Citation Nr: 18123720 Decision Date: 08/02/18 Archive Date: 08/02/18 DOCKET NO. 14-21 931 DATE: August 2, 2018 ORDER Entitlement to service connection for an acquired psychiatric disorder is granted. FINDING OF FACT The evidence is at least in relative equipoise that the Veteran’s diagnosed acquired psychiatric disorder was incurred in service. CONCLUSION OF LAW The criteria for entitlement to service connection for an acquired psychiatric disorder, to include as secondary to service-connected chronic gastritis have been met. 38 U.S.C. §§ 1110, 5107(b) (2012); 38 C.F.R. 3.102, 3.303 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from November 1967 to November 1969. 1. Entitlement to service connection for an acquired psychiatric disorder, to include as secondary to service-connected chronic gastritis. Service connection will be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303, 3.304. Service connection generally requires evidence of (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. Walker v. Shinseki, 701 F.3d 1331 (Fed. Cir. 2013). Notwithstanding the lack of evidence of disease or injury during service, service connection may still be granted if all of the evidence, including that pertinent to service, establishes that the disability was incurred in service. See 38 U.S.C. § 1113(b); 38 C.F.R. § 3.303(d); Cosman v. Principi, 3 Vet. App. 503 (1992). The evidence of record demonstrates that the Veteran has a current diagnosis of major depressive disorder. He filed a claim of entitlement to service connection for an acquired psychiatric disorder under the theory that the disability was caused or aggravated by service-connected chronic gastritis, a condition that began in service. To date, there has been no conclusive medical opinion verifying this theory. Instead, in May 2017 the Veteran submitted a disability benefits questionnaire from a private psychiatrist, Dr. R.J.G., stating that the Veteran’s mental disorder has provoked his chronic gastritis. This opinion echoed the conclusions of a September 1981 medical visit in which the Veteran’s doctor attributed the Veteran’s epigastric discomfort to an anxiety reaction. More recently, in April 2016, the Veteran told Dr. R.J.G. that his primary care doctor told him that his abdominal pain was entirely due to anxiety. The Veteran began seeking treatment for mental health conditions in 1976. However, in a December 1969 medical examination, less than one month after the Veteran left military service, the physician noted that the Veteran showed “a certain state of anxiety.” In a July 1971 treatment report, the physician noted that the Veteran appeared very nervous and refused to talk about his mental condition, but the Veteran ultimately admitted that, during military service, his hands would start to tremble without any apparent motivation and that he would avoid going out in public. The Board finds that the medical evidence of record is at least in relative equipoise to conclude that the Veteran’s acquired psychiatric disorder had its onset in service. Although there are medical opinions of record denying a relationship between gastritis and an acquired psychiatric disorder, there are three separate medical opinions from 1981, 2016, and 2017 that each attribute gastritis to a mental condition. Notably, the Veteran’s service-connected gastritis was documented during military service. If gastritis existed in service, and is attributable to a mental condition, it would follow that the Veteran also suffered from a mental condition during service. This conclusion is supported by the fact that the Veteran demonstrated symptoms of anxiety within one month of service. It is also supported by the Veteran’s statements to a physician, in the course of treatment, that he avoided going out in public during service and experienced trembling hands without any apparent motivation— a demonstration of potential in-service symptoms.   The Veteran therefore has a current diagnosis of an acquired psychiatric disorder, and the evidence is at least in relative equipoise that the condition had its onset in service. Accordingly, the Veteran has met the required criteria for service connection on a direct basis. BETHANY L. BUCK Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Giaquinto, Associate Counsel