contradicts the results of the June 2016 VA exam. Given the duration and specific goals of the treatment, the Board finds the evidence from the prolonged exposure therapy to be highly probative. The Veteran submitted a private opinion by Dr. B. V. dated January 2018. Dr. B. V. opined that the Veteran’s PTSD was due to a military trauma described as witnessing and responding to an aircraft crash. The Veteran submitted a second positive nexus opinion from Dr. J.G. in September 2018. Both private opinions are corroborated by and consistent with records from VA treatment providers. As both private examiners considered the Veteran’s symptoms and history and applied medical knowledge and training in linking the Veteran’s psychiatric symptoms to the in-service event, the Board finds the opinions probative. (Continued on the next page)   After having carefully reviewed the record, and weighing the evidence in support of and the evidence against the claim, the Board finds that the most probative evidence of record supports the Veteran’s claim of entitlement to service connection for PTSD, and the appeal is granted. GAYLE STROMMEN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD C. Sherman Associate Counsel