Citation Nr: 18160726 Decision Date: 12/27/18 Archive Date: 12/27/18 DOCKET NO. 16-52 260 DATE: December 27, 2018 ORDER Entitlement to service connection for posttraumatic stress disorder (PTSD) is granted. FINDING OF FACT Resolving reasonable doubt in favor of the Veteran, his current PTSD is etiologically related to active service. CONCLUSION OF LAW Resolving reasonable doubt in favor of the Veteran, his PTSD was incurred in or is related to active service. 38 U.S.C. §§ 1110, 1131, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.304(f) (2018). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from August 2007 to January 2008 and from February 2008 to December 2008. The Veteran was afforded a videoconference hearing before the undersigned Veterans Law Judge (VLJ) in March 2017. The hearing transcript is associated with the record. 1. Entitlement to service connection for posttraumatic stress disorder (PTSD) The Veteran asserts that his PTSD is related to his active service. At his March 2017 hearing, the Veteran testified that he attempted suicide as a result of participating in missions while stationed in Kuwait. He also testified that he experienced nightmares as a result of his deployment to Kuwait, and he was currently in therapy to work through his symptoms. A veteran is entitled to VA disability compensation for service connection if the facts establish that a disability resulted from disease or personal injury incurred in the line of duty or for aggravation of a preexisting injury in the active military, naval or air service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Generally, to establish a right to compensation, a veteran must show (1) a present disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection for PTSD requires medical evidence diagnosing the condition; a link, established by medical evidence, between current symptoms and an in-service stressor; and credible supporting evidence that the claimed in-service stressor occurred. 38 C.F.R. § 3.304 (f). As pertinent herein, a 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 fourth edition of the American Psychiatric Association’s Diagnostic and Statistical Manual for Mental Disorders (DSM-IV). 38 C.F.R. § 3.304 (f). If a stressor claimed by a veteran is related to the veteran’s fear of hostile military or terrorist activity and a VA psychiatrist or psychologist, or a psychiatrist or psychologist with whom VA has contracted, confirms that the claimed stressor is adequate to support a diagnosis of PTSD and that the veteran’s symptoms are related to the claimed stressor, in the absence of clear and convincing evidence to the contrary, and provided the claimed stressor is consistent with the places, types, and circumstances of the veteran’s service, the veteran’s lay testimony alone may establish the occurrence of the claimed in-service stressor. 38 C.F.R. § 3.304 (f)(3). For purposes of 38 C.F.R. § 3.304 (f)(3), “fear of hostile military or terrorist activity” means that a veteran experienced, witnessed, or was confronted with an event or circumstance that involved actual or threatened death or serious injury, or a threat to the physical integrity of the veteran or others, such as from an actual or potential improvised explosive device; vehicle-imbedded explosive device; incoming artillery, rocket, or mortar fire; grenade; small arms fire, including suspected sniper fire; or attack upon friendly military aircraft, and the veteran’s response to the event or circumstance involved a psychological or psycho-physiological state of fear, helplessness, or horror. Id. Effective August 4, 2014, VA amended the portion of its Schedule for Rating Disabilities dealing with mental disorders and its adjudication regulations that define the term “psychosis” to remove outdated references to the Diagnostic and Statistical Manual of Mental Disorders (DSM) and replace them with references to the recently updated Fifth Edition (DSM-V). The rulemaking also updated the nomenclature used to refer to certain mental disorders in accordance with DSM-V. Specifically, the rulemaking amends 38 C.F.R. §§ 3.384, 4.125, 4.126, 4.127, and 4.130. See 79 Fed. Reg. 149, 45094 (August 4, 2014). The provisions of the interim final rule apply to all applications for benefits that are received by VA or that are pending before the Agency of Original Jurisdiction (AOJ) on or after August 4, 2014. The Secretary does not intend for the provisions of this interim final rule to apply to claims that have been certified for appeal to the Board, or are pending before the Board, such as this one, the United States Court of Appeals for Veterans Claims, or the United States Court of Appeals for the Federal Circuit, even if such claims are subsequently remanded to the AOJ. VA adopted as final, without change, the interim final rule, effective March 19, 2015. 80 Fed. Reg. 53, 14308 (March 19, 2015). Thus, DSM-V applies to the current case. The Board finds that all the elements necessary for an award of PTSD are established. The record reflects a current diagnosis of PTSD from a VA treating physician, and the record reflects the Veteran has received continued treatment for PTSD at the VA Grove City Outpatient Clinic since August 2015. He also participates in individual therapy through VA. His VA therapist provided an updated February 2017 letter which detailed the Veteran’s continued therapy for management of his PTSD symptoms. The therapist opined the Veteran’s PTSD manifested as a result of his claimed in-service stressors. The therapist’s diagnosis of PTSD was based on the Veteran’s reports of intrusive thoughts and hyper-arousal after his assigned missions overseas in Kuwait. The Veteran was also diagnosed with PTSD by a September 2016 VA treating psychiatrist who found the Veteran’s PTSD was directly due to his nightmares and intrusive thoughts concerning his military experiences in Kuwait. The record also contains evidence verifying the Veteran’s in-service stressors. Personnel records confirm that the Veteran served in Kuwait from April 2008 to December 2008 as a unit supply specialist. Although no verification of the Veteran’s claimed stressors is of record, the Board observes that the Veteran’s DD-214 confirms his presence in Kuwait and characterizes the service as taking place within a designated imminent danger pay area. Moreover, the Board finds no reason to doubt the Veteran’s credibility regarding his claimed stressors and description of his active service. The Board finds the description of the Veteran’s location as an “imminent danger” area, as well as his competent reports of in-service stressors as a result of his overseas deployment, are sufficient to verify his exposure to extremely high stress and combat-like conditions during active duty. The Board notes an August 2016 VA examination report which found the Veteran did not have a diagnosis of PTSD. However, the Board finds that this medical opinion did not give due consideration to the Veteran’s previous VA diagnoses or his continued treatment and therapy at his local VAMC for diagnosed PTSD. Thus, the Board finds that the August 2016 VA examination has no probative value. Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). Resolving all doubt in favor of the Veteran, the record contains a valid diagnosis of PTSD and service records which substantiate the reported non-combat stressors; therefore, all the elements of service connection are met, and the Board finds that service connection for PTSD is warranted. THOMAS H. O'SHAY Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD N. Peden, Associate Counsel