Citation Nr: 18154312 Decision Date: 11/29/18 Archive Date: 11/29/18 DOCKET NO. 15-08 328 DATE: November 29, 2018 ORDER Entitlement to service connection for an acquired psychiatric disorder, to include post-traumatic stress disorder (PTSD) and depression, is denied. FINDING OF FACT An acquired psychiatric disorder, to include PTSD and depression, did not have its onset during, nor was is aggravated by the Veteran’s service. CONCLUSION OF LAW An acquired psychiatric disability, to include PTSD and depression, was not incurred in or aggravated by the Veteran’s service. 38 U.S.C. §§ 5103, 5103A, 5107; 38 C.F.R. §§ 3.159, 3.102, 3.303, 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from March 1970 to January 1972. This matter comes before the Board from an March 2014 rating decision. 1. Entitlement to service connection for post-traumatic stress disorder Under the relevant laws and regulations, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131 (2012). Generally, the evidence must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). VA regulations provide that service connection for PTSD requires medical evidence diagnosing the condition; 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) (2018). Certain chronic diseases, including psychoses, are subject to presumptive service connection if manifest to a compensable degree within one year from separation from service even though there is no evidence of such disease during the period of service. This presumption is rebuttable by affirmative evidence to the contrary. 38 U.S.C. §§ 1112, 1113 (2012); 38 C.F.R. §§ 3.307(a)(3), 3.309(a) (2018). Under 38 C.F.R. § 3.303(b), an alternative method of establishing the second and third Shedden element is through a demonstration of continuity of symptomatology if the disability claimed qualifies as a chronic disease listed in 38 C.F.R. § 3.309(a). Psychoses are qualifying chronic diseases. See Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Even though a disease is not included on the list of presumptive diseases, a nexus between the disease and service may nevertheless be established based on direct service connection. Stefl v. Nicholson, 21 Vet. App. 120 (2007). When a claimed disability is not included as a presumptive disability, direct service connection may nevertheless be established by evidence demonstrating that the disability was in fact incurred during service. Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994). It is the policy of VA to administer the law under a broad interpretation, consistent with the facts in each case, with all reasonable doubt to be resolved in favor of the claimant. 38 C.F.R. § 3.102 (2018). The Veteran asserts that his psychiatric disorder is related to his military service. The record shows that he began to receive mental health treatment through VA in April 2011. He has received continuous treatment since that time. In October 2012, the Veteran was referred for evaluation for possible PTSD. He described hyperarousal, distressing thoughts, avoidance symptoms, and nightmares. However, the examiners noted that his descriptions were vague, and found that the Veteran did not meet the full diagnostic criteria for PTSD, but more closely met the diagnostic criteria for anxiety disorder NOS and cannibis abuse disorder. The examiners indicated that the Veteran did not meet the diagnostic criterion B and C for PTSD and that it was difficult to fully assess Criterion C because of pervasive marijuana use. The Veteran was afforded a VA examination in March 2014. While serving in Vietnam, he described being sent to a bunker where it was known that they were heavily outnumbered by enemy forces. He said a fire fight ensued. He also recalled witnessing several service members accosting a local Vietnamese man. The examiner indicated that the Veteran had a stressor sufficient to satisfy criterion A, but did not find that the Veteran met the full diagnostic criteria for a diagnosis of PTSD. A detailed explanation was provided with respect to why a PTSD diagnosis was not warranted. The examiner did diagnose of depressive disorder, with anxious distress, and cannibis use disorder; however, the examiner determined that the Veteran’s diagnosed psychiatric disorders were less likely than not related to his military stressors. The examiner found that there was limited evidence linking the Veteran’s post-military mental health diagnoses to his military service as the service treatment records were negative of mental health complaints from entrance to separation. Additionally, the examiner noted that the Veteran does not link his symptoms such as loss of interest in things and procrastination to his reported military stressors. The persuasive evidence of record demonstrates that the criteria for a diagnosis of PTSD have not been met. The March 2014 VA examination and October 2012 evaluation more than adequately addressed this question. The evidence is also against the finding that any other acquired psychiatric disorder, to include depressive disorder and cannibis use disorder, manifested during service or within one year of the Veteran’s discharge from service. There is likewise insufficient evidence showing that a present psychiatric disorder is etiologically related to the Veteran’s service, to include his stated stressors. The mental disorder diagnoses provided in the October 2012 and March 2014 VA examination report are supported by the reported findings. The examiner is shown to have reviewed the evidence of record and to have adequately considered the lay statements and reported symptom manifestations history of record. See Dalton v. Nicholson, 21 Vet. App. 23 (2007). There is no competent medical opinion refuting the October 2012 and March 2014 findings. Consideration must be given to a Veteran’s personal assertion that he has an acquired psychiatric disorder related to his service. However, while lay persons are competent to provide opinions on some medical issues, see Kahana v. Shinseki, 24 Vet. App. 428, 435 (2011), the specific issues in this case falls outside the realm of common knowledge of a lay person. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007). The disabilities at issue are not conditions that are readily amenable to lay diagnosis or probative comment regarding etiology. See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Woehlaert v. Nicholson, 21 Vet. App. 456, 462 (2007). The Board acknowledges that the Veteran is competent to report observable symptoms, but there is no indication that he is competent to etiologically link any such symptoms to a current diagnosis. He is not shown to possess the requisite medical training, expertise, or credentials needed to render a diagnosis or a competent opinion as to medical causation. Nothing in the record demonstrates that he received any special training or acquired any medical expertise in evaluating such disorders. See King v. Shinseki, 700 F.3d 1339, 1345 (Fed. Cir. 2012). Accordingly, the lay evidence does not constitute competent medical evidence and lacks probative value. When all the evidence is assembled VA is then responsible for determining whether the evidence supports the claim or is in relative equipoise, with the claimant prevailing in either event, or whether a preponderance of the evidence is against the claim in which case the claim is denied. Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990); Ortiz v. Principi, 274 F.3d 1361 (Fed. Cir. 2001). The preponderance of the evidence in this case is against the Veteran’s service connection claims for an acquired psychiatric disorder, to include PTSD and depression. MICHAEL A. HERMAN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD E. Rekowski, Associate Counsel