Citation Nr: 18157357 Decision Date: 12/13/18 Archive Date: 12/12/18 DOCKET NO. 16-54 392 DATE: December 13, 2018 ORDER Entitlement to service connection for an acquired psychiatric disorder is denied. FINDING OF FACT The Veteran’s an acquired psychiatric disorder did not have its onset in service, was not manifested to a compensable degree within one year of service discharge, and is not otherwise related to service. CONCLUSION OF LAW The criteria for service connection for an acquired psychiatric disorder are not met. 38 U.S.C. §§ 105, 1101, 1110, 1112, 1113, 1131, 1137, 5107(b); 38 C.F.R. §§ 3.102, 3.301, 3.303(a)-(b), (d), 3.307, 3.309(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Air Force from June 1986 to October 1987. Entitlement to service connection for an acquired psychiatric disorder The Board has carefully reviewed the evidence of record and finds that the preponderance of the evidence is against the award of service connection for an acquired psychiatric disorder on either a direct or presumptive basis. The reasons follow. The Veteran has been diagnosed with an acquired psychiatric disorder, and thus there is evidence of a current disability. For example, the Veteran has been variably diagnosed with disorganized chronic schizophrenia with acute exacerbations, psychoactive substance dependence not otherwise specified (NOS), cannabis dependence, alcohol dependence, bipolar type schizoaffective disorder, psychotic disorder NOS, depressive disorder NOS, and recurrent severe/major depressive disorder with mood congruent psychotic features. Service connection may not be granted for substance abuse on the basis of in-service incurrence or aggravation. However, secondary service connection is available for substance abuse if such abuse is found to be secondary to a service-connected disability. 38 U.S.C. §§ 105, 1110; 38 C.F.R. § 3.301(a); VAOPGCPREC 2-98. The Veteran does not have any service connected disabilities. Accordingly, the Veteran’s psychoactive substance dependence NOS, cannabis dependence, and alcohol dependence are not subject to service connection. However, as to direct service incurrence, the Veteran’s claim fails on both the in-service disease or injury and the nexus to service. For example, the service treatment records (STRs) show that the Veteran was found to have a clinically normal psychiatric evaluation at his separation examination in September 1987. At a September 1987 Report of Medical History, the Veteran also denied a history of depression or excessive worry, denied a history of nervous trouble of any sort, and specifically stated that he did not have any personal or family history of psychosis. In March 1987, May 1987, and September 1987, the Veteran was noted to engage in alcohol abuse, however it was not attributed to any psychiatric disorder. This evidence weighs against a finding that the Veteran had an acquired psychiatric disorder during service. As to a nexus to service, private medical records from Western State Hospital indicate that the Veteran sought psychiatric assistance for the first time in November 1994, and was diagnosed with disorganized chronic schizophrenia with acute exacerbations in December 1994, which is approximately seven years following service discharge, and tends to establish that an acquired psychiatric disorder did not have its onset in service. The Veteran contends in his September 2016 Notice of Disagreement that his acquired psychiatric disorder manifested prior to 1994, and that this constitutes evidence that his acquired psychiatric disorder is related to service. The Veteran also contends in an August 2016 statement that his alcohol abuse during service was a symptom of his later diagnoses. However, the Veteran is not medically trained and is therefore not qualified to competently opine about medical etiology. Although he claims that his acquired psychiatric disorder is related his service, a layperson without medical training is not qualified to render medical opinions regarding the etiology of certain disorders and disabilities. 38 C.F.R. § 3.159(a)(1). In certain instances, lay testimony may be competent to establish medical etiology or nexus. However, psychiatric disabilities require specialized training for determinations as to diagnosis and causation, and is therefore, not susceptible to lay opinions on etiology. The origin or cause of the Veteran’s acquired psychiatric disorder is not a simple question that can be determined based on mere personal observation by a lay person, the Veteran’s lay assertion is not competent to establish a nexus. To the extent that the Veteran has stated that an acquired psychiatric disorder had its onset in service, his service treatment records do not support such a finding. The Board accords high probative value to these reports by the Veteran, as he completed these forms contemporaneously with service. Given the above evidence, the Board finds that the Veteran did not incur an event, injury, or disease related to his current acquired psychiatric disorder in service and that his acquired psychiatric disorder did not manifest during service or within one year of separation from service. Furthermore, the evidence of record does not demonstrate that the Veteran’s symptoms attributable to a psychosis have been continuous since separation from service in October 1987. See 38 C.F.R. §§ 3.303(b), 3.307, 3.309(a). There were no complaints, diagnosis, or treatment for this disorder for approximately years following service discharge. The absence of post-service complaints, findings, diagnosis, or treatment for approximately seven years after service is one factor that tends to weigh against a finding of continuous symptoms since separation from service. The Board may weigh the absence of contemporaneous medical evidence as one factor in determining whether a disability is related to service. A prolonged period without medical complaint can be considered, along with other factors, as evidence of whether an injury or a disease was incurred in service which resulted in any chronic or persistent disability. In sum, the Board concludes that the preponderance of the evidence of record is against the Veteran’s claim for service connection for an acquired psychiatric disorder, which has been variously diagnosed. The benefit-of-the-doubt doctrine enunciated in 38 U.S.C. § 5107(b) is not applicable, as there is no approximate balance of evidence.   A. P. SIMPSON Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD R. Husain, Associate Counsel