Citation Nr: 20036799 Decision Date: 05/28/20 Archive Date: 05/28/20 DOCKET NO. 17-55 912 DATE: May 28, 2020 ORDER Service connection for schizoaffective disorder, bipolar type, is granted. FINDING OF FACT The Veteran’s diagnosed schizoaffective disorder, bipolar type, was incurred in active service. CONCLUSION OF LAW The criteria for service connection for schizoaffective disorder, bipolar type, are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.   REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from October 1998 to November 1998. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2015 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). Although the Veteran filed a claim for a “personality disorder,” which is how the RO characterized it, the Board has expanded the claim to include any acquired psychiatric disorder reasonably raised by the record. See Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009) (the scope of a mental health disability claim includes any acquired psychiatric disability that may reasonably be encompassed by the claimant’s description of the claim, reported symptoms, and the other information of record). The Veteran testified at a hearing before the undersigned in January 2020; a transcript of the hearing is of record. Service Connection Service connection generally will be awarded when a veteran has 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(a). Service connection may 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 service connection on a direct basis, the evidence must show: (1) a current disability; (2) incurrence or aggravation of a disease or injury in service; and (3) a link between the in-service disease or injury and the current disability (the “nexus” element). Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). A claimant is entitled to the benefit of the doubt when there is an approximate balance of positive and negative evidence on any issue material to the claim. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990) (when the evidence supports the claim or is in relative equipoise, the claim will be granted). Service connection for schizoaffective disorder, bipolar type, is granted. The Board finds that service connection for the Veteran’s psychiatric disorder, diagnosed as schizoaffective disorder, bipolar type, is established. The Veteran’s August 1998 enlistment examination report reflects that on clinical evaluation, no psychiatric abnormalities were noted. The report includes a physical inspection date stamp of October 20, 1998, and the same date stamp for psychological and psychomotor testing, indicating that the Veteran was re-examined at entrance and no psychiatric abnormalities were noted. Accordingly, his mental health is presumed sound at entrance. See 38 U.S.C. § 1111. The Veteran denied a pre-service history of psychiatric conditions in the August 1998 report of medical history. The VA and private treatment records do not show that the Veteran reported a history of psychiatric problems or treatment prior to service. He denied such a history in his January 2020 hearing testimony. The service treatment records show that shortly after the Veteran entered on active duty, in late October 1998, he received emergency treatment for physical symptoms including dizziness and nausea after experiencing an allergic reaction to medication. The next day, the Veteran reported “subjective weakness” that was suspected to be psychosomatic in nature. A few days later, he received emergency treatment for symptoms and behavior found to be consistent with a psychotic disorder or a major depressive episode, and was admitted to the psychiatric hospital. His symptoms included seeing faces and hearing voices, as well as nightmares, decreased sleep, decreased appetite, and memory loss. He stated that he felt like he was going crazy. His DD 214 reflects that he discharged from service later that month based on a “personality disorder” At the January 2020 Board hearing, the Veteran testified that he has experienced psychiatric symptoms ever since service. However, he did not seek treatment until 2015. The VA treatment records show that in November 2015 he reported a history of psychotic symptoms, including hallucinations, in service. The treating psychiatrist diagnosed him with schizoaffective disorder, bipolar type, and stated that the Veteran presented with what sounded like a history of a manic psychotic episode in service, with periods of hypomania and chronic psychosis. Post-service private treatment records show that the Veteran reported a history of experiencing anxiety symptoms and panic attacks for many years. See February 2017 Private Treatment Record. It was noted that he had a history of a psychotic breakdown and hallucinations in service. He was diagnosed with unspecified bipolar disorder and unspecified anxiety disorder. A VA examination was performed in September 2017. The examiner, a psychologist, diagnosed schizoaffective disorder, bipolar type. Following examination of the Veteran and a detailed review of his medical history, the examiner opined that the Veteran’s schizoaffective disorder, bipolar type, was at least as likely as not “incurred or caused by the Veteran’s mental complaints” during service. The examiner explained that the Veteran endorsed symptoms consistent with that diagnosis, which described major mood episodes with delusions and hallucinations, which could also occur between mood episodes. The examiner noted that these chronic symptoms are documented initially in the November 1998 service treatment records reflecting the Veteran’s psychiatric hospitalization. The September 2017 VA medical opinion is probative, as it represents the conclusion of a medical professional specializing in mental health disorders, is based on examination of the Veteran and review of his medical history, and is supported by an explanation that is consistent with the evidence of record. (The Board notes that the September 2017 Statement of the Case, in adjudicating the claim de novo and confirming the initial denial, inexplicably does not discuss this opinion, even though it is listed as an item of evidence on the first page.) Based on the Veteran’s in-service symptoms and psychiatric hospitalization, his competent statements attesting to experiencing recurrent psychiatric symptoms in the years following service, and the September 2017 VA psychologist’s opinion linking the Veteran’s currently diagnosed schizoaffective disorder, bipolar type, to “chronic symptoms” that had their initial onset in service, the Board finds that a medical nexus is established, resolving any reasonable doubt in favor of the Veteran. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102. Accordingly, the criteria for service connection are satisfied. See Holton, 557 F.3d at 1366. The Board notes that the VA psychologist who rendered the September 2017 opinion also provided an opinion in September 2015 finding that the Veteran’s in-service symptoms were transient manifestations of a personality disorder. As the same psychologist subsequently rendered the positive opinion discussed above based on a different diagnosis, and as the Veteran has not otherwise been diagnosed with a personality disorder, the probative value of this opinion is discounted. The service treatment records themselves do not reflect diagnoses of a personality disorder. Rather, the only mention of a personality disorder is in the Veteran’s DD 214. A personality disorder in itself is not a disease or injury for VA compensation purposes, and thus may not be service connected as a matter of law. 38 C.F.R. § 3.303(c). P.M. DILORENZO Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Rutkin, 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.