Citation Nr: 21000491 Decision Date: 01/05/21 Archive Date: 01/05/21 DOCKET NO. 17-28 951 DATE: January 5, 2021 ORDER Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD) and other specified trauma and stressor-related disorder: adjustment-like disorder is granted. FINDING OF FACT Resolving reasonable doubt in the Veteran’s favor, his acquired psychiatric disorder, to include PTSD and other specified trauma and stressor-related disorder: adjustment-like disorder is at least as likely as not related to a corroborated in-service stressor. CONCLUSION OF LAW The criteria for service connection for an acquired psychiatric disorder, to include PTSD and other specified trauma and stressor-related disorder: adjustment-like disorder have been met. 38 U.S.C. §§ 1110, 1131, 1154, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 4.125. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from June 1998 to June 2002. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a May 2016 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). In March 2020, the Veteran testified at a videoconference hearing before the undersigned Veterans Law Judge; a copy of the hearing transcript is of record. 1. Entitlement to service connection for an acquired psychiatric disorder, to include PTSD and other specified trauma and stressor-related disorder: adjustment-like disorder. The Veteran originally claimed entitlement to service connection for PTSD. At a February 2016 VA examination, the Veteran was diagnosed with other specified trauma and stressor-related disorder: adjustment-like disorder. Accordingly, the Veteran’s claim for service connection has been broadened and recharacterized as a claim for entitlement to service connection for an acquired psychiatric disorder, to include PTSD and other specified trauma and stressor-related disorder: adjustment-like disorder. Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009). For the reasons that follow, the Board finds that service connection for an acquired psychiatric disorder is warranted. Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active service, even if the disability was initially diagnosed after service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). Service connection for PTSD requires medical evidence diagnosing the condition in accordance with 38 C.F.R. § 4.125(a); 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). VA must give due consideration to all pertinent lay and medical evidence in a case where a veteran is seeking service connection. 38 U.S.C. § 1154(a). When all the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the veteran prevailing in either event, or whether a preponderance of the evidence is against a claim, in which case, the claim is denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. While the Veteran’s service treatment records (STRs) are absent of complaint of or treatment for an acquired psychiatric disability, he maintains that his PTSD is related to an in-service stressor. The Veteran provided a stressor statement, listing two claimed stressors, in July 2015 on VA Form 21-0781, Statement in Support of Claim for Service Connection for PTSD. The Veteran contends that, upon landing in northern Greece for a NATO-led exercise in Kosovo, his battalion, 2nd Battalion, 6th Marines, 24th Marine Expeditionary Unit, was greeted by more than 100 protesters affiliated with a communist party in Greece, blocking his convoy. The Veteran noted that there was frustration, as the rules of engagement did not allow them to protect themselves during the onslaught. He reported that the noises of the rocks hitting the vehicles was deafening, and that “in the confusion they didn’t know if they were being shot at or what to make of the situation.” The Veteran also contends that a soldier was killed from friendly fire during training exercises at a base where he was stationed. This claimed stressor was not conceded after development by the RO because the Veteran’s unit was not determined to have been in the same location as of the deceased at the time of the incident. The Board also notes that the nexus opinions of record do not link any of diagnosed psychiatric disorders to this reported in-service event. Therefore, the Board will limit its consideration to the stressor related to the Veteran’s convoy being attacked by protestors in Kosovo - to be referred to as “the in-service stressor.” The Veteran submitted several news articles that report on the 2nd Battalion, 6th Marines, 24th Marine Expeditionary Unit arriving via ship to Greek shores to participate in NATO’s Exercise Dynamic Response 2000 in Kosovo. One of the articles, from the Associated Press, notes that more than 100 protestors chanted and hurled sticks and stones at the convoy of vehicles carrying the 24th Marine Expeditionary Unit, briefly blocking the convoy on a Greek highway before being dispersed by riot police. In development efforts to corroborate this stressor, in November 2015 the National Archives and Records Administration (NARA) determined that, although the Veteran served in the 2nd Battalion, 6th Marines, 24th Marine Expeditionary Unit (MEU), there was no evidence that the Veteran was deployed to Kosovo with that unit. NARA also determined that the Veteran’s records show sea service but not foreign service. Therefore, NARA found that the stressor was not conceded. However, information subsequently added to the claims file from VADIR (Veterans Affairs and Department of Defense Identity Repository) shows that the Veteran received “hostile fire/imminent danger pay” for the period 4/1/2000 to 4/30/2000, which corresponds with the timing of his unit’s deployment in Kosovo. He also received a ‘Combat Zone Tax Exclusion’ for the dates of March 1, 2000 to July 31, 2001 for the area ‘YO.’ After careful review of the above evidence, and resolving all doubt in favor of the Veteran, the Board finds that the Veteran’s account of the in-service stressor related to his convoy being attacked by protestors in Greece is reasonably corroborated by credible supporting evidence. The Board finds that the combination of evidence showing the Veteran’s attachment to the 24th MEU which was deployed to Kosovo, along with the corroborating news articles, and the hostile fire/imminent danger pay provide sufficient evidence to corroborate his reported stressor. Thus, an in-service stressor is established. Having so concluded, the Board must now address whether the Veteran has a current diagnosed psychiatric disorder and, if so, whether a link exists between the diagnoses and the claimed in-service stressor. The Veteran was afforded a VA examination in February 2016. The examiner noted that the Veteran’s in-service stressor would be adequate to support a diagnosis of PTSD, but that his symptoms did not meet the diagnostic criteria for PTSD under DSM-5. However, the examiner diagnosed the Veteran with an ‘other specified trauma and stressor-related disorder: adjustment-like disorder: adjustment-like disorders with prolonged duration of more than six months without prolonged duration of stressor’ and indicated that it appeared to be largely a manifestation of exposure to stressful military experience while stationed in Kosovo. The examiner opined that this disorder was as least as likely as not caused by the in-service stressor related to the events in Kosovo. Given that the in-service event has been established and the VA opinion was supported with an adequate rationale, the Board finds that service connection is warranted for this disorder. The Veteran submitted private medical records from Dr. Dar, a psychiatrist, documenting a May 2017 psychiatric evaluation. At the evaluation, the Veteran was diagnosed with severe PTSD. Dr. Dar opined that the Veteran’s PTSD symptoms derived from his exposure to events in Kosovo. Dr. Dar is a psychiatrist who is competent to diagnose PTSD; however, his opinion and supporting explanation is significantly less comprehensive and detailed than that of the VA examination report. Dr. Dar’s opinion did not clearly reflect an indication that the diagnosis of PTSD was made pursuant to recognized diagnostic criteria and it did not contain a sufficiently explained rationale explaining the basis for his conclusions. In contrast, the VA examiner reviewed the claims file, his opinion was consistent with DSM-IV criteria, and he set forth a sufficient rationale explaining the basis of his findings. As such, Dr. Dar’s diagnosis is not given equal weight to the VA examiner’s findings and opinion. See Owens v. Brown, 7 Vet. App. 429, 433 (1995) (holding that VA may favor the opinion of one competent medical expert over that of another when decision makers give an adequate statement of reasons and bases). The Board further notes, however, that the Veteran submitted medical records from the Vet Center for psychiatric treatment received between March 2015 and July 2015. These records show that P.C., LPMHC:D, a readjustment counselor, rendered a diagnosis of PTSD related to the events in Kosovo based on her interview and clinical evaluation of the Veteran. While the June 2015 assessment of P.C., LPMHC:D did not specifically indicate which of the DMS-5 diagnostic criteria were met, it nonetheless provides reasonably sufficient detail that reflects the underpinning of her diagnosis of PTSD. Therefore, resolving all doubt in favor of the Veteran, the Board finds he has a current diagnosis of PTSD in accordance with 38 C.F.R. § 4.125(a). Given that the in-service stressor has been reasonably corroborated and there is a diagnosis of PTSD based on such stressor, the Board finds that service connection is warranted for PTSD. Accordingly, after resolving all doubt in favor of the Veteran, service connection for acquired psychiatric disorder, to include PTSD and other specified trauma and stressor-related disorder: adjustment-like disorder is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102, 3.304(f). D. JOHNSON Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board R. Caban, 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.