Citation Nr: 18154985 Decision Date: 12/03/18 Archive Date: 12/03/18 DOCKET NO. 17-18 177 DATE: December 3, 2018 ORDER Service connection for an acquired psychiatric disability (claimed as posttraumatic stress disorder), diagnosed as major depressive disorder with alcohol abuse disorder, is granted. FINDINGS OF FACT 1. The Veteran’s psychiatric disability, diagnosed as major depressive disorder with alcohol abuse disorder, was incurred in service. 2. The Veteran does not have a diagnosis of posttraumatic stress disorder (PTSD). CONCLUSION OF LAW The criteria for establishing service connection for an acquired psychiatric disability (claimed as PTSD), diagnosed as major depressive disorder with alcohol abuse, have been met. 38 U.S.C. §§ 1110, 1131 (2012); 38 C.F.R. §§ 3.102, 3.303 (2017). REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran served on active duty service from September 1967 to August 1969. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a May 2012 rating decision that denied service connection for PTSD. The Veteran filed a timely Notice of Disagreement in May 2013, but in a March 2014 rating decision, the regional office (RO) confirmed and continued its denial. Although the Veteran initially claimed service connection for PTSD, other psychiatric diagnoses are documented in the record demonstrating that the scope of this claim should be construed more broadly as a psychiatric disability. See Clemons v. Shinseki, 23 Vet. App. 1 (2009). The Board has recharacterized the issue accordingly. Service connection may be granted if the evidence demonstrates that a current disability resulted from an injury or disease that was incurred or aggravated during active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). In general, service connection requires: (1) 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). When a disability is initially diagnosed after separation from service and not within any applicable presumptive period, service connection may be granted if all the evidence establishes that it was incurred in service. 38 C.F.R. § 3.303(d). In rendering a decision on appeal, the Board must analyze the credibility and probative value of all medical and lay evidence of record, account for the evidence which it finds to be persuasive or unpersuasive, and provide the reasons for its rejection of any material evidence favorable to the claimant. 38 U.S.C. § 1154(a); Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006); Gilbert v. Derwinski, 1 Vet. App. 49, 57 (1990). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Board must resolve reasonable doubt in favor of the veteran. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert, 1 Vet. App. 49. To deny a claim on its merits, the evidence must preponderate against the claim. Alemany v. Brown, 9 Vet. App. 518 (1996). The Veteran asserts that he is entitled to service connection for an acquired psychiatric disability. In his March 2012 claim, he asserted that he suffers from PTSD. By November 2018, the Veteran’s representative recharacterized the Veteran’s psychiatric disability as major depressive disorder with alcohol abuse disorder, based on a recent psychiatric evaluation. Indeed, an October 2018 psychological assessment discloses that the Veteran is currently diagnosed with major depressive disorder. The Veteran also suffers from alcohol abuse disorder that is a “facet of [major depressive disorder]” because the Veteran seeks to mitigate his depressive symptoms with alcohol. Accordingly, the Board finds that the Veteran currently suffers from an acquired psychiatric disability and, specifically, major depressive disorder with alcohol abuse disorder. As such, he meets the first requirement of service connection. The Veteran’s service treatment records are silent as to any complaints about depression or related symptoms during service. His examinations at entry into service and at separation do not reveal any psychological disorders or any symptoms thereof. Moreover, the Veteran’s treatment records indicate that he sought treatment for depression beginning in 2006. However, written statements from the Veteran and his brother indicate that the Veteran struggled with psychological issues immediately upon his return home from active duty service in Vietnam. In his April 2018 statement, the Veteran’s brother explained that the Veteran “came back from Vietnam very different from what we were used to.” He was drinking heavily, spending time with “people of questionable character,” and he would often come home drunk, late at night and act out violently. His behavior was so reckless that he was in multiple car accidents, including some in which he was almost killed, and his behavior “affected the instability of his home.” In addition, the Veteran experienced anxiety and nervousness when he began attending university and, then, when he began working at a post office. He would experience nightmares related to failing at work at school. He was sometimes so nervous that