Citation Nr: 18155310 Decision Date: 12/04/18 Archive Date: 12/03/18 DOCKET NO. 16-52 291 DATE: December 4, 2018 ORDER Entitlement to service connection for posttraumatic stress disorder (PTSD) is granted. FINDING OF FACT The Veteran has been shown to have PTSD that is related to military sexual trauma (MST). CONCLUSION OF LAW The criteria for service connection have been met for PTSD. 38 U.S.C. §§ 1101, 1110, 1131, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from April 1984 to December 1989. During her period of service, the Veteran earned the Army Service Ribbon, Overseas Service Ribbon, Army Good Conduct Medal, Army Achievement Medal, Army Commendation Medal, Parachutist Badge, and Noncommissioned Officer Professional Development Ribbon. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. In order to prevail on a claim of service connection, generally, there must be (1) medical evidence of a current disability; (2) medical, or in certain circumstances, lay evidence of in-service occurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the present disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). In certain cases, competent lay evidence may demonstrate the presence of any of these elements. Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009). Service connection for PTSD similarly requires (1) medical evidence establishing a diagnosis of the disorder, (2) credible supporting evidence that the claimed in-service stressor occurred, and (3) a link established by medical evidence between current symptoms and an in-service stressor. 38 C.F.R. § 3.304(f). The diagnosis of PTSD must be established in accordance with 38 C.F.R. § 4.125 (a), which provides that all psychiatric diagnoses must conform to the American Psychiatric Association’s DSM. 38 C.F.R. § 3.304(f). The record does not reflect, and the Veteran does not contend, that she engaged in combat with the enemy, has a combat-related stressor, or has a non-combat stressor related to fear of hostile military or terrorist activity. Thus, the provisions of 38 U.S.C. § 1154(b) and 38 C.F.R. §§ 3.304(f)(2) and (3) are not applicable here. If there is no combat experience, or if there is a determination that the Veteran engaged in combat but the claimed stressor is not related to such combat, there must be independent evidence to corroborate the Veteran’s statement as to the occurrence of the claimed stressor. Doran v. Brown, 6 Vet. App. 283, 288-89 (1994). The Veteran’s testimony, by itself, cannot, as a matter of law, establish the occurrence of a non-combat stressor. Dizoglio v. Brown, 9 Vet. App. 163, 166 (1996). Instead, the Veteran contends that she has PTSD as a result of a personal assault in service. Specifically, she has reported that she was forcibly raped by a Sergeant when signing off from guard duty while stationed at Fort Benning, Georgia. Because personal assault is an extremely personal and sensitive issue, many incidents are not officially reported, which creates a proof problem with respect to the occurrence of the claimed stressor. In such situations, it is not unusual for there to be an absence of service records documenting the events the Veteran has alleged. The victims of such trauma may not necessarily report the full circumstances of the trauma for many years after the trauma. Thus, when a PTSD claim is based on in-service personal assault, evidence from sources other than the Veteran’s service records may corroborate the Veteran’s account of the stressor incident. 38 C.F.R. § 3.304(f)(5); see also Patton v. West, 12 Vet. App. 272, 277 (1999). Examples of such evidence include, but are not limited to: records from law enforcement authorities, rape crisis centers, mental health counseling centers, hospitals, or physicians; pregnancy tests or tests for sexually transmitted diseases; and statements from family members, roommates, fellow service members, or clergy. 38 C.F.R. § 3.304(f)(5). Evidence of behavior changes following the claimed assault is one type of relevant evidence that may be found in these sources. Examples of behavior changes that may constitute credible evidence of the stressor include, but are not limited to: a request for a transfer to another military duty assignment; deterioration in work performance; substance abuse; episodes of depression, panic attacks, or anxiety without an identifiable cause; or unexplained economic or social behavior changes. Further, corroboration of every detail of a claimed stressor, including the Veteran’s personal participation, is not required; rather, a Veteran only needs to offer independent evidence of a stressful event that is sufficient to imply her personal exposure. See Pentecost v. Principi, 16 Vet. App. 124, 128 (2002). A March 2014 VA treatment note shows a diagnosis of PTSD in conformity with the DSM-IV. A September 2016 VA treatment note indicates that the Veteran was sexually assault while stationed at Fort Benning, Georgia in November 1984. Since that time, the Veteran reported that she has had two failed marriages. She also experiences jumpiness, anger, sadness, flashbacks, nightmares, shame, and guilt. The examiner noted that the Veteran appeared visibly anxious, as evidenced by fidgeting, pacing, and shallow breathing while recalling her trauma. The Veteran further stated in her September 2016 mental health consultation that she did not report the MST. The Board notes that a Veteran’s failure to report an in-service sexual assault to military authorities may not be considered as relevant evidence tending to prove that a sexual assault did not occur. AZ v. Shinseki, 731 F.3d 1303, 1318 (Fed. Cir. 2013). A private medical opinion submitted by Dr. M. G. in May 2018 indicates that the Veteran suffers from PTSD secondary to a sexual assault which occurred while on duty in November 1984. The examiner noted that the perpetrator was a fellow soldier. The examiner opined that the Veteran experienced symptoms of social anxiety, panic attacks, insomnia, nightmares, flashbacks, exaggerated startle response, impaired concentration, and emotional numbing secondary to the sexual assault that she suffered. For personal assault PTSD claims, an after-the-fact medical opinion can serve as the credible supporting evidence of the stressor. 38 C.F.R. § 3.304(f)(5); Menegassi v. Shinseki, 638 F.3d 1379, 1383 (Fed. Cir. 2011); Bradford v. Nicholson, 20 Vet. App. 200, 207 (2006); Patton v. West, 12 Vet. App. 272, 280 (1999). Therefore, the May 2018 private opinion provides highly probative evidence of both PTSD diagnosis in conformance with the DSM and corroboration of the in-service stressor. (Continued on the next page)   In consideration of the evidence of record, the Board finds that the preponderance of the evidence is in favor of service connection for PTSD. As such, the benefit of the doubt will be conferred in the Veteran’s favor, and her claim for service connection for PTSD secondary to military sexual trauma is granted. See 38 C.F.R. §§ 3.307, 3.309 (2017); see also Gilbert v. Derwinski, 1 Vet. App. 49 (1990); 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102 (2017). A. S. CARACCIOLO Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD T. Joseph, Associate Counsel