Citation Nr: 19119033 Decision Date: 03/19/19 Archive Date: 03/15/19 DOCKET NO. 16-07 792 DATE: March 19, 2019 ORDER Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD) is granted. REFERRED In June 2016, July 2016, and August 2016, the Veteran filed claims for temporary total evaluations for periods of hospitalization for psychological treatment. See also September 2016 Correspondence. The Agency of Original Jurisdiction acknowledged the claim in an August 2016 letter but did not adjudicate the issue because the Veteran’s acquired psychiatric disorder claim was on appeal. Thus, the issue of entitlement to a temporary total evaluation for periods of hospitalization for psychological treatment is now referred to the AOJ for adjudication. FINDING OF FACT The evidence is sufficient to show that the Veteran’s acquired psychiatric disorders, to include PTSD, had their onset in service or are related to service. CONCLUSION OF LAW The criteria for entitlement to service connection for an acquired psychiatric disorder, to include PTSD, have been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a), (c), 3.304(f), 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active duty from November 1994 to November 1997 and from March 2003 to March 2004. The Veteran also had Gulf War service. 1. Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD). 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; 38 C.F.R. § 3.303. To establish service connection for a disability, the evidence 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. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). Service connection may also be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). To establish entitlement to service connection for PTSD, there must be: (1) medical evidence diagnosing the condition in accordance with 38 C.F.R. § 4.125(a); (2) a link, established by medical evidence, between the current symptoms and an in-service stressor; and (3) credible supporting evidence that the claimed in-service stressor occurred. 38 C.F.R. § 3.304(f). 38 C.F.R. § 3.304(f) was amended regarding service connection for PTSD, by liberalizing the evidentiary standard for establishing the required in-service stressor. 38 C.F.R. § 3.304(f)(3). Specifically, this amendment eliminates the requirements for corroborating that the claimed in-service stressor occurred if a stressor claimed by a Veteran is related to the Veteran’s fear of hostile military or terrorist activity. Id. Pursuant to 38 C.F.R. § 3.304(f)(3), if a stressor claimed by a veteran is related to the veteran's fear of hostile military or terrorist activity and a VA psychiatrist or psychologist, or a psychiatrist or psychologist with whom VA has contracted, confirms that the claimed stressor is adequate to support a diagnosis of PTSD and that the veteran’s symptoms are related to the claimed stressor, in the absence of clear and convincing evidence to the contrary, and provided the claimed stressor is consistent with the places, types, and circumstances of the veteran’s service, the veteran's lay testimony alone may establish the occurrence of the claimed in-service stressor. Id. For purposes of section 3.304(f)(3), “fear of hostile military or terrorist activity” means that a veteran experienced, witnessed, or was confronted with an event or circumstance that involved actual or threatened death or serious injury, or a threat to the physical integrity of the veteran or others, such as from an actual or potential improvised explosive device; vehicle-imbedded explosive device; incoming artillery, rocket, or mortar fire; grenade; small arms fire, including suspected sniper fire; or attack upon friendly military aircraft, and the veteran's response to the event or circumstance involved a psychological or psycho-physiological state of fear, helplessness, or horror. Id. Additionally, for a Veteran who served 90 days or more of active service after December 31, 1946, there is a presumption of service connection for psychoses if the disability is manifest to a compensable degree within one year of discharge from service. 38 U.S.C. § 1112; 38 C.F.R. §§ 3.307(a), 3.309(a). Here, January 2014 and December 2015 VA psychological evaluations found that the Veteran did not meet the criteria for PTSD. However, numerous other medical treatment records including VA treatment records, private treatment records, and a December 2016 VA examination found that the Veteran met the criteria for PTSD. As such, the evidence is sufficient to show that the Veteran has a current diagnosis of PTSD. Regarding the issue of whether the Veteran’s PTSD is related to service, the preponderance of the evidence is in support of the claim. The Veteran asserted stressors include experiencing small arms fire when he was on convoys and witnessing tents being shelled at his base during deployment. The Veteran’s assertions are consistent with the places, types, and circumstances of his service. 38 C.F.R. § 3.304(f)(3). In addition, the VA examiners and private mental health service provider concluded that the Veteran’s reported stressors met the criteria to support a diagnosis of PTSD and were related to fear of hospital military or terrorist activity. The Veteran submitted an October 2014 private psychological evaluation from J.A, Jr., licensed clinical psychologist. The Veteran showed diagnoses of PTSD, alcohol dependence not related to PTSD, and mood disorder NOS with depression, anger, and anxiety. J.A. concluded that the Veteran had a disturbed life from his earliest days which included neglect and abuse. J.A. noted that these experiences caused depression and feelings of low self-worth, which were greatly exacerbated in service. J.A. also concluded that the Veteran met the diagnostic criteria for PTSD based on his experiences in service. The Veteran was afforded an additional VA examination in December 2016. The Veteran showed a current diagnosis of PTSD. The examiner concluded that the Veteran’s PTSD diagnosis appears to be a progression of unspecified depressive disorder and due to combat related stressors during service. (Continued on the next page)   Thus, the evidence is sufficient to show that the Veteran’s PTSD had its onset in service. Service connection for an acquired psychiatric disorder is granted. R. FEINBERG Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J.A. Williams, Associate Counsel