Citation Nr: 20002268 Decision Date: 01/10/20 Archive Date: 01/09/20 DOCKET NO. 17-53 161 DATE: January 10, 2020 ORDER Entitlement to service connection for posttraumatic stress disorder (PTSD) is granted. FINDINGS OF FACT 1. The Veteran has a current diagnosis of PTSD. 2. There is credible evidence of an in-service stressor based on personal assault. 3. The medical evidence establishes a link between the Veteran’s current PTSD symptoms and the in-service stressor. CONCLUSION OF LAW Resolving all reasonable doubt in the Veteran’s favor, the criteria for service connection for PTSD are met. 38 U.S.C. § 1110 (2012); 38 C.F.R. §§ 3.102, 3.304 (2018). REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran served on active duty from November 2010 to November 2014. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a March 2016 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Houston, Texas, which, in pertinent part, denied entitlement to service connection for PTSD. The Veteran timely perfected an appeal. See March 2017 Notice of Disagreement; August 2017 Statement of the Case; October 2017 VA Form 9. In October 2019, the Veteran testified at a hearing before the undersigned Veterans Law Judge, a transcript of which is of record. Entitlement to Service Connection for PTSD The Veteran contends that she has PTSD that is related to an in-service sexual assault. A. Legal Criteria Service connection is warranted where the evidence of record establishes that a particular injury or disease resulting in disability was incurred in the line of duty in the active military service or, if pre-existing such service, was aggravated thereby. 38 U.S.C. § 1110, 1131; 38 C.F.R. § 3.303 (a). Establishing service connection generally requires competent evidence of (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004); see also Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Pond v. West, 12 Vet. App. 341 (1999). Establishment of service connection for PTSD requires: (1) medical evidence diagnosing PTSD; (2) credible supporting evidence that the claimed in-service stressor actually occurred; and (3) medical evidence of a link between current symptomatology and the claimed in-service stressor. 38 C.F.R. § 3.304 (f); see also Cohen v. Brown, 10 Vet. App. 128 (1997). In determining whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). B. Facts and Analysis The record before the Board contains conflicting evidence as to whether the Veteran meets the criteria for a diagnosis of PTSD. A June 2015 VA initial PTSD intake assessment shows that the Veteran was diagnosed with PTSD by a VA clinical psychologist. The psychologist noted that the Veteran met Criterion A for a diagnosis of PTSD due to being sexually assaulted in service. The psychologist also noted that the Veteran’s PTSD symptoms met Criteria B, C, D, and E, and the psychologist listed the symptoms meeting each criterion. The psychologist concluded that the Veteran was exposed to military-related criterion A trauma and met the DSM-5 criteria for military-related PTSD as a primary psychiatric diagnosis. A July 2015 VA treatment record shows that the Veteran was diagnosed with PTSD by another VA psychologist. Subsequent VA treatment records show treatment for chronic PTSD due to MST. The Veteran was afforded a VA examination in February 2016. The examiner indicated that the Veteran’s reported in-service sexual assault met Criterion A for a diagnosis of PTSD. Nonetheless, the examiner opined that the Veteran did not meet the full DSM-5 criteria for PTSD because she did not endorse symptoms of persistent avoidance (Criterion C) or negative alterations in cognitions and mood (Criterion D). Upon review of the medical evidence of record, the Board finds that the evidence is at least in equipoise on the issue of whether the Veteran currently has a diagnosis of PTSD in conformance with the DSM-5. The Veteran has been diagnosed with PTSD by two VA psychologists. A PTSD diagnosis by a mental-health professional must be presumed to have been made in accordance with the applicable DSM criteria as to both the adequacy of the symptomatology and the sufficiency of the stressor absent compelling evidence to the contrary. Cohen v. Brown, 10 Vet. App. 128, 140 (1997); see also Rizzo v. Shinseki, 580 F.3d 1288, 1291 (Fed. Cir. 2009) (holding that, in the absence of evidence to the contrary, medical professionals are presumed to be competent to render the diagnoses they render). In light of Cohen, the Board finds that the Veteran has been diagnosed with PTSD and to determine otherwise the Board would have to rely on its own medical judgment to support its conclusions. Colvin v. Derwinski, 1 Vet. App. 171 (1991) (holding that the rating board cannot substitute its own medical judgment for that of medical professionals). The Board acknowledges the February 2016 VA examiner’s opinion that the Veteran did not meet the diagnostic criteria for PTSD. However, given the conflicting diagnoses based on examination by VA mental health professionals the evidence is at least in equipoise on the issue. When evidence is in relative equipoise, reasonable doubt must be decided in the Veteran’s favor. Accordingly, resolving all reasonable doubt in favor of the Veteran, the Board finds that the Veteran currently has a confirmed DSM-5 diagnosis of PTSD. 38 U.S.C. § 5107 (b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). The Board also finds that there is credible evidence of an in-service stressor. The Veteran relates that she was assaulted by her NCO while deployed to Afghanistan. Military personnel and service treatment records confirm that the Veteran reported the sexual assault while in service. Additionally, the Veteran submitted lay statements from fellow service members corroborating her account. Moreover, in the context of personal assault claims, the U.S. Court of Appeals for the Federal Circuit has held that 38 C.F.R. § 3.304 (f)(5) specifically contemplates medical opinions as probative evidence that may corroborate a past assault stressor. Menegassi v. Shinseki, 638 F.3d 1379 (2011). In this case, both the February 2016 VA examiner and the Veteran’s VA psychologists found that the Veteran met the DSM-5 stressor criterion with the primary stressor related to PTSD being an in-service sexual assault. Accordingly, the Board finds that the Veteran’s cited sexual assault stressor is corroborated. Turning to the question of whether there is a nexus, or link, between the currently shown disability and service, the evidence indicates that the Veteran’s current PTSD is attributable to her military sexual trauma. The Veteran’s VA psychologists specifically linked the Veteran’s PTSD to her military experiences, and the February 2016 VA examiner indicated that the Veteran’s PTSD symptoms were related to military sexual trauma. Further, VA treatment records have consistently related the Veteran’s PTSD to her reported in-service military sexual trauma stressor. There are no contrary opinions of record. Therefore, all three elements of 38 C.F.R. § 3.304 (f) have been met, and service connection for PTSD as due to an in-service personal assault is warranted. DEBORAH W. SINGLETON Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board R. Kipper, 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.