he could not eat breakfast or lunch because he was so nauseous. In his own written statements, the Veteran explained that, during service in Vietnam as a cook in combat zones, he often feared for his life. At times, he would have to deliver meals to distant places where temporary perimeters had been established; and, on the way, he would find himself in the middle attacks by the enemy. He often could not sleep because of the noise from nearby cannons, which made him nervous and put him “in a bad mood,” and “the only diversion was the abuse of alcohol and smoking.” In another statement, the Veteran further described the nervousness and anxiety that plagued him soon after his return from service. In an interview with the Veteran’s psychologist, the Veteran’s wife explained that “when [the Veteran] came back from the Army, I knew that he needed help, and I told him, but he did not listen to me[. H]e told me that this was for crazy people and [took] refuge in alcohol[. I]t would calm him down and he would not think so much about those things, but this would harm him.” The Veteran is competent to provide evidence of his experience with fear and anxiety during and after service, and his brother and wife are competent to speak to their experience with the Veteran and what they observed after service. There is no apparent reason to doubt the credibility of their statements. See Layno v. Brown, 6 Vet. App. 465, 469 (1994). Accordingly, their recollection is entitled to great probative weight. Thus, while the Veteran’s service records do not contain complaints related to psychological issues during service, the competent and credible statements describing the Veteran’s psychological difficulties during and after service lend credence to the Veteran’s assertions that his acquired psychiatric disability had its onset during service. As for nexus to service, the Veteran provided a private psychological examination report (dated in October 2018) in which his psychologist determined that his major depressive disorder with alcohol abuse disorder was more likely than not related to service. Specifically, the psychologist found that the evidence “clearly supports that [the Veteran] experienced significant trauma while in the military and consequently developed a psychiatric disability.” He notes that the Veteran’s medical records consistently report symptoms associated with a severe mental illness along with a concomitant alcohol abuse disorder, and that there is a “high probability” that the Veteran’s alcohol abuse disorder is a “facet of MDD, rather than a competing diagnosis.” This refutes a May 2012 VA examination for PTSD that concluded that the Veteran did not suffer from PTSD, and that his only diagnosis was alcohol abuse disorder. In assigning probative weight to a medical opinion, the Board must consider whether it is: (1) based on sufficient facts or data; (2) the product of reliable principles and methods; and (3) the result of principles and methods reliably applied to the facts. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 302 (2008). It may also consider whether the examiner had access to the claims file, reviewed prior clinical records and pertinent evidence, and provided a thorough, detailed and definitive opinion supported by a detailed rationale. Prejean v. West, 13 Vet. App. 444, 448-9 (2000). Here, the psychiatrist’s report is adequate to address the Veteran’s claim. It is predicated on a review of the Veteran’s medical and service history, an in-person evaluation, clinical observation, an interview with the Veteran’s wife, and various anxiety and depression inventories. In addition, it contains a thorough and well-reasoned explanation for the opinions rendered. Accordingly, it is entitled to great probative weight. Based on the foregoing, the Board finds that the evidence is at least in equipoise that the Veteran’s currently diagnosed major depressive disorder with alcohol abuse disorder is related to the Veteran’s service. Accordingly, the Veteran is afforded the benefit of the doubt, and service connection is granted. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert, 1 Vet. App. 49. As a concluding point, the Board notes that the Veteran originally brought his claim as one for service connection for PTSD. The evidence of record indicates that the Veteran does not have a current diagnosis of PTSD. In the May 2012 VA examination, mentioned above, the examiner determined that the Veteran’s symptoms did not meet the criteria for such a diagnosis. Similarly, following his extensive psychological examination in October 2018, the Veteran’s private psychologist diagnosed the Veteran only with major depressive disorder and alcohol abuse disorder. For these reasons, the Board is granting service connection for an acquired psychiatric disability (claimed as PTSD), diagnosed as major depressive disorder with alcohol abuse. ROMINA CASADEI Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Freda J. F. Carmack, Associate Counsel