Citation Nr: 21002107 Decision Date: 01/12/21 Archive Date: 01/12/21 DOCKET NO. 14-34 999A DATE: January 12, 2021 ORDER Service connection for posttraumatic stress disorder (PTSD) is granted.   FINDING OF FACT The Veteran has PTSD as a result of in-service stressors. CONCLUSION OF LAW The criteria for service connection for PTSD have been met. 38 U.S.C. §§ 1110, 1131, 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 May 1962 to December 1965. The case is on appeal from a November 2009 rating decision. In March 2018, the Veteran testified at a Board hearing. He then testified at a second Board hearing in November 2020. Both presiding Veterans Law Judges (VLJs) are participating in the decision on appeal. At the November 2020 Board hearing, the Veteran waived his right to testify before the third VLJ deciding the case. See Arneson v. Shinseki, 24 Vet. App. 379 (2011) (a veteran must be provided the opportunity to testify before all members of a Board panel deciding the case). The Board remanded the claim for additional development in August 2018. Service connection for PTSD. Legal Criteria Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. A veteran seeking compensation under these provisions must establish three elements: “(1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service.” Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). To establish service connection for PTSD generally, a veteran must show: (1) medical evidence diagnosing the condition in accordance with 38 C.F.R. § 4.125(a) (conforming to the Diagnostic and Statistical Manual of Mental Disorders (DSM)); (2) medical evidence establishing a link between current symptoms and an in-service stressor; and (3) credible supporting evidence that the claimed in-service stressor occurred. 38 C.F.R. § 3.304(f). Where there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). Analysis The Veteran contends he has PTSD due to in-service stressors. These stressors include his presence on an airplane when it crashed upon landing in France and traumatic events associated with his duties an aero medical specialist. See October 2009 statement, February 2010 statement. With regard to his duties as an aero medical specialist, he specifically asserts that his duties included providing medical care to several premature babies who died and identifying who pilots who died. See November 2020 statement. Initially, the Board finds the Veteran has a diagnosis of PTSD. In this regard, the underwent a VA examination in November 2019, wherein a PTSD diagnosis according to the DSM-5 was confirmed. Accordingly, the first element of service connection is met. Concerning the second requirement as it applies to PTSD, i.e., whether medical evidence establishes a link between current symptoms and an in-service stressor, the evidence of record weighs in favor of the claim. In this regard, the evidence of record includes an evaluation conducted by a private psychologist provided by the Veteran in May 2018 and a November 2019 VA opinion. The private psychologist interviewed the Veteran but did not review records in the Veteran’s claims file. She concluded the Veteran’s PTSD is the result of his disturbing medical duties and responsibilities over the course of his enlistment. She noted the Veteran’s duties included identifying deceased pilots as well as attending to the medical needs of premature babies, most of whom died, and their suffering parents. Pursuant to the Board’s August 2018 remand, the Veteran underwent a November 2019 VA examination. The examiner interviewed the Veteran and reviewed the claims file. With regard to the Veteran’s in-service stressors, she considered the Veteran’s reports concerning his duties as an aero medical specialist. Specifically, she considered the Veteran’s description of his first day of duty at a new station which included going to the morgue and seeing a sergeant who died from choking on his vomit, in addition to being tasked with cutting the toes off the foot of a pilot who died in plane crash in order to take prints for purposes of identification. With regard to his medical duties, she additionally considered the Veteran’s reports of the medical care he provided to premature babies, many whom died. The examiner also considered the Veteran’s reports of being aboard a plane that crashed upon landing, injuring a crewmember. The examiner determined each stressor described by the Veteran met Criterion A in the DSM-5, i.e., it is adequate to support a diagnosis of PTSD. She also concluded the Veteran’s PTSD was at least as likely as not incurred in service and was caused by multiple trauma events during his service, including a hard or crash landing of a plane and multiple incidents of exposure to trauma as it occurred to others in the course of his duties as an aero medical specialist. In this case, the Board finds the examiner who provided the November 2019 opinion adequately concluded that the Veteran’s PTSD is a result of the trauma he experienced during service. The November 2019 examiner’s opinion is persuasive with a complete rationale and is based on a thorough review of the record and interview with the Veteran. The psychologist established clear conclusions with supporting references to the medical and lay evidence of record, as well as the Veteran’s service records. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). In addition, the November 2019 VA examiner conclusions are consistent with other evidence of record including the May 2018 private evaluation. As such, the Board finds there is sufficient medical evidence establishing a link between the Veteran’s current symptoms and an in-service stressor(s). With regard to the final requirement, the evidence of record also contains sufficient credible supporting evidence that a claimed in-service stressor occurred, particularly when reasonable doubt is resolved in the Veteran’s favor. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. As noted above, the Veteran contends his in-service stressors include traumatic experiences associated with his duties as an aero medical specialist and his presence aboard an airplane when it crashed. In this case, the Board finds that the Veteran is competent to report what he experienced during service. Moreover, concerning the traumatic experiences associated with his duties as an aero medical specialist, his statements regarding these experiences are consistent with the circumstances of his service. In this regard, the Veteran’s service personnel records (SPRs) reflect “aero medical specialist” as his specialty, he completed extensive coursework related to medical care, and he was assigned to the flight surgeons office. As such, the Board finds the Veteran’s reported stressors are generally consistent with the circumstances of his service as an aero medical specialist. 38 U.S.C. § 1154(a). Moreover, other evidence of record bolsters the Veteran’s statements with regard to experiencing traumatic events as an aero medical specialist including several letters he sent to his family during his service. In these letters, the Veteran described providing electrocardiograms to premature babies. He described witnessing a doctor perform CPR on one baby and hoping that another baby would not die. In another letter the Veteran stated, “Many times I do daily EKGs on a patient for months and then the patient dies and its odd because you get to know the patient fairly well.” In addition, the Board finds the Veteran’s lay statements and hearing testimony consistent and credible. As such, the Board finds the evidence of record contains sufficient credible supporting evidence that the Veteran experienced traumatic events as an aero medical specialist, particularly when reasonable doubt is resolved in the Veteran’s favor. Given the above, the Board does not find it necessary to address the question of whether the record contains sufficient credible supporting evidence of the whether the stressor concerning the Veteran’s presence aboard an airplane when it crashed occurred. Accordingly, when resolving reasonable doubt in the Veteran’s favor, the Board finds that his PTSD is a result of his in-service stressors. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. Therefore, service connection for PTSD is warranted. MICHAEL D. LYON Veterans Law Judge Board of Veterans’ Appeals STEVEN D. REISS Veterans Law Judge Board of Veterans’ Appeals RYAN T. KESSEL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E. Gray, 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.