Citation Nr: 18136136 Decision Date: 09/18/18 Archive Date: 09/18/18 DOCKET NO. 16-02 031 DATE: September 18, 2018 ORDER Entitlement to service connection for adjustment disorder with mixed anxiety and depressed mood is granted. Entitlement to service connection for posttraumatic stress disorder (PTSD) is denied. FINDINGS OF FACT 1. The Veteran’s adjustment disorder with mixed anxiety and depressed mood is attributable to service. 2. The Veteran has not been diagnosed with PTSD pursuant to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). CONCLUSIONS OF LAW 1. The criteria for service connection for adjustment disorder with mixed anxiety and depressed mood have been met. 38 U.S.C. §§ 1110, 5103, 5103A; 38 C.F.R. §§ 3.303, 3.304. 2. The criteria for service connection for PTSD have not been met. 38 U.S.C. §§ 1110, 1131, 5103, 5103A; 38 C.F.R. §§ 3.303, 3.304. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from December 1988 to March 1992. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a November 2013 rating decision. 1. Entitlement to service connection for an acquired psychiatric disability other than PTSD. In January 2013, the Veteran filed a claim of entitlement to service connection for PTSD. He cited nightmares, flashbacks, sleep disturbance, irritability, and anxiety that he related to disturbing events witnessed or otherwise experienced during service. The claim will be construed broadly to include any acquired psychiatric disability that may reasonably be encompassed by the description of the claim, reported symptoms, and other information of record. Clemons v. Shinseki, 23 Vet. App. 1 (2009). Service connection will be granted for a current disability that resulted from an injury or disease incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Generally, service connection requires: (1) a present disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the present disability and the disease or injury incurred or aggravated during service. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for any disease diagnosed after discharge when all of the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). VA must give a claimant the benefit of the doubt as to any issue material to the determination of a matter when there is an approximate balance of positive and negative evidence. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. The Veteran has adjustment disorder with mixed anxiety and depressed mood. See October 2014 examination report and October 2015 addendum opinion for PTSD. According to the Veteran, his depression began during service and continues to the present. He attributes the depression, anxiety, and intrusive memories to his traumatic experiences in the military, including the loss of 14 friends or service members who died during his Gulf War service when stationed in Saudi Arabia, seeing burned dead bodies on the side of the road, and being ordered to dispose of the bloodied personal effects of a friend who had been killed in an explosion. See October 2014 VA examination report for PTSD. The service treatment records note no psychiatric symptoms. The Veteran was found to be normal as to “psychiatric” in the September 1991 separation examination report. Personnel records indicate that the Veteran served in Saudi Arabia from May 1989 to May 1991. His specialty was air traffic controller, and his decorations include the Southwest Asia Service Medal with 2 Bronze Stars. See DD Form 214. The Veteran states that, at one point, he served at a site in the desert 17 kilometers from the border of Saudi Arabia and Iraq. He was also in a convoy that moved to different areas for which the Veteran no longer recalls the exact locations. He claims to have seen numerous burned and destroyed vehicles with bodies inside along the highway and to have witnessed the discarding of dead Iraqi soldiers on the roadside. See Veteran’s statements of October 2015. The Board finds the Veteran to be competent and credible in his report of psychologically upsetting events during service. Special regulatory requirements relating to credible “supporting evidence” that a claimed in-service stressor occurred apply to PTSD claims and not to other psychiatric disabilities generally. 38 C.F.R. § 3.304(f). In the opinion of the October 2014 VA examiner, the Veteran’s adjustment disorder with mixed anxiety and depressed mood is likely related to his traumatic experiences during service. See also October 2015 addendum opinion. There is no medical opinion of record that disassociates the Veteran’s psychiatric disability from service. With all three elements of service connection having been met, service connection is warranted. 2. Entitlement to service connection for PTSD is denied. The Veteran filed a service-connection claim for PTSD in January 2013. Establishing service connection for PTSD generally requires: (1) medical evidence diagnosing PTSD in conformance with established criteria; (2) a link, established by medical evidence, between a veteran’s present symptoms and an in-service stressor; and (3) credible supporting evidence that the claimed in-service stressor actually occurred. 38 C.F.R. §§ 3.304(f), 4.125; Arzio v. Shinseki, 602 F.3d 1343, 1347 (Fed. Cir. 2010). VA must give a claimant the benefit of the doubt as to any issue material to the determination of a matter when there is an approximate balance of positive and negative evidence. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. A diagnosis of PTSD for compensation purposes must be established in accordance with 38 C.F.R. § 4.125(a), which mandates that, for VA purposes, all mental disorder diagnoses must conform to the Fifth Edition of the American Psychiatric Association 's Diagnostic and Statistical Manual for Mental Disorders (DSM-5). VA has determined that the DSM-5 applies to claims filed, or pending before the agency of original jurisdiction, on or after August 4, 2014. 79 Fed. Reg. 45,093, 45,094 (Aug. 4, 2014). As the Veteran's appeal was certified to the Board in August 2016, the DSM-5 applies here. The Veteran underwent a VA examination for PTSD in October 2014. An addendum opinion was also obtained in October 2015. The examiner diagnosed adjustment disorder with mixed anxiety and depressed mood. It was determined that the Veteran did not meet the full criteria for PTSD. Specifically, he did not show symptoms relating to Criterion D and Criterion E of the DSM-5. The VA treatment records note numerous negative PTSD screens. There is no competent PTSD diagnosis of record. VA must give due consideration to all pertinent medical and lay evidence in evaluating a claim for disability or death benefits. See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009) (construing, in relevant part, 38 U.S.C. § 1154(a)). The Veteran, as a layperson, is competent to report the symptoms that he has experienced. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). Service connection for PTSD specifically requires medical evidence establishing a diagnosis of the disability. 38 C.F.R. § 3.304(f). The Veteran is not competent to associate any of his claimed symptoms to a diagnosis of PTSD. Such opinion requires specific medical training. Competent medical evidence means evidence provided by a person who is qualified through education, training, or experience to offer medical diagnoses, statements, or opinions. 38 C.F.R. § 3.159(a)(1). Accordingly, the statements offered by the Veteran in support of his own claim do not establish PTSD. The Veteran’s claim of service connection for PTSD fails on the basis of a lack of medical evidence diagnosing PTSD in conformity with criteria of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. A preponderance of the competent evidence is against finding a diagnosis of PTSD made in accordance with 38 C.F.R. § 4.125 at any time since the Veteran’s claim was filed. Therefore, service connection cannot be granted. See Degmetich v. Brown, 104 F.3d 132 (Fed. Cir. 1997). (Continued on the next page)   Notably, however, the Veteran’s claimed symptoms of PTSD have been medically associated with an adjustment disorder related to service; and, those symptoms will be rated based on the criteria for rating all mental health disorders, regardless of the diagnosis. In other words, the denial of service connection for PTSD does not prohibit the evaluation of the same symptoms under another diagnosis (adjustment disorder) because the rating criteria for all mental health disorders is the same. L. B. CRYAN Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Steven D. Najarian, Associate Counsel