Citation Nr: 18158636 Decision Date: 12/18/18 Archive Date: 12/17/18 DOCKET NO. 17-05 395 DATE: December 18, 2018 ORDER Entitlement to service connection for depressive disorder, alcohol-induced (claimed as mood disorder, generalized anxiety disorder and alcohol dependence with physiological dependence) is denied. FINDING OF FACT Depressive disorder, alcohol-induced, did not manifest in service and is not otherwise related thereto. CONCLUSION OF LAW The criteria for entitlement to service connection for depressive disorder, alcohol-induced, have not been met. 38 U.S.C. §§ 1101, 1112, 1113, 1131, 1137, 5103, 5103A, 5107 (West 2015); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309, 3.655, 3.384 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION 1. Entitlement to service connection for depressive disorder, alcohol-induced (claimed as mood disorder, generalized anxiety disorder and alcohol dependence with physiological dependence) Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303 (a). Establishing service connection generally requires competent evidence of three things: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship, i.e., a nexus, between the current disability and an in-service precipitating disease, injury or event. Fagan v. Shinseki, 573 F.3d 1282, 1287 (Fed. Cir. 2009); 38 C.F.R. § 3.303 (a). Alternatively, service connection may be established either by showing that a chronic disability or disease was incurred during service and later manifestations of such chronic disability or disease are not due to intercurrent cause(s) or that a disorder or disease was incurred during service and there is evidence of continuity of symptomatology which supports a finding of chronicity since service. 38 C.F.R. § 3.303 (b). When a chronic disease becomes manifest to a degree of 10 percent within one year of a veteran’s discharge from service, such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the veteran’s period of service. 38 U.S.C. § 1112 (West 2015); 38 C.F.R. §§ 3.307, 3.309 (2016). Service connection may also be granted for any injury or disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease or injury was incurred in service. 38 C.F.R. § 3.303 (d) (2016). In order to establish service connection for a disability, there must be (1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of nexus between the claimed in-service disease or injury and the current disability. See Hickson v. West, 12 Vet. App. 247, 253 (1999). The Board is charged with the duty to assess the credibility and weight given to evidence. Madden v. Gober, 125 F.3d 1477, 1481 (Fed. Cir. 1997), cert. denied, 523 U.S. 1046 (1998); Wensch v. Principi, 15 Vet. App. 362, 367 (2001). In Jefferson v. Principi, 271 F.3d 1072 (Fed. Cir. 2001), the United States Court of Appeals for the Federal Circuit (Federal Circuit), citing its decision in Madden, recognized that that Board had inherent fact-finding ability. Id. at 1076; see also 38 U.S.C. § 7104 (a). Moreover, the Court has declared that in adjudicating a claim, the Board has the responsibility to weigh and assess the evidence. Bryan v. West, 13 Vet. App. 482, 488-89 (2000); Wilson v. Derwinski, 2 Vet. App. 614, 618 (1992). When there is an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C. § 5107 (b) (West 2015) The Veteran claims that his depressive disorder, alcohol-induced, is related to his active duty service. The Veteran’s service treatment records (STR) are negative for any reports or diagnoses of a depressive disorder. In addition, it was noted on the Veteran’s April 1970 enlistment examination that the Veteran did not experience frequent trouble sleeping, frequent or terrifying nightmares, depression or excessive worry, loss of memory or amnesia, bed wetting, nervous trouble of any sort, any drug or narcotic habit or excessive drinking habit prior to service. He also denied any psychiatric conditions during his February 1973 separation examination. In February 2011 the Veteran underwent a private psychological evaluation. The examiner diagnosed the Veteran with depression and anxiety with significant substance abuse. It was noted that the examiner’s methods of assessment include a clinical interview, Minnesota Multiphasic Personality Inventory and a review of records. However, the examiner specifically noted that the Veteran provided the majority of the information. It also appears that the only military record reviewed was a copy of the Veteran’s DD-214. The examiner recounted the Veteran’s personal history, including his childhood, social development, education, employment, medical, mental health, marriage and substance abuse histories. In regard to his military history, the Veteran reported that he served in Germany and his trauma exposure occurred there. His trauma exposure included witnessing fights in the barracks and a bullet striking his door. He also stated that he fathered a child in Germany and the mother followed through with the pregnancy in order to follow him back to the United States. Post military, the Veteran reported that he had experience marked difficulties with the social dynamics that were apparent upon his return from service. He described being involved in argumentative confrontations