Citation Nr: 20037550 Decision Date: 06/02/20 Archive Date: 06/02/20 DOCKET NO. 17-41 654 DATE: June 2, 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 military service. 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. §§ 3.303, 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from June to October 1965. This appeal to the Board of Veterans’ Appeals (Board) is from a June 2015 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In February 2020, in support of this claim, the Veteran testified at a hearing at the RO before the undersigned Veterans Law Judge of the Board (Travel Board hearing). The Board held the record open for an additional 90 days after the hearing to allow the Veteran time to obtain and submit additional supporting evidence – specifically, an additional medical nexus opinion concerning the cause of his PTSD in terms of it being the result of his service. He submitted this additional opinion in April 2020 and, partly because of it, the Board is granting the claim. Entitlement to service connection for PTSD is granted. As for why he believes his PTSD is the result of his military service, the Veteran asserts that, as a drill sergeant, he was a first responder when a recruit committed suicide and one of the first on the scene after another recruit was critically injured during a training exercise. During his recent February 2020 hearing before this Board, he testified that he did not even know what PTSD was when those particularly traumatic events (“stressors”) occurred during his service. And, indeed, VA did not adopt the PTSD nomenclature until 1980 or thereabouts, so not until long after his service had ended in 1965. He said he began having a lot of anger issues following his experiences in service, in fact, within a year of his discharge, as evidenced by him not being able to hold jobs. His wife and son provided supporting testimony during the hearing, including in terms of his ongoing anger and difficulty sleeping in the many years since his service. In other testimony during his hearing, the Veteran pointed out that he has been receiving treatment in a VA mental health clinic for PTSD since 2015 and that he has been told by his VA doctor that his mental disorder dates back many years, i.e., to his time in service. Primarily because of this reported attribution of his PTSD to his service, the Board as mentioned held the record open for an additional 90 days following the hearing to allow the Veteran time to obtain and submit a supporting medical nexus opinion from his doctor in the VA outpatient mental health clinic. To this end, the Veteran later submitted this additional statement in April 2020. Service connection for PTSD requires: (1) medical evidence diagnosing 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)); (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). Regarding element (2), a May 2015 Memorandum reflects that the RO made a formal finding on the lack of information required to confirm stressors associated with this claim for service connection for PTSD. It was determined the information required to corroborate the stressors, as described by the Veteran, was insufficient to send to the U.S. Army and Joint Services Records Research Center (JSRRC) and/or insufficient to allow for a meaningful research of the Marine Corps or National Archives and Records Administration (NARA) records. This Memorandum states that all procedures to obtain this information from the Veteran had been properly followed, including evidence of written and telephonic efforts to obtain this information was in the file. The memorandum concluded that all efforts to obtain the needed information had been exhausted, and that any further attempts would be futile. To support this finding, the RO considered the Veteran’s service treatment records (STRs) and written communications from him dated April 2, 2015 and April 27, 2015. Although that April 2, 2015 and April 27, 2015 correspondence from the Veteran lacked sufficient information to corroborate any of his claimed stressors, as they were general in nature and lacked specificity, he since has submitted additional written correspondence on May 14, 2015 and reported more exacting details of his stressors in service, including in terms of the locations where the events occurred and specific time period in which the incidents took place. The RO issued its formal finding without citing or considering the May 14, 2015 correspondence.   Moreover, as indicated during his more recent February 2020 Travel Board hearing that would be forthcoming, the Veteran also since has submitted an additional supporting letter from his treating psychologist at the VA Portland Healthcare System – Vancouver Division. This commenting VA psychologist explained that it was the third letter he had written in support of the Veteran’s claim and affirmed that he had been providing the Veteran individual therapy periodically since 2015. Also, notably, not only did he confirm the Veteran continues to meet the criteria for a diagnosis of PTSD, he said this diagnosis is clearly related to his military activities. This commenting VA psychologist then goes on to discuss in rather extensive detail these several stressful experiences during the Veteran’s service and, although he conceded the Veteran (himself) had recounted them in the course of his treatment, this commenting VA psychologist added that the Veteran’s recollection of these events since their first session in 2015 has been consistently reported – not varying over time, i.e., credible. If VA determines either that the Veteran did not engage in combat with the enemy or that he did engage in combat, but that the alleged stressor is not combat related, then his lay testimony, by itself, generally is insufficient to establish the occurrence of the alleged stressor. Instead, the record must contain credible supporting evidence that corroborates his testimony or statements. 38 C.F.R. § 3.304(f)(2); Stone v. Nicholson, 480 F.3d 1111 (Fed. Cir. 2007); Cohen, 10 Vet. App. at 147. The same is true if the alleged stressor is not claimed to have involved hostile military or terrorist activity (subpart (f)(3)) or one of the other specifically defined pleading-and-proof exceptions – e.g., prison of war (POW) experience (subpart (f)(4)) or personal assault or military sexual trauma (MST) (subpart (f)(5)). So, generally speaking, absent one of those specifically defined exceptions, after-the-fact medical nexus evidence usually cannot establish the occurrence of the claimed in-service stressor. Moreau v. Brown, 9 Vet. App. 389, 395 (1996).   However, that said, corroboration of every detail of a claimed in-service stressor, including the Veteran's personal participation, is not required; rather, he only needs to offer independent evidence of a stressful event that is sufficient to imply his personal exposure. See Pentecost v. Principi, 16 Vet. App. 124, 128 (2002) (quoting Suozzi v. Brown, 10 Vet. App. 307 (1997) (a stressor need not be corroborated in every detail)). Consider also that an examiner’s reliance on the Veteran’s self-reported history does not automatically undermine the probative value of the opinion relying on that self-reported history – unless there is justifiable reason to believe the self-reported history is not credible or that the opinion does not consider or otherwise account for evidence in the file tending to refute the history or basis of the opinion. See Kowalski v. Nicholson, 19 Vet. App. 171 (2005); Coburn v. Nicholson, 19 Vet. App. 427 (2006). Since there is no such contradictory indication in this instance, the Board is resolving all reasonable doubt in the Veteran’s favor and concluding that his PTSD is the result of his military service. 38 U.S.C. § 5107. 38 C.F.R. § 3.102. Thus, his claim is granted. KEITH W. ALLEN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Hamm, Associate 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.