Citation Nr: 20006010 Decision Date: 01/24/20 Archive Date: 01/23/20 DOCKET NO. 15-28 900 DATE: January 24, 2020 ORDER Entitlement to service connection for posttraumatic stress disorder (PTSD) is granted. FINDING OF FACT Resolving all reasonable doubt in the Veteran’s favor, her PTSD is due to military sexual trauma. CONCLUSION OF LAW The criteria for service connection for PTSD have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303(a), 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service in the United States Army from September 1973 to September 1975. This matter is on appeal from an August 2013 rating decision. In October 2019, the Veteran testified at a travel Board hearing before the undersigned. A transcript of the proceeding has been associated with the record. Entitlement to service connection for PTSD. The Veteran testified that she was raped in December of 1973. She reported the rape to her commanding officer. The commanding officer informed her that since the rape happened off-base he did not have jurisdiction over the matter. She was sent for counselling. The Board concludes that the Veteran has a current diagnosis of PTSD that is related an in-service sexual trauma. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). Service connection for PTSD requires: medical evidence diagnosing the condition in accordance with 38 C.F.R. § 4.125 (a) (conforming to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV or DSM 5)); a link, established by medical evidence, between current symptoms and an in-service stressor; and credible supporting evidence that the claimed in-service stressor occurred. 38 C.F.R. § 3.304 (f). If a PTSD claim is based on an in-service personal assault, evidence from sources other than the veteran’s service records may corroborate the veteran’s account of the stressor incident. Gallegos v. Peake, 22 Vet. App. 329 (2008); see 38 C.F.R. § 3.304 (f)(5). Examples of such evidence include but are not limited to: records from law enforcement authorities, rape crises centers, mental health counseling centers, hospitals, or physicians; tests for sexually transmitted diseases; and statements from family members, roommates, fellow service members, or clergy. Evidence of behavioral changes following the claimed assault is one type of relevant evidence that may be found in these alternate sources. Examples of behavioral changes that may constitute credible evidence of a stressor include but are not limited to: request for transfer to another military duty assignment; deterioration in work performance; substance abuse; episodes of depression, panic attacks, or anxiety without an identifiable cause; or unexplained economic or social behavioral changes. 38 C.F.R. § 3.304 (f)(5). In cases involving personal assault, the existence of a stressor in service does not have to be proven by the “preponderance of the evidence” because this would be inconsistent with the benefit of the doubt, or equipoise, doctrine contained in 38 U.S.C. § 5107 (b). YR v. West, 11 Vet. App. 393, 399 (1998); Patton v. West, 12 Vet. App. 272, 279-280 (1999). Additionally, under 38 C.F.R. § 3.304(f), VA can submit any evidence, including alternate source evidence, to a medical or mental health professional for interpretation. Bradford v. Nicholson, 20 Vet. App. 200 (2006). Most significantly, for claims involving an in-service personal assault, after-the-fact medical evidence can be used to establish a stressor. See Id.; Patton, 12 Vet. App. at 278. The Veteran’s personnel records indicate that she was reassigned shortly after her sexual assault in January 1974. The Veteran’s psychiatric evaluation was normal at enlistment. In September 1974 the Veteran was treated for vaginal discharge and burning. Additionally, the Veteran was treated for irregular vaginal bleeding in November 1974. Additionally, the Veteran has submitted numerous lay statements from G.N., a registered nurse and her sisters indicating that she sought treatment in 1975 for trauma associated with sexual assault and that her behavior changed after 1973. The Veteran was first afforded a VA examination in August 2013. The VA examiner diagnosed depressive disorder not otherwise specified. She opined that it was less likely than not that the Veteran’s depressive disorder was caused by or incurred in active service. The VA examiner explained that the service treatment records were silent for mental health counseling and that she was highly respected in her command. There was no indication that she requested a change in duty station. In May 2015, the Veteran was afforded another VA examination. The VA examiner diagnosed PTSD. The Veteran reported that she was raped prior to service and raped while she was in-service. The VA examiner commented that a PTSD diagnosis was given with caution. Her personnel records indicate that she excelled. However, the 2507 included in the report explains that an unusual increase in performance after a claimed stressor could indicate an overcompensation reaction. The VA examiner noted that the Veteran had stressors prior to and after her active service. It is unclear whether the Veteran’s PTSD was caused by her prior service rape, her military sexual trauma, or being held at gunpoint after service. She pointed out that the Veteran did not have mental health counseling documented in her service treatment records. The VA examiner opined that it was less likely as not that the Veteran’s PTSD was caused by or a result of military service. The Veteran’s VA treatment records contain numerous notations for military sexual trauma and PTSD. The Board notes that the VA examiners improperly relied on absence of mental health records in the Veteran’s service treatment records to conclude that her PTSD was not incurred as a result of military sexual trauma. The Veteran has made competent and credible statements that she sought treatment after the assault. Her statement was corroborated by G.N. Here, the Board finds that the Veteran’s statements regarding the in-service sexual assaults are credible. Furthermore, the Board finds that the Veteran’s transfer shortly after her assault to a different duty station and subsequent medical treatment support her assertion that she was raped during service. The May 2015 VA examination report explains that high achievement can be an overcompensation response to a stressor. The May 2015 VA examiner indicated that she could not determine if the PTSD was caused by a pre-service stressor, military sexual trauma or being held at gunpoint after service. The Board notes that the Veteran has consistently reported military sexual trauma to VA providers and has received a PTSD diagnosis as a result. Furthermore, the Veteran is presumed sound upon entry to active service as there were no diseases or defects noted on the enlistment examination. In light of the above, the Board finds that the evidence is at least in equipoise as to whether the Veteran’s PTSD is related to an in-service sexual trauma. The benefit   of the doubt rule is therefore for application, and the claim is granted. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102. DAVID L. WIGHT Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board R.R. Watkins, 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.