Citation Nr: 19190845 Decision Date: 12/03/19 Archive Date: 12/03/19 DOCKET NO. 17-32 230 DATE: December 3, 2019 ORDER Entitlement to service connection for PTSD with anxiety symptoms is granted. FINDING OF FACT The Veteran has PTSD with anxiety symptoms that is related to an in-service stressor. CONCLUSION OF LAW The criteria for service connection for PTSD with anxiety symptoms are met. 38 U.S.C. §§ 1110, 1131 (2012); 38 C.F.R. §§ 3.303, 3.304 (2018). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from May 2003 to September 2005. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an April 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In October 2019, the Veteran testified before the undersigned at a Board hearing. The transcript from the hearing has not yet been associated with the file, as this appeal is being adjudicated under the One-Touch program. The hearing transcript will still be processed and associated with the claims file in the ordinary course of business. Service Connection Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131 (2012); 38 C.F.R. § 3.303(a) (2018). To establish a right to compensation for a present disability, a Veteran must show: (1) the existence of a present disability; (2) 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 - the so-called “nexus” requirement. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Service connection may be granted for any disease initially diagnosed after discharge when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d) (2018). Service connection for PTSD specifically requires medical evidence establishing a diagnosis of the disability, credible supporting evidence that the claimed in-service stressor actually occurred, and a link, established by medical evidence, between the current symptomatology and the claimed in-service stressor. 38 C.F.R. § 3.304(f) (2018). If a PTSD claim is based on military sexual trauma or personal assault in service, evidence from sources other than the Veteran’s records may corroborate the Veteran’s account of the stressor incident. Examples of such evidence include, but are not limited to: records from law enforcement authorities, rape crisis centers, mental health counseling centers, hospitals or physicians; pregnancy tests or tests for sexually transmitted diseases; and statements from family members, roommates, fellow service members, or clergy. 38 C.F.R. § 3.304(f)(5) (2018). Furthermore, an appropriate medical or mental health professional may provide an opinion as to whether the evidence of record indicates that a personal assault occurred. 38 C.F.R. § 3.304(f)(5). Medical opinion evidence may be submitted for use in determining whether a claimed stressor occurred and such opinion evidence should be weighed along with the other evidence of record in making this determination. Menegassi v. Shinseki, 628 F.3d 1379, 1382 n.1 (Fed. Cir. 2011). The Veteran alleges that she has PTSD that is related to military sexual trauma suffered during her military service. See e.g. February 2014 claim. First, the Board finds that there is a current disability. See Holton, 557 F.3d at 1366; 38 C.F.R. § 3.303(d). Though a diagnosis of PTSD was not found on initial VA examination in October 2014, VA treatment records before and after this visit document the disorder. Further, a subsequent VA examination conducted in September 2018 confirmed a diagnosis of PTSD. Accordingly, a present diagnosis is demonstrated. Second, the Board finds that there was an in-service injury or disease. See Holton, 557 F.3d at 1366; 38 C.F.R. § 3.303(d). In a May 2014 Statement in Support of Claim for Service Connection for PTSD secondary to Personal Assault, the Veteran described suffering verbal abuse from fellow soldiers. In addition, she described in detail how she suffered domestic abuse from her now ex-husband during her period of active duty. Notably, this stressor was found to meet the stressor criteria for a diagnosis of PTSD in both the October 2014 and September 2018 VA examinations, and it is clear that the Veteran’s history of domestic abuse was considered as an integral part of her psychiatric history in the VA examinations. Accordingly, the Board concedes the Veteran’s in-service stressor. Third, the Board finds that the evidence of record does support a finding that the Veteran’s PTSD is related to her reported stressors during active service. See Holton, 557 F.3d at 1366; 38 C.F.R. § 3.303(d). Again, though the October 2014 VA examination did not diagnose PTSD, the September 2018 VA examiner clearly diagnosed the disorder and related it to the Veteran’s history of complex trauma, including childhood and late adolescence trauma, military sexual trauma during her service, and traumatic events post-military. The Board accords the September 2018 VA examination significant probative weight because it reflects consideration of the Veteran’s medical history, to include her recurrent treatment for PTSD during the claim period, addresses her credible stressor accounts, and is supported by rationale and the evidentiary record. Prejean v. West, 13 Vet. App. 444, 448-9 (2000) (holding that factors for assessing the probative value of a medical opinion are the physician’s access to the claims file and the thoroughness and detail of the opinion); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) (holding that a medical opinion must be supported by an analysis that the Board can consider and weigh against contrary opinions). The VA examination supports a finding that the Veteran’s has PTSD that is related, in part, to a stressor from her military service. In the absence of any evidence against the Veteran’s claim, service connection for PTSD is warranted. Further, although no diagnosis of anxiety was rendered, the September 2018 examiner found that symptoms of anxiety were contemplated in the Veteran’s PTSD diagnosis. As such, any anxiety symptoms will be contemplated in the rating assigned. Further, the Veteran is already service-connected for dysthymia. At the September 2018 VA examination, the examiner clearly explained that the Veteran’s dysthymia is considered to be the same condition as a diagnosis of depression rendered at that time. For this reason, this rating may be considered a full grant of the benefit sought, as the Veteran’s claimed PTSD, anxiety symptoms, and depressive symptoms are already contemplated by a currently service-connected disorder or are part of a disorder for which service connection is being granted. K. MILLIKAN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Steve Ginski, Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.