Citation Nr: 19190887 Decision Date: 12/03/19 Archive Date: 12/03/19 DOCKET NO. 16-51 318 DATE: December 3, 2019 ORDER Entitlement to service connection for an acquired psychiatric disability, to include posttraumatic stress disorder (PTSD), insomnia disorder, and alcohol abuse disorder, is granted. FINDING OF FACT Resolving all reasonable doubt in favor of the Veteran, the probative evidence of record reflects that the Veteran’s acquired psychiatric disabilities are directly related to his active duty service. CONCLUSION OF LAW The criteria for entitlement to service connection for an acquired psychiatric disability, to include posttraumatic stress disorder (PTSD), insomnia, and alcohol abuse disorder have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.303, 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from August 1989 to November 1991. This case comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Newnan, Georgia. In September 2019, the Veteran and his spouse testified before the undersigned Veterans Law Judge (VLJ) at a live videoconference hearing. A transcript of the hearing is of record. Entitlement to service connection for an acquired psychiatric disability, to include posttraumatic stress disorder (PTSD), insomnia disorder, and alcohol abuse disorder. The Veteran contends that he currently has a psychiatric disability that is related to a traumatic event he experienced during active duty service; specifically, from the accidental killing of two fellow servicemen during a live fire training session in Korea. Generally, to prevail on a direct service connection claim, there must be competent evidence of (1) a current disability, (2) in-service incurrence or aggravation of a disease or injury, and (3) a nexus between the in-service disease or injury and the current disability. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009); 38 U.S.C. § 1110, 1131; 38 C.F.R. § 3.303(a). Furthermore, to establish service connection for PTSD, the record must contain the following: (1) medical evidence diagnosing PTSD; (2) credible supporting evidence that the claimed in-service stressor occurred; and (3) medical evidence of a link between current symptomatology and the claimed in-service stressor. 38 C.F.R. § 3.304(f). After review of the evidence, the Board finds that service connection is warranted for an acquired psychiatric disability, as this disability was casually related to service. The record establishes a current disability, as the Veteran was diagnosed with PTSD, insomnia, and alcohol abuse disorder by VA and private examiners/treating physicians throughout the rating period on appeal. Additionally, the Board notes the VA has verified the Veteran’s claimed in-service stressor related to the accidental killings at a live fire exercise in Korea in October 1990; thus, finding that the second element is met. In a March 2015 VA examination, the examiner diagnosed the Veteran with PTSD; however, did not provide an opinion as to the nature or etiology of this condition. In a September 2015 VA examination, the examiner found that the Veteran’s symptoms did not meet the diagnostic criteria for PTSD under the DSM-5 criteria; however, diagnosed the Veteran with insomnia disorder and alcohol use disorder. The examiner opined that the Veteran’s psychiatric disabilities were less likely than not incurred in or caused by the claimed in-service stressor. After review of the Veteran’s claims file, the examiner rationalized the following: the Veteran does not meet the criteria for PTSD; the Veteran’s insomnia disorder was incurred after military service, as the Veteran states he began having difficulty sleeping for the past 5 years, with no evidence in service treatment records (STRs) of insomnia during service; and the Veteran’s alcohol abuse disorder began prior to service and worsened over the past few years, with alcoholism running in the Veteran’s family, and no relation to service or aggravation by service. In a November 2015 private examination, the examiner, Dr. G.T., diagnosed the Veteran with PTSD under the DSM-5 criteria; and opined that it is more likely than not, by 50% or more, that the above PTSD symptoms are service connected. In December 2015, an addendum opinion to the November 2015 private examination was provided, where the same examiner, Dr. G.T., noted that the Veteran has been a psychiatric patient of his since December 2014; and confirmed the opinion that it is more likely than not, by 50% or more, that the Veteran’s PTSD symptoms are service connected, as the Veteran’s trauma is documented and consistent with service-related trauma. Therefore, the examiner concluded that, after assessing hundreds of veterans for PTSD, he finds that the Veteran is typical for PTSD from service-related trauma. To further support his claim, the Veteran submitted another private medical opinion from Dr. G.T. in September 2019, where he noted that after careful review of the Veteran’s STRs and post-service treatment records, it is his medical professional opinion that the Veteran’s PTSD is more likely than not, derived from the stressful event experienced in service during a training exercise in South Korea. Dr. G.T. added that the Veteran’s PTSD falls in-line with the sequence of events that the Veteran described during their counseling sessions, with no known significant event that happened post-service that can be the cause of the Veteran’s diagnosed condition of PTSD. In a September 2019 VA medical opinion from the Veteran’s treating psychiatric physician, Dr. W. N., she noted that the Veteran’s diagnosed PTSD was incurred during service in Korea, in which the Veteran and other soldiers in his unit mistakenly fired upon and killed fellow American troops. The physician added that, even though she did not have access to the Veteran’s military service records, a review of his medical records at the current VA facility along with her clinical expertise results in the Veteran’s PTSD being directly caused by the accident during his military service, as there is no history of other traumas that may account for his current PTSD symptoms. The Board acknowledges that the September 2015 VA examination provided a lack of diagnosis of PTSD and an opinion tending to weigh against the Veteran’s claim; however, the Board finds this examination to be inadequate, as the examiner failed to consider and/or discuss the various diagnoses of PTSD in the Veteran’s treatment records, did not provide a well-supported rationale regarding the Veteran’s PTSD claim, nor did the examiner consider and/or discuss the subsequent private and VA medical opinions in support of the Veteran’s claim. Therefore, given this, the Board assigns this examination little, if any, probative weight. Conversely, the Board accords the December 2015 and September 2019 private opinions, and the September 2019 VA opinion, great probative weight, as the examiners reviewed the Veteran’s claims file and/or pertinent evidence related to this claim, provided sufficient consideration of the Veteran’s confirmed in-service stressor, and based their rationales on their medical expertise in treating other PTSD patients and specifically caring for the Veteran over the past few years. Therefore, as there is probative evidence of record in support the Veteran’s claim, and resolving any reasonable doubt in favor of the Veteran, the Board finds that service connection for the Veteran’s acquired psychiatric disability, to include PTSD, insomnia disorder, and alcohol abuse disorder, is warranted; and the claim is granted. See 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49, 54-56 (1990). M. H. HAWLEY Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board B. Hodges, Associate 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.