Citation Nr: 18155532 Decision Date: 12/04/18 Archive Date: 12/04/18 DOCKET NO. 11-00 848 DATE: December 4, 2018 ORDER Entitlement to an effective date of June 6, 1972, for the grant of service connection for posttraumatic stress disorder (PTSD) is granted. FINDINGS OF FACT 1. The Veteran filed a claim for service connection for an acquired psychiatric disorder, claimed as nervousness and schizoaffective/paranoid, on June 6, 1972, that was denied by a final July 1972 rating decision. 2. The Veteran’s claim for PTSD was granted in July 2009, with an effective date of April 12, 2002, the date of claim to reopen the previously denied claim for service connection for a psychiatric disorder. 3. The eventual grant of service connection for PTSD was based, in part, on the receipt of new service department records obtained from the Joint Services Records Research Center (JSRRC). 4. The competent and probative medical evidence of record demonstrates that the Veteran more likely than not suffered from PTSD at the time of the initial June 6, 1972, claim. CONCLUSION OF LAW The criteria are met for an effective date of June 6, 1972, for the award of service connection for PTSD and related symptoms. 38 U.S.C. § 5110; 38 C.F.R. §§ 3.156 (c) in effect in 2005; 3.400. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from April 1969 to July 1970. At the outset, the Board finds that new service department records have been associated with the file such that the Veteran’s claim must be reconsidered from the original date of claim, June 6, 1972. See 38 C.F.R. § 3.156(c). In this case, the July 2009 rating decision that granted service connection for PTSD was based, in part, upon new information obtained by the JSRRC confirming five of the Veteran’s reported service stressors. The confirmation of these stressors led the RO to determine that the Veteran was a combat veteran, as he contended. These new service records fulfill the criteria delineated in 38 C.F.R. §§ 3.156(c). The Board notes here that the Veteran’s current claim was filed in 2002, and such predates the amendment to 38 C.F.R. §§ 3.156(c)(2), which limits the application of 38 C.F.R. §§ 3.156(c) where the claimant fails to provide sufficient information for VA to identify and obtain the records from the respective service department. In Cline v. Shinseki, 26 Vet. App. 18, 26 (2012), the United States Court of Appeals for Veteran Claims (Court) held that the October 2006 amended version of 38 C.F.R. § 3.156(c)(2) constituted a substantive rule change when it was added, and that where a claimant was granted service connection for PTSD prior to the October 2006 effective date of the new version of 38 C.F.R. § 3.156 (c), the new version of that regulation could not be applied retroactively. Therefore, the above restriction, mainly the burden placed on the claimant to identify the service stressors such that they can be verified, is not applicable to the Veteran’s case. Therefore, the JSRRC records obtained in 2008 meet the criteria for reconsideration of the original claim. Because service connection for PTSD has already been granted, Board must determine the appropriate effective date of that award i.e. the date when the Veteran was diagnosed with PTSD. See 38 C.F.R. § 3.400. The Board has considered numerous medical opinions as to this question. VA examiners provided negative opinions in May 2014, January 2017, and May 2018. These opinions agreed that the Veteran’s symptomatology shown in service, and when he was hospitalized shortly after service separation, as well as records dated in the 1990s, failed to demonstrate the necessary criteria for a diagnosis of PTSD. Rather, the Veteran was shown to suffer from symptoms that related to a personality disorder and a substance abuse disorder in service and for many decades following service. The May 2014 VA examiner supported the conclusion that the Veteran did not suffer from PTSD prior to April 2002 by pointing to the lack of any reported stressors or reports of acute PTSD symptoms in the service records. The examiner concluded that the Veteran’s symptoms following service demonstrated a substance abuse disorder. The examiner also found there to be an inconsistency with regard to the Veteran’s report of stressors to various mental health professionals. The January 2017 VA examiner provided a similar opinion, determining that the Veteran’s symptoms described in service, such as rebelliousness, procrastination, and passive resistance to authority was indicative of a personality disorder, rather than evidence of a trauma-related disorder. The examiner found the lack of evidence of PTSD symptoms, such as anger, mood instability, and anxiety, made it unlikely that he was suffering from such at that time. Moreover, when the Veteran was hospitalized in 1976, he was not diagnosed with any condition other than