Citation Nr: 18123779 Decision Date: 08/03/18 Archive Date: 08/02/18 DOCKET NO. 13-12 640 DATE: August 3, 2018 ORDER Service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD), major depressive disorder and opioid use disorder in sustained remission, is granted. FINDING OF FACT The Veteran’s PTSD is the result of his active service, his major depressive disorder is proximately due to his PTSD, and his opioid use disorder in sustained remission is proximately due to his PTSD and major depressive disorder. CONCLUSION OF LAW The criteria for entitlement to service connection for an acquired psychiatric disorder, to include PTSD, major depressive disorder and opioid use disorder in sustained remission, are met. 38 U.S.C. §§ 1110, 1154, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304(f), 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Navy from April 1970 to January 1972. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an October 2012 rating decision. In December 2016, the Board remanded the appeal for additional development. 1. Entitlement to service connection for an acquired psychiatric disorder. Service connection will be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Additionally, disability which is proximately due to or the result of a service-connected disease or injury shall be service connected. 38 C.F.R. § 3.310. Service connection for PTSD requires: (1) medical evidence diagnosing PTSD in accordance with 38 C.F.R. § 4.125(a); (2) credible supporting evidence that the claimed in-service stressor occurred; and (3) medical evidence of a link between current symptoms and the claimed in-service stressor. 38 C.F.R. § 3.304(f). In this case, the Veteran asserts that his PTSD is due to an in-service assault. Review of his service treatment records reveals he was assaulted in his sleep in June 1971, resulting in his hospitalization for five days. Hence, the in-service stressor is supported based on the documented evidence of record. The post-service evidence also reflects a diagnosis of PTSD, major depressive disorder and opioid use disorder in sustained remission. See, e.g., Vet Center treatment records; VA treatment records; June 2012 VA examination report; March 2017 PTSD Disability Benefit Questionnaire (DBQ); May 2017 VA examination report. Accordingly, with regard to PTSD, what remains to be determined is whether this diagnosis is related to the documented in-service assault. The May 2017 VA PTSD examiner found that the in-service assault was adequate to support a PTSD diagnosis, but determined that the Veteran’s PTSD was instead due to the death of the Veteran’s daughter in a motor vehicle accident involving a drunk driver in 2000. As rationale, the examiner indicated that the Veteran’s post-service work history suggested above average functioning, with no evidence of the existence of PTSD until after the death of his daughter. The June 2012 VA examiner, in opining against the claim, also noted that it did not “appear” that the in-service stressor affected his social and occupational functioning for a number of years. Notably, the Veteran’s spouse has competently and credibly reported her observations of the Veteran’s continuous psychiatric symptomatology (lack of trust and motivation, fear, and social withdrawal) during the period he was employed, which was not considered by either examiner. See February 2017 statement from C.M. Moreover, the Board finds significant that Dr. A.C. discusses the Veteran’s in-service assault in the mental health history section of the March 2017 DBQ diagnosing PTSD, but only discusses his childhood abuse and the death of his daughter in the social history section. Given this distinction, the Board finds it reasonable to assume Dr. A.C.’s PTSD diagnosis was rendered in relation to the in-service assault. Jackson v. Virginia, 443 U.S. 307, 319 (1979) (stating it is “the responsibility of the trier of fact fairly to... draw reasonable inferences from basic facts to ultimate facts”); Bastien v. Shinseki, 599 F.3d 1301, 1306 (Fed. Cir. 2010) (“The evaluation and weighing of evidence and the drawing of appropriate inferences from it are factual determinations committed to the discretion of the fact finder.”). An April 2012 statement from LMSW M.M. similarly only references the in-service assault in addressing the Veteran’s PTSD diagnosis, noting he sleeps with a baseball bat and flashlight under his bed. Id.; see also April 2012 VA treatment record (noting the Veteran sleeps with a baseball bat in order to “protect” himself from [a] possible attack in his sleep); February 2017 statement from C.M. Finally, VA psychiatrist Dr. T. diagnosed PTSD in relation to the reported in-service stressor in a May 2008 psychiatric diagnostic interview examination, and upon discussing the Veteran’s daughter’s death in detail added bereavement as a diagnosis in March 2012 (pre-DSM-5) in addition to PTSD, with no indication the underlying stressor supporting the PTSD diagnosis had changed. Thus, the Board finds that the evidence is at least in equipoise as to whether the Veteran’s PTSD is related to the in-service assault, and service connection is warranted for PTSD. Additionally, secondary service connection for major depression disorder and opioid use disorder in sustained remission is warranted. Notably, LMSW M.M. indicated that the Veteran’s major depressive disorder is secondary to his PTSD, and there is no competent opinion to the contrary. 38 C.F.R. § 3.310. In this regard, M.M., as a social worker, is considered competent to provide an opinion on the etiology of the Veteran’s major depressive disorder, as such an opinion is within his area of expertise. See MERRIAM-WEBSTER’S COLLEGIATE DICTIONARY 1184 (11th ed. 2003) (defining “social work” as “any of various professional activities or methods concretely concerned with providing social services and esp[ecially] with the investigation, treatment, and material aid of the economically, physically, mentally, or socially disadvantaged”). Moreover, the May 2017 VA examiner attributed the Veteran’s opioid use disorder to both major depressive disorder and PTSD. See also June 2012 VA examination report. S. BUSH Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. Marley, Counsel