Citation Nr: 20046076 Decision Date: 07/09/20 Archive Date: 07/09/20 DOCKET NO. 13-28 591 DATE: July 9, 2020 ORDER Service connection for an acquired psychiatric disorder, including claimed posttraumatic stress disorder (PTSD), is denied. FINDING OF FACT No psychiatric injury or disease was manifested during service and the current psychiatric disabilities were not shown in service; the identified stressor of having witnessed the suicide of a fellow service member or discovered the body during service has not been corroborated by independent, supporting evidence. CONCLUSION OF LAW The criteria for service connection for an acquired psychiatric disorder, including PTSD, have not been met. 38 U.S.C. §§ 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304, 4.125. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran, who is the appellant, had active service from December 1981 to December 1984. This matter is on appeal from a December 2010 rating decision. In December 2014, the Board reopened service connection for an acquired psychiatric disability and remanded the reopened issue for complete service personnel records, additional VA treatment records, and verification of the claimed stressor event, a VA examination with a medical opinion if a stressor event is verified, and subsequent readjudication of the appeal. In November 2015, the Board again remanded the issue on appeal for any criminal investigation records associated with the claimed stressor event of witnessing the 1982 suicide of an ammunition supervisor, unit records from Fort Knox from December 1981 to February 1982 regarding the claimed stressor, and a VA examination with a medical opinion if the claimed stressor is verified followed by readjudication of the appeal. To comply with remand directives, the AOJ requested criminal records from the U.S. Army Crime Records Center on several occasions from December 2015 to January 2020 and received a negative response for records in February 2020. The April 2018 response from the Joint Services Records Research Center (JSRRC) responded that they were unable to locate copies of unit records and historical documents were unable to document the suicide death of an unnamed soldier during February 1982 at Fort Knox but did document an apparent suicide death in August 1982 in Louisville, Kentucky by gunshot wound. In March 2020, the appeal was readjudicated. For these reasons, the Board finds that there was compliance with prior remand directives. Service Connection Legal Authority Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military, naval, or air service. 38 U.S.C. § 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). Service connection may be established on a direct basis when there is competent, credible evidence of: (1) a current disability; (2) a disease or injury in service, and; (3) a relationship or nexus between the current disability and any injury or disease during service. 38 C.F.R. § 3.303(a), (d). Service connection may be established on a presumptive basis for chronic diseases listed under 38 C.F.R. § 3.309(a) if chronic symptoms of the disease were shown in service; the disease was manifested to a compensable degree with a presumptive period, usually one year after service separation; or continuous symptoms of the disease were manifested since service. 38 U.S.C. §§ 1112, 1113; 38 C.F.R. §§ 3.33(b), 3.307, 3.309(a); see also Walker v. Shinseki, 708 F. 3d 1131 (Fed. Cir. 2013). The Veteran is diagnosed with PTSD and bipolar I disorder with psychotic features. A psychosis is listed as a chronic disease under 38 C.F.R. § 3.303(b); however, bipolar I disorder with psychotic features is not considered a psychotic disorder, so the presumptive service connection provisions are not applicable in this case. See 71 Fed. Reg. 42758-01 (July 28, 2006) (not all disorders presenting with psychotic features should be considered psychoses; only disorders listed by the DSM-IV-TR as psychotic disorders should be considered psychoses). In this case, the Veteran did not have combat service and was not exposed to hostile military or terrorist activity; therefore, the presumptions afforded to combat veterans and veterans who allege fear of hostile military or terrorist activity are inapplicable in this case. Any alleged in-service stressors must be independently verified, i.e., corroborated by objective credible supporting evidence. Effective August 4, 2014, VA revised the portion of the Schedule for Rating Disabilities dealing with mental disorders and its adjudication regulations to remove outdated references to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), and replace them with references to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). See 79 Fed. Reg. 149, 45094 (August 4, 2014). The revised provisions apply to all applications for benefits that are received by VA or that were pending before the Agency of Original Jurisdiction on or after August 4, 2014. The provisions of this interim final rule do not apply to claims that have been certified for appeal to the Board or are pending before the Board, the United States Court of Appeals for Veterans Claims, or the United States Court of Appeals for the Federal Circuit. In this case, the appeal was certified to the Board in January 2014, so the revised regulations are inapplicable. Service Connection Analysis The Veteran contends that the current psychiatric disability is related to service. He asserts that witnessing the suicide death of another service member (i.e., a fellow service member