substance abuse. In May 2018, the same VA examiner provided an addendum opinion, adding that on April 1995 VA examination, PTSD was not diagnosed. Rather, the Veteran was once again diagnosed with a paranoid personality disorder. Finally, the examiner concluded that while in June 1999 the Veteran was noted to suffer from symptoms that sounded like PTSD, that assessment was completed by a nonpsychiatric physician and was thus bearing of less weight. On the other hand, the Veteran has submitted numerous private opinions supporting his contention that he has suffered from PTSD since he filed his initial 1972 claim. In July 2011, a psychiatrist reviewed the record and argued that the diagnosis of a personality disorder in service should bear little clinical significance. The physician explained that PTSD as a psychiatric disorder was not understood by clinicians at that time in history, and therefore the Veteran’s trauma symptoms at that time would not have been apparent. The physician noted that the Veteran was described as angry, mean, and aggressive following service separation by his family, and therefore there is evidence that he was suffering from symptoms now understood to be related to PTSD. The physician further noted that the Veteran’s severe substance abuse disorder, which began in service, has been accepted to be secondary to his PTSD, and was in fact found to be related to PTSD by the December 2017 VA examiner. The physician noted that the 1995 VA examiner described the Veteran’s substance abuse disorder as being related to his desire to “numb out everything” and to mitigate his fear, horror, and nightmares related to Vietnam. The physician pointed out that while the 1995 VA examination focused on the Veteran having a substance abuse disorder as his primary disorder, it did not address the underlying reason for such severe substance abuse spanning since service. The physician concluded that, given the nature of the Veteran’s substance abuse disorder and psychiatric symptoms since his service, it would be an error to state that the Veteran’s PTSD suddenly manifested in 2002. Rather, in June 1999, a VA treatment record described the Veteran as suffering from Vietnam war PTSD, and these same symptoms had been apparent for many decades. In April 2015, a private addendum opinion was provided, reiterating that when the Veteran was evaluated in service and when he underwent psychiatric treatment shortly after service, there was no diagnosis of PTSD in the DSM and thus there was a low likelihood that the Veteran’s trauma-related symptoms would have been properly identified then. The physician noted that the Veteran has consistently described an emotional deterioration due to his combat experiences, and has described turning to drugs to end the related nightmares and intrusive thoughts. Then, in November 2018, a private psychiatrist reviewed the file and further noted that the 1976 hospitalization for a substance abuse disorder did not diagnose any personality disorder. Such contradicted the May 2018 VA examiner’s opinion that the Veteran suffered from a personality disorder, rather than a mood disorder or trauma disorder, beginning in service and for decades following service. The physician concluded that if the Veteran had actually been suffering just from a substance abuse disorder at that time, then it would follow that such was likely related to his PTSD or trauma symptoms, as was indicated on 2017 VA examination. After reviewing these above medical opinions, the Board determines that the competent and probative evidence weighs in the Veteran’s favor, and the Board finds that an effective date of June 6, 1972, for service connection for PTSD is warranted. While the Veteran was not actually diagnosed with PTSD prior to the early 2000s, the record does demonstrate symptoms that have been attributed to PTSD spanning many decades. An April 1995 industrial survey noted that the Veteran appeared to be suffering from PTSD, and the Veteran reported numerous combat stressors at that time. He has provided credible and consistent testimony that he has suffered from nightmares, intrusive thoughts, anger, and other PTSD symptoms since service and being subjected to many combat traumas. Significantly, there is competent evidence for and against the question of when his PTSD began. For instance, while a VA examiner questions whether the Veteran displayed a mood disorder in the 1970s based on a lack of indication of diagnosis, a private physician points out that the Veteran’s substance abuse was masking those trauma symptoms. (Continued on the next page)   Given the above, the Board finds that the evidence is at least in equipoise as to the onset of the Veteran’s PTSD, and therefore, the Board finds in the Veteran’s favor. M.E. Larkin Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD R. Erdheim, Counsel