Citation Nr: 20007867 Decision Date: 01/30/20 Archive Date: 01/30/20 DOCKET NO. 16-46 709 DATE: January 30, 2020 ORDER Entitlement to service connection for posttraumatic stress disorder (PTSD) is granted. FINDING OF FACT It is just as likely as not the Veteran’s PTSD is the result of especially traumatic events (“stressors”) that occurred during his service in the Vietnam War as a gunner’s mate while engaged in combat against enemy forces. CONCLUSION OF LAW Resolving all reasonable doubt in his favor, the criteria are met for entitlement to service connection for PTSD. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304.   REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from February 1970 to January 1974. This matter comes before the Board of Veteran’s Appeals (Board) on appeal from a February 2014 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In September 2019, in support of this claim, the Veteran testified at a videoconference hearing before the undersigned Veterans Law Judge of the Board. A transcript of the hearing is of record. The day of the hearing, the Veteran also submitted a supporting medical statement providing grounds for granting this claim. Entitlement to service connection for PTSD is granted. Service connection for PTSD requires medical evidence establishing a diagnosis of the condition in accordance with 38 C.F.R. § 4.125(a) (meaning in accordance with the Diagnostic and Statistical Manual of Mental Disorders (DSM)), credible supporting evidence that the claimed in-service stressor actually occurred, and a link, established by medical evidence, between current symptoms and a claimed in-service stressor. 38 C.F.R. § 3.304(f). The Veteran has the required confirmed medical diagnosis of PTSD by a VA psychologist – as noted in the report of a November 2013 VA examination. Additionally, he has continued to receive ongoing treatment for PTSD at a VA medical facility during the several years since. Consequently, resolution of this appeal turns on whether there also is the required attribution of his PTSD to his military service – and especially to one of his alleged stressors. When evaluating evidence, the Board must give due consideration to all pertinent medical and lay evidence, and in the service-connection context must consider the circumstances, conditions and hardships of the Veteran's service. 38 U.S.C. § 1154(a). Moreover, in Reeves v. Shinseki, the U. S. Court of Appeals for the Federal Circuit (Federal Circuit Court) held that the combat presumption contained in 38 U.S.C. § 1154(b) not only applied to a combat injury, but also to the consequences of that injury, at least in service. Reeves v. Shinseki, 682 F.3d 988, 999 (Fed. Cir. 2012) (holding that the Board was required to apply the § 1154(b) presumption to the Veteran’s claimed acoustic trauma during service and the separate question of whether he suffered permanent hearing loss while on active duty). Section 1154(b) provides that service connection for the in-service injury can only be rebutted by clear and convincing evidence to the contrary. The VA regulation implementing this statute is 38 C.F.R. § 3.304(d), and for PTSD claims specifically there is similar provision by way of § 3.304(f)(2). Typically, lay testimony alone is insufficient to establish that a stressor occurred; it must be corroborated by “credible supporting evidence.” See Cohen v. Brown, 10 Vet. App. 128, 142 (1997). However, lay testimony alone may establish the occurrence of stressors if: 1) evidence establishes that the Veteran engaged in combat with the enemy; 2) the claimed stressor is related to that combat; 3) the claimed stressor is consistent with the circumstances, conditions, or hardships of the Veteran's service; 4) and there is no clear and convincing evidence to the contrary. 38 C.F.R. § 3.304(f)(2). See also Gaines v. West, 11 Vet. App. 353 (1998) (holding that the benefit-of-the-doubt rule applies to the determination of whether a Veteran engaged in combat with the enemy). The second prong for service connection for PTSD requires credible supporting evidence that the claimed in-service stressor actually occurred. During the Veteran’s September 2019 hearing he testified extensively regarding his experiences in Vietnam, identifying several in-service stressors that he says occurred while there. He reported being assigned temporary duty (TDY) to Vietnam while stationed aboard the USS Savanaugh. He testified he saw soldiers wounded in action (WIA), including during combat recovery missions. In denying the claim, the RO concluded that VA was unable to corroborate combat or any other in-service stressor. However, the Board disagrees. The Veteran has consistently pled and testified under oath to the events that he claims as stressors causing his PTSD. He also provided credible testimony at his September 2019 hearing regarding his role in the Navy and the experiences and stressors he endured. The Board finds that the Veteran’s claimed stressors are entirely consistent with his duties and responsibilities in service. The third prong to establishing service connection for PTSD requires a link, established by medical evidence, between current symptoms and a claimed in-service stressor. The Veteran has consistently received treatment for PTSD at a VA medical center or community-based outpatient clinic (CBOC) during the last several years, at least since 2013. Moreover, the November 2013 VA medical diagnosis of PTSD is directly attributed to the stressors that occurred while he was in Vietnam, and the additional supporting statement that he more recently submitted in September 2019, on the day of his hearing before the Board, also attributes his PTSD to his service. Therefore, the Board finds that he has established the required correlation (“nexus”) between his service and eventual PTSD diagnosis. When the evidence supports the claim or is in relative equipoise, meaning about evenly balanced for versus against the claim, the claimant prevails; in other words, he is given the benefit of the doubt and the claim granted rather than denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990) (“a [V]eteran need only demonstrate that there is an 'approximate balance of positive and negative evidence' in order to prevail.”); see also Alemany v. Brown, 9 Vet. App. 518, 519 (1996) (An “absolutely accurate” determination of etiology is not a condition precedent to granting service connection, nor is “definite” or “obvious” etiology).   Therefore, here, certainly when applying the benefit-of-the-doubt doctrine, the Board concludes that entitlement to service connection for PTSD is warranted. KEITH W. ALLEN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board P. Poindexter 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.