Citation Nr: 18153028 Decision Date: 11/27/18 Archive Date: 11/26/18 DOCKET NO. 16-42 049 DATE: November 27, 2018 ORDER Service connection for an acquired psychiatric disorder, diagnosed as psychotic disorder, bipolar disorder, and/or schizophrenia, is granted. FINDING OF FACT Resolving all doubt in his favor, the Veteran’s acquired psychiatric disorder, diagnosed as psychotic disorder, bipolar disorder, and/or schizophrenia, had its onset during service. CONCLUSION OF LAW The criteria for service connection for an acquired psychiatric disorder, diagnosed as psychotic disorder, bipolar disorder and/or schizophrenia, have been satisfied. 38 U.S.C. §§ 1101, 1110, 1112, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Air Force from May 1997 to June 2002. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2014 rating decision from the Department of Veterans Affairs (VA) Regional Office (RO), which denied service connection for posttraumatic stress disorder (PTSD). However, such claim has been recharacterized to include all psychiatric disorders reasonably raised by the record. Clemons v. Shinseki, 23 Vet. App. 1 (2009). Entitlement to service connection for an acquired psychiatric disorder. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Service connection may also be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Direct service connection may not be granted without evidence of a current disability; in-service incurrence or aggravation of a disease or injury; and a nexus between the claimed in-service disease or injury and the present disease or injury. Id.; see also Caluza v. Brown, 7 Vet. App. 498, 506 (1995) aff’d, 78 F.3d 604 (Fed. Cir. 1996) [(table)]. Where a veteran served for at least 90 days during a period of war or after December 31, 1946, and manifests certain chronic diseases, such as psychosis, to a degree of 10 percent within one year, from the date of termination of such service, such disease shall be presumed to have been incurred or aggravated in service, even though there is no evidence of such disease during the period of service. 38 U.S.C. §§ 1101, 1112; 38 C.F.R. §§ 3.307, 3.309. In this regard, a psychosis is defined as brief psychotic disorder, delusional disorder, psychotic disorder due to another medical condition, other specified schizophrenia spectrum and other psychotic disorder, schizoaffective disorder, schizophrenia, schizophreniform disorder, and substance/medication-induced psychotic disorder. Alternatively, when a disease at 38 C.F.R. § 3.309(a) is not shown to be chronic during service or the one year presumptive period, service connection may also be established by showing continuity of symptomatology after service. See 38 C.F.R. § 3.303(b). However, the use of continuity of symptoms to establish service connection is limited only to those diseases listed at 38 C.F.R. § 3.309(a) and does not apply to other disabilities which might be considered chronic from a medical standpoint. See Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). The Board finds that service connection for an acquired psychiatric disorder, diagnosed at various times as a psychotic disorder, bipolar disorder, and schizophrenia, is warranted. The Veteran was diagnosed with a psychotic disorder as early as January 2005 and was later diagnosed with schizophrenia and bipolar disorder. All three diagnoses have been based on a constellation of symptoms that include sleep disturbance, depression, anxiety, hallucinations, suspiciousness and delusions. The Veteran asserts that such disorder began during service after he witnessed a traumatic event while on deployment. Specifically, he reports that, while serving as a fire fighter in Saudi Arabia, he saw 3 bodies mangled in an auto accident in approximately November 1999. The evidence of record corroborates the Veteran’s reports that his psychiatric symptoms began in service and have continued since that time. His primary military occupational specialty was Fire Protection. His DD 214 shows that he had 3 years of foreign service and his service treatment records show that he was cleared for overseas deployment to Saudi Arabia from September 1999 to December 1999. These records corroborate the Veteran’s report of witnessing mangled bodies during service because such an event is consistent with the places, types, and circumstances of his service. Moreover, the July 2016 written statement of the Veteran’s wife confirms that his symptoms began during service. In that statement, she reports that she first observed the Veteran exhibit behavioral changes and psychiatric symptoms after his return from deployment in December 1999. She reported that, although they had planned a vacation upon the Veteran’s return, he abruptly decided he did not want to go. She stated that he would have occasional night sweats, as well as episodes of jumping and shaking in his sleep. She also noted that he started sleeping with more or heavier blankets. She observed that he become more spiritual and more protective of her and their children. She stated that his symptoms became progressively worse over time, resulting in numerous hospital admissions. The Veteran and his wife are competent to report the onset and recurrence of the symptoms they observed, and the Board finds these reports credible. See Layno v. Brown, 6 Vet. App. 465 (1994). In January 2005, less than 3 years after the Veteran’s separation from service, he sought treatment for his continuing psychiatric symptoms and was diagnosed with a psychotic disorder. At that time, he reported the same sleep disturbances and suspiciousness as he experienced in service, in addition to restless, and anxiety or panic attacks (episodes of rapid heartbeat and difficulty breathing). Based on these symptoms and the additional symptoms listed above, his provider diagnosed him with a psychotic disorder and indicated that he may have schizophrenia. Although there is no medical opinion of record that a nexus exists between the Veteran’s symptoms during service and his post-service psychiatric diagnosis, such evidence is not necessary in light of the lay evidence of record concerning the onset and recurrence of his symptoms that were later diagnosed as a psychosis. King v. Shinseki, 700 F.3d 1339, 1344-45 (Fed. Cir. 2012); 38 U.S.C. §§ 1101, 1112; 38 C.F.R. §§ 3.303, 3.307, 3.309. A. JAEGER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Tracie N. Wesner, Counsel