Citation Nr: 21002704 Decision Date: 01/14/21 Archive Date: 01/14/21 DOCKET NO. 12-28 640 DATE: January 14, 2021 ORDER Entitlement to service connection for an acquired psychiatric disorder, to include PTSD and major depressive disorder, is denied. FINDING OF FACT The Veteran does not currently have an acquired psychiatric disorder that is etiologically related to service or to a service-connected disability or that is a superimposed disability on a personality disorder. CONCLUSION OF LAW The criteria for service connection for an acquired psychiatric disorder are not met. 38 U.S.C. §§ 105, 1110, 1112, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304, 3.307, 3.309, 4.125. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from September 1974 to February 1975. In March 2020, the Veteran testified before the undersigned Veterans Law Judge. A transcript of the hearing is of record. The Veteran’s claims were previously remanded by the Board in a May 2020 decision. The Board finds that the RO has substantially complied with the May 2020 Board remand directives. See Stegall v. West, 11 Vet. App. 268 (1998). Entitlement to service connection for an acquired psychiatric disorder, to include PTSD and major depressive disorder The Board notes the record contains various psychiatric diagnoses, so the Veteran’s claim has been expanded to include any acquired psychiatric disorder. Clemons v. Shinseki, 23 Vet. App. 1 (2009). The Veteran contends that his acquired psychiatric disorder is the result of trauma experienced during basic training. Alternatively, he contends that his current psychiatric disorder manifested in service as a “suicidal gesture” with eventual discharge for adjustment disorder. The Veteran has contended that he sees ghosts and hears helicopters flying overhead. The Board notes the record does not reflect service in combat or overseas during his five months in service. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 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). The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. The Board concludes that, while the Veteran has a current diagnosis of an acquired psychiatric disorder that has been diagnosed variously as PTSD, major depressive disorder, a personality, or another specified trauma/stressor-related disorder, and evidence shows that a psychiatric hospitalization in service resulting in the Veteran’s discharge occurred, the preponderance of the evidence weighs against finding that the Veteran’s diagnosis of a current acquired psychiatric disorder began during service or is otherwise related to an in-service injury, event, or disease. The Veteran testified at the hearing that he first sought treatment for a mental condition in 2005 with the VA. A November 2005 treatment note indicates the Veteran denied experiencing any traumatic events or any symptoms related to a traumatic event. In May 2007, the Veteran reported to a clinician after screening positive for several PTSD symptoms. The treatment notes indicated the Veteran reported he could not cope with military service and left after 5 months. The Veteran reported he did not have combat experience but had traumatic incidents while a taxi driver in New York City. No history of trauma or PTSD was noted. The Veteran was diagnosed with major depressive disorder, single episode, in partial remission; dysthymia; and avoidant personality disorder with dependent traits. A PTSD screening was again negative in February 2008. In May 2011, the Veteran reported negative experiences while living in Jacksonville, Florida, causing PTSD symptoms. In October 2015, the Veteran reported he “got PTSD” from an incident in June 2015. The Veteran’s treatment notes from September 2016 indicate the Veteran was experiencing PTSD following an incident that occurred at work in June 2015. The Veteran reported that he experienced symptoms of paranoia and flashbacks related to the June 2015 incident. A February 2017 VA treatment note indicates the Veteran’s PTSD symptoms were improved, but he continued to have nightmares and flashbacks related to the June 2015 incident. The Veteran has also reported significant difficulties with familial relationships and reported over twenty traumatic events following service. Thus, VA treatment records show the Veteran was not diagnosed with PTSD until 2015, decades after his separation from service. While the Veteran is competent to report having experienced symptoms of a mental impairment since basic training, he is not competent to provide a diagnosis in this case or determine that these symptoms were manifestations of major depressive disorder or PTSD. The issue is medically complex, as it requires knowledge of interpretation of complicated diagnostic medical testing. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Further, the Veteran did not report symptoms of PTSD until after a specified stressor event decades after military service. The record contains conflicting medical opinions regarding whether the Veteran’s acquired psychiatric disability is at least as likely as not related to an in-service injury, event, or disease, including an incident in a shower or the Veteran’s hospitalization in service. The September 2020 VA examiner opined that it was not. The rationale was that the Veteran does not have a current diagnosis of PTSD but does meet the criteria of a trauma/stressor related disorder as a result of the June 2015 workplace incident. The examiner also indicated that the Veteran’s primary impairment appears to be the result of a personality disorder. The examiner noted inconsistencies in the Veteran’s story related to an incident in the shower during military service, the Veteran’s frequent personality conflicts and interpersonal difficulties, and notations of secondary gains issues in past medical records. The VA examiner indicated they were unable to rely on the Veteran’s testimony due to credibility issues throughout his treatment history. The VA examiner noted the Veteran’s 2020 treatment notes indicate he has PTSD due to a combat stressor, but noted the Veteran never served in combat. The VA examiner’s opinion is probative, because it is based on an accurate medical history and provides an explanation that contains clear conclusions and supporting data. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). In March 2018, the Veteran supported a privately obtained opinion from D.K., Ph.D., that the Veteran’s PTSD was related to his military service. The examiner noted a significant history of trauma beginning in childhood with behavioral problems during childhood. The examiner noted emotional and behavioral difficulties in the Army resulting in his discharge. Dr. D.K. diagnosed the Veteran was PTSD and major, depressive disorder, recurrent, moderate, but also noted that the Veteran denied specific PTSD symptoms prior to the workplace assault. This opinion is, however, less probative than the VA examiner’s opinion. The opinion appears to be based on the Veteran’s self-reported medical history, which is inconsistent with more recent treatment notes and the September 2020 VA examination. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008); Reonal v. Brown, 5 Vet. App. 458, 460-61 (1993). The Board notes that personality disorders are not “diseases” for which service connection can be granted, and as a matter of law are not compensable disabilities. 38 C.F.R. § 3.303(c); Beno v. Principi, 3 Vet. App. 439, 441 (1992). However, disability