reportedly shot himself after receiving a Dear John letter) and/or finding the body of another service member after his suicide death while undergoing basic training at Fort Knox caused the current psychiatric disability. After review of all the lay and medical evidence of record, the Board finds that the weight of the evidence is against finding that there was psychiatric injury or disease during service. The service treatment records (STRs) only include the October 1981 service enlistment examination, so they are incomplete; however, post-service treatment records show that the Veteran has told mental health providers that psychotic symptoms were initially manifested and bipolar disorder was diagnosed in 1997, approximately 13 years after service separation. See October 2000 VA mental health history note. Also, the earliest post-service evidence suggesting a PTSD diagnosis is noted in October 2000, approximately 16 years after service separation. See October 2000 mental health history note (noting that the Veteran reported a history of exposure to trauma in Desert Storm and may meet the criteria for PTSD). Although the Veteran has indicated pursuant to this claim that several psychiatric symptoms began during service, the account is given less probative value as it is inconsistent with, and outweighed by, post-service lay and medical evidence showing no psychiatric symptoms, diagnosis, or treatment until 13 years after service. Because the Veteran's recent assertion that psychiatric symptoms were manifested during service is inconsistent with and outweighed by such evidence, it is not credible, so lacks probative value. The weight of the evidence is against finding that the current psychiatric disability is otherwise related to service. As stated above, the credible evidence shows that the earliest psychiatric symptoms are shown in 1997, approximately 13 years after service separation. The 13-year gap between the onset of psychiatric symptoms in 1997 and service separation in 1984 is one factor in this case, along with other factors, that weighs against service incurrence. Although the Veteran contends that the current psychiatric disability is related to the claimed in-service stressor event of witnessing the suicide death of a fellow service member, the claimed stressor event is not supported by independent, corroborative evidence, as is required to establish a PTSD stressor. See 38 C.F.R. §§ 3.304(f), 4.125. The JSRRC provided a negative response for verification of the claimed stressor event after researching the historical documentation, including casualty data, for the 19th Battalion, 4th Brigade, which is the unit to which the Veteran was assigned during basic training according to service personnel records. The JSRRC was unable to document a suicide death of a soldier in February 1982 at Fort Knox. The JSRRC did note documentation of an apparent suicide death of a service member in August 1982 in Louisville, Kentucky; however, the Veteran was no longer stationed at Fort Knox at that time. Rather, he was then serving in Germany so he could not have witnessed the August 1982 suicide death of a fellow service member or discovered the service member’s body. Also, in October 2000, the Veteran told a treating VA mental health provider that he experienced trauma while serving in Operation Desert Storm; however, the Veteran’s service ended many years before that conflict began in 1991, so he could not have experienced a stressor event during that period. Although the Veteran, as a lay person, is competent to report any psychiatric symptoms he has experienced at any given time, as well as a contemporaneous diagnosis by a medical provider, he is not competent to diagnose a psychiatric disability or render a competent medical opinion on the questions of causation because answers to such questions require medical expertise in the area of psychiatric disorders and falls outside the realm of common knowledge of a lay person. See Young v. McDonald, 766 F.3d 1348, 1353 (Fed. Cir. 2014) (holding that "PTSD is not the type of medical condition that lay evidence . . . is competent and sufficient to identify"). The DSM-5 cautions that it was "not sufficient to simply check off the symptoms in the diagnostic criteria to make a mental disorder diagnosis." Rather, clinical training is required "to recognize when the combination of predisposing, precipitating, perpetuating, and protective factors has resulted in a psychopathological condition in which physical signs and symptoms exceed normal ranges." The "purpose of DSM-5 is to assist trained clinicians in the diagnosis" of various mental disorders. The weight of the evidence shows that the current psychiatric disability was not manifested until many years after service separation and is not related to service. Consequently, the Veteran's attribution of the current psychiatric disability to service is of no probative value. Although PTSD was diagnosed based on the claimed in-service stressor event, its occurrence has not been sufficiently supported by credible independent evidence. Also, the weight of the credible and probative evidence shows that no psychiatric symptoms were manifested until many years after service, and the current psychiatric disability is unrelated to service. For those reasons, service connection for an acquired psychiatric disability is not warranted, and the appeal must be denied. J. PARKER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Ferguson, 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.