Citation Nr: 19166293 Decision Date: 08/27/19 Archive Date: 08/27/19 DOCKET NO. 18-36 420 DATE: August 27, 2019 ORDER Entitlement to service connection for posttraumatic stress disorder (“PTSD”) is granted. FINDING OF FACT The Veteran has a diagnosis of PTSD based on an in-service stressor with credible supporting evidence that the claimed in-service stressor actually occurred. CONCLUSION OF LAW Resolving all doubt in the Veteran’s favor, the criteria for entitlement to service connection for posttraumatic stress disorder (“PTSD”) have been met. 38 U.S.C. §§ 1101, 1110, 1112; 38 C.F.R. §§ 3.303, 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served in the United States Navy from July 28, 1997 to December 29, 2001. 1. Entitlement to service connection for posttraumatic stress disorder (“PTSD”). The Veteran contends that his PTSD was caused by his military service. Specifically, he contends that he witnessed a refugee drown during a rescue attempt while he was stationed aboard the USS Nassau in approximately March 1999. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). Establishing service connection for PTSD requires specific findings. These are: (1) a current medical diagnosis of PTSD; (2) credible supporting evidence that the claimed in-service stressor actually occurred; and, (3) medical evidence of a causal nexus between current symptomatology and the specific claimed in-service stressor. See 38 C.F.R. § 3.304(f). The diagnosis of PTSD must comply with the criteria set forth in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, of the American Psychiatric Association (DSM-V). Id.; see 38 C.F.R. §§ 4.125(a), 4.130. However, the record reflects that the Veteran’s psychiatric health has also been analyzed under the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, of the American Psychiatric Association (DSM-IV) criteria because it was analyzed prior to the release of the DSM-V. See Cohen v. Brown, 10 Vet. App. 128, 140 (1997) (holding that VA may presume that a diagnosis made by a mental health care professional was made in accordance with the DSM-IV). Thus, the Board shall consider the Veteran’s appeal in light of both the DSM-IV and DSM-V. DSM-IV provides that a valid diagnosis of PTSD requires that a person has been exposed to a traumatic event in which both of the following were present: (1) the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of himself or others, and (2) the person’s response involved intense fear, helplessness, or horror. At the outset, the Board notes that the Veteran has a current medical diagnosis of PTSD pursuant to the DSM-IV and DSM-V criteria as shown by countless VA treatment records dating to at least 2012. As such, the requirements of element (1) for service connection for PTSD have been met. As for element (2), a link between the Veteran’s current symptoms and an in-service stressor, in a November 2018 letter, the Veteran’s treating VA psychiatrist, Dr. R.A., indicated he had diagnosed the Veteran with “PTSD due to combat trauma.” Dr. R.A.’s treatment notes show that he diagnosed the Veteran with PTSD in August 2018 based on the Veteran’s report that while his ship was attempting to rescue a group of refugees in the waters off Bosnia/Kosovo, he witnessed one refugee fall off the ship’s rescue ladder and presumably drown. The Veteran reported experiencing recurrent intrusive memories of the man screaming after he fell in the water, then disappeared, and presumably died. In addition, Dr. R.A. specifically noted that he had reviewed the Veteran’s CPRS medical records. As discussed in greater detail below, the Veteran’s VA treatment records reflect a consistent retelling of this basic story throughout his treatment history. As such, the Board finds that the medical evidence establishes a link between the Veteran’s PTSD and a claimed in-service stressor and the requirements of element (2) have been met. Because the Veteran has a current diagnosis of PTSD and his treating VA psychiatrist has opined that it was caused by an in-service stressor, the question becomes whether there is credible supporting evidence that the in-service stressor occurred. Here, the Veteran has consistently reported in his statements in support of his claim, as well as in his treatment records, that he witnessed a refugee drown in a rescue mission while he was aboard the USS Nassau in approximately March 1999. At times, these reports have been extremely detailed as to the events experienced and the important details of these events have remained consistent over time. Similarly, the Veteran’s ex-wife, sister, and friend all wrote letters describing the Veteran’s account of his time in service and the stressful events that occurred therein. These letters show the Veteran has told the same basic story of witnessing a refugee drown to family and friends since leaving the Navy. In addition, the record contains other significant corroborating evidence for the Veteran’s reports. For example, the Veteran’s personnel records confirm that he was in fact aboard the USS Nassau during the time period in question and historical information in the record shows the USS Nassau participated in Operation Allied Force/Noble Anvil, the 1999 NATO bombing of Yugoslavia, which began in March 1999. As such, the Veteran’s description of where his ship was and what it was doing in March 1999 is accurate. Further, in May 2019, DPRIS indicated that a search of the 1999 command history and March-April 1999 deck logs submitted by the USS Nassau revealed that on April 6, 1999, deck logs recorded that at 0600 hours, all Flight Quarters were set (meaning the ship readied one or more helicopters) and the order was given to man a life boat, but no follow-on details were recorded. The Board finds that these deck logs tend to support the Veteran’s statements for several reasons. First, while the deck logs do not directly confirm a specific rescue attempt of a refugee by the ship, the Board finds they do show some sort of rescue attempt was taking place while the Veteran was aboard the USS Nassau. Second, in September 2017, in one of his more detailed reports, the Veteran described the rescue attempt as occurring early in the morning, just after wakeup call and muster. The April 1999 deck logs show the event occurred at 0600 hours, or 6:00 AM. The Board finds that the deck logs lend support to the Veteran’s description of the timing of the incident. Third, the Veteran has consistently reported the incident occurred in approximately March 1999, the deck logs show it occurred at the beginning of April 1999. The Board finds that considering the passage of time since the incident, the Veteran’s severe psychological symptoms, and his significant substance abuse issues, the minor inconsistency in the dates does not detract from the credibility of the Veteran’s statements, but rather, it adds to his credibility. Finally, the evidence shows a significant change in the Veteran’s behavior following April 1999. For example, the Veteran’s military personnel records show a marked change in his performance and behavior around that time. Whereas he was previously successful and disciplined, the Veteran began to have disciplinary issues and went AWOL from September 7, 1999 to September 8, 1999 and from September 20, 1999 to October 27, 1999. As a result, he was given 45 days restriction, 45 days extra duties, a forfeiture of pay, and a reduction in rank. Then, the Veteran again went AWOL from June 14, 2000 to October 9, 2000. He was sentenced to 30 days of correctional custody, a forfeiture of pay, and another reduction in rank. In addition, the letters from the Veteran’s ex-wife, sister, and friend all describe an extremely dramatic change in the Veteran’s personality and behavior following his discharge from the Navy in 2001 as compared to prior to his enlistment in 1997. These behavioral changes lend further support to the Veteran’s reports. After a thorough review of the record, and after affording the Veteran the benefit of the doubt, the Board concludes that the record shows corroborating evidence of the claimed in-service stressor. As a result, the requirements of element (3), credible supporting evidence that the claimed in-service stressor occurred, have been satisfied. Because the requirements of all three elements have been met, the Board finds the Veteran is entitled to service connection for PTSD. L. B. CRYAN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Department of Veterans Affairs 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.