Citation Nr: 18151864 Decision Date: 11/20/18 Archive Date: 11/20/18 DOCKET NO. 15-14 268A DATE: November 20, 2018 ORDER Service connection for posttraumatic stress disorder (PTSD) is granted. FINDING OF FACT Resolving all reasonable doubt in the Veteran’s favor, he currently has PTSD due to in-service combat stressors. CONCLUSION OF LAW The criteria for service connection for posttraumatic stress disorder (PTSD) have been met. 38 U.S.C. §§ 1110, 5103, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran testified before the undersigned Veterans Law Judge in a November 2018 video conference hearing. Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110 (2017); 38 C.F.R. § 3.303 (2017). Service connection for posttraumatic stress disorder (PTSD) requires medical evidence diagnosing the condition in accordance with 38 C.F.R. § 4.125(a); a link, established by medical evidence, between current symptoms and an in-service stressor; and credible supporting evidence that the claimed in-service stressor occurred. 38 C.F.R. § 3.304(f). VA regulations require that a medical diagnosis be competent. See 38 C.F.R. § 3.159(a). Competent medical evidence means evidence provided by a person who is qualified through education, training, or experience to offer the medical diagnosis. Id. The VA Clinician’s Guide provides guidance on who is qualified to diagnose PTSD. See VA Clinician’s Guide § 14.7 (Mar. 2002). Board certified psychiatrists and licensed psychologists have the requisite professional qualifications to conduct compensation and pension examinations for PTSD. Psychiatric residents and psychology interns are also qualified to perform these examinations, under close supervision of attending psychiatrists or psychologists. Id. In order to conduct an initial examination for mental disorders, the examiner must meet one of the following criteria: a board-certified or board-eligible psychiatrist; a licensed doctorate-level psychologist; a doctorate-level mental health provider under the close supervision of a board-certified or board-eligible psychiatrist or licensed doctorate-level psychologist; a psychiatry resident under close supervision of a board-certified or board-eligible psychiatrist or licensed doctorate-level psychologist; or a clinical or counseling psychologist completing a one-year internship or residency (for purposes of a doctorate-level degree) under close supervision of a board-certified or board-eligible psychiatrist or licensed doctorate-level psychologist. To conduct a review examination for mental disorders, the examiner must meet one of the criteria from above, OR be a licensed clinical social worker (LCSW), a nurse practitioner, a clinical nurse specialist, or a physician assistant, under close supervision of a board-certified or board-eligible psychiatrist or licensed doctorate-level psychologist. Id. The Veteran asserts that his PTSD is related to his combat in the Republic of Vietnam. The Board concedes that the Veteran experienced stressful events in service related to fear of hostile military or terrorist activity. The question before the Board is whether there is a proper diagnosis of PTSD, and whether this diagnosis is based on the in-service stressor. The Veteran was diagnosed with PTSD by at least two different VA clinicians (a social worker and staff physician), with the earliest diagnosis of record dated November 2011, and the most recent, dated in February 2013. Unfortunately, neither of these providers meet the criteria as stated in the VA Clinician’s Guide to perform an initial examination for mental disorders. A VA clinical psychologist performed the February 2012 VA PTSD examination and he concluded that the Veteran’s symptoms did not meet the diagnostic criteria for PTSD under DSM-IV criteria. However, there are two VA medical records that show a diagnosis of PTSD by a psychiatrist. A September 2012 VA psychiatry assessment note and a January 2013 VA psychiatry progress note indicate a diagnosis of PTSD that conforms to the DSM-IV. These diagnoses were provided by a VA psychiatrist. The Board finds that these diagnoses hold more probative value than the February 2012 VA examination, as there are two separate diagnoses and they both come after the February 2012 VA examiner’s conclusion, and are the most recent medical records of evidence. Moreover, these diagnoses were provided in conjunction with treatment of the Veteran and were based on the assessment of his entire medical history. As such, the Board finds all reasonable doubt in the Veteran’s favor that he has a diagnosis of PTSD due to his combat stressors. Additionally, the VA social worker who has been treating the Veteran since June 2011, has consistently diagnosed the Veteran as having PTSD—also attributing the PTSD to in-service combat stressors. The Board finds all reasonable doubt in the Veteran’s favor that he has a diagnosis of PTSD based on the confirmed and conceded in-service stressors. All reasonable doubt created by the evidence is resolved in favor of the Veteran; entitlement to service connection for PTSD is warranted. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. H.M. WALKER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD T. Talamantes, Associate Counsel