Citation Nr: 18150081 Decision Date: 11/14/18 Archive Date: 11/14/18 DOCKET NO. 13-03 464 DATE: November 14, 2018 ORDER Service connection for an acquired psychiatric disorder, to include bipolar disorder; schizoaffective disorder bipolar type, unstable and schizoaffective disorder is denied. FINDING OF FACT The Veteran does not have a current acquired psychiatric disorder, to include bipolar disorder; schizoaffective disorder bipolar type, unstable and schizoaffective disorder. CONCLUSION OF LAW The criteria to establish entitlement to service connection for an acquired psychiatric disorder, to include bipolar disorder; schizoaffective disorder bipolar type, unstable and schizoaffective disorder have not been met. 38 U.S.C. § 1131 (2012); 38 C.F.R. § 3.303(d) (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served a period of active duty for training (ACDUTRA) in the U.S. Army from February 1977 to August 1978 and served on active duty in the U.S. Air Force from July 1987 to July 1990. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a March 2010 rating decision of the Portland, Oregon Regional Office (RO). In March 2017, the Veteran was afforded a videoconference hearing before the undersigned Veterans Law Judge (VLJ). During the hearing, the VLJ engaged in a colloquy with the Veteran toward substantiation of the claim. Bryant v. Shinseki, 23 Vet. App. 488, 496-97 (2010). A hearing transcript is in the record. In August 2017, the Board reopened and remanded the appeal to the RO for additional action. There was substantial compliance with the Board’s remand directives. See Stegall v. West, 11 Vet. App. 268 (1998). Service connection for an acquired psychiatric disorder, to include bipolar disorder; schizoaffective disorder bipolar type, unstable and schizoaffective disorder Service connection may be granted for a current disability arising from a disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1131 (2012). Service connection may be granted for any disease diagnosed after discharge when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d) (2017). Service connection generally requires (1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of an in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the current disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service treatment records (STRs) are silent for diagnoses of bipolar or schizoaffective disorder. However, there are several diagnoses of undifferentiated somatoform disorder and histrionic traits. VA is precluded from differentiating between the symptoms of the Veteran’s service-connected posttraumatic stress disorder (PTSD) and those of any other psychiatric disorders in the absence of clinical evidence that clearly shows such a distinction. See Mittleider v. West, 11 Vet. App. 181, 182 (1998). In the Veteran’s March 1978 Army pre-separation medical examination report, no psychiatric abnormalities were noted. In her March 1978 Army pre-separation medical history report, the Veteran did not report a medical history concerning bipolar disorder. In the Veteran’s May 1990 Air Force pre-separation medical examination report, no psychiatric abnormalities were noted. In her May 1990 Air Force pre-separation medical history report, the Veteran did not report a medical history concerning bipolar disorder. VA treatment records dated March 2001, August 2007 and January 2010 reflect the Veteran’s diagnoses of bipolar disorder and schizoaffective disorder bipolar type, unstable. In a December 2009 VA treatment record, the Veteran reported that she no longer has bipolar disorder and attributed her mood symptoms to celiac disease. The Board notes that the Veteran was diagnosed with celiac disease in August 2009. The VA physician indicated that celiac disease could cause difficulties with cognition and mood. In VA treatment records dated December 2010 and July 2013, the Veteran reported no longer having bipolar disorder and attributed her “emotional problems” to celiac disease. In September 2012, the Veteran submitted an article titled “what is celiac disease” which indicated that gluten sensitivity and celiac disease can influence mood and behavioral disorders, such as bipolar disorder. In October 2012, the Veteran was afforded a VA examination. She was diagnosed with schizoaffective disorder. In an October 2012 statement, the Veteran reported that she “no longer [has] bipolar swings.” In a November 2015 VA treatment record, a VA psychiatrist indicated that although the Veteran had a prior diagnosis of bipolar disorder, her previous psychological testing suggests that her symptoms were more consistent with major depressive disorder, PTSD and histrionic traits. In her March 2017 Board hearing, the Veteran reported having a previous diagnosis of bipolar disorder but no positive nexus opinion. In October 2017, the Veteran was afforded another VA examination. The Veteran reported having a history of being diagnosed with bipolar disorder; however, she contended that the diagnosis was in error because her symptoms resulted from celiac disease. The VA examiner indicated that the Veteran’s contentions were supported by VA medical records and that the Veteran does not have schizoaffective or bipolar disorder. The examiner also indicated that the October 2012 VA examination diagnosis of schizoaffective disorder was in error because it failed to diagnose PTSD. A preponderance of the evidence is against a finding that the Veteran has a current acquired psychiatric disorder. Although the Veteran has several diagnoses of schizoaffective and bipolar disorder, she has indicated that these diagnoses were in error and that her symptoms were the result of celiac disease. In addition, the October 2017 VA examiner did not diagnose the Veteran with schizoaffective or bipolar disorder and indicated that the October 2012 VA examination diagnosis of schizoaffective disorder was in error. Therefore, service connection is not warranted and the claim is denied. Vito A. Clementi Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD B. Cohen, Associate Counsel