regarding his military service. The examiner noted that the Veteran reported being stressed most of the day, nearly every day. Anhedonia in the form of his sacrifice of activities such as traveling and boating was reported, and was attributed to having run out of money a couple years prior to assessment. Other symptoms include insomnia, psychomotor retardation, fatigue and loss of energy, feelings of worthlessness and guilt, poor judgment, concentration difficulties, cognitive difficulties, recurrent thoughts of death and suicidal ideation, extensive worry, irritability, muscle tension, restlessness and sleep disturbance. The Veteran reported that his difficulties with depression and anxiety had been evident since service. The examiner fond that the Veteran’s symptoms were consistent with the presence of depression and anxiety, as well as a history of significant substance abuse. His more recent symptoms were consistent with major depressive disorder. The examiner concluded that the Veteran’s symptoms were as likely as not service connected. She did not elaborate with a rationale. Notably, the examiner did discuss the Veteran normal psychiatric evaluation at service discharge in February 1973. In December 2013, the Veteran was afforded a VA mental disorder examination. The Veteran was diagnosed with severe alcohol use disorder and alcohol induced depressive disorder. The examiner performed an in-person examination and reviewed the Veteran’s claims file. He also reviewed the February 2011 private examination report. The examiner was not able to differentiate between what symptoms were attributable to each diagnosis. He noted that the alcohol use disorder was the likely cause of his depressive symptoms. His occupational and social impairment was due to mild or transient symptoms which decrease work efficiency and ability to perform occupational tasks only during period of significant stress, or; symptoms controlled by medication. As with the February 2011 examination, the VA examiner relayed the Veteran’s personal, military, occupational, legal, educational, mental health, substance abuse and medical history. The examiner noted that the Veteran’s symptoms include depressed mood, worry, stress and sleep disturbance. He stated that these symptoms occurred 70 percent of the time and have existed since he was in the service. The Veteran was oriented to time, place, person and situation, he was cooperative, thought content and progression was within normal limits. There were no hallucinations, delusions, suicidal or homicidal ideations. His attention, concentration and memory were all within normal limits. Upon conclusion of the examination, the examiner determined that the Veteran’s claimed condition was less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service injury, event or illness. He reasoned that although the February 2011 examiner opined that the Veteran’s current symptoms were associated with service, this opinion was rejected. She provided no rationale for the basis of her opinion and only reviewed his D-214. She did not have access to his claims file or review his STRs. She did not account for other factors that were more likely to be the cause of his mood symptoms. For example, she did not account of difficulties during childhood, serious medical issues related to a motorcycle accident in 1982, four divorces, chronic alcohol abuse with multiple DUI charges, financial difficulties and situational stresses. The Veteran STRs were negative for any complaints of mental health issues. He was never treated for, or diagnosed with, a mental disorder in service. There were no objective records showing he had any mental health treatment during the military or within 18 months of discharge. The only evidence is the Veteran’s lay statements that he had been treated by an unknown mental health provider right after discharge. He could not recall any details of the provider and there were no records available for review. The Board has placed greater probative weight on the opinion reached by the December 2013 VA examiner that concluded that the Veteran’s current depressive disorder was not etiologically related to his service-connected. The opinion was reached by a thorough review of the Veteran’s medical history and are consistent with his documented metal history. Further, the VA examiner’s opinion is consistent with the Veteran’s February 1973 separation examination that showed that psychiatric evaluation was within normal limits. The normal psychiatric findings at separation weigh strongly against the Veteran’s current contentions that his acquired psychiatric disorder was initially manifested during service and have continued since service. The Board gives the February 2011 private examination less probative weight, because it is based almost solely on the in-person interview and did not include a review of the Veteran’s claims file, to include his STRs and VA treatment records. Accordingly, the preponderance of the evidence is against the Veteran’s service   connection claim for depressive disorder, alcohol-induced. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). DAVID L. WIGHT Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. Nelson, Associate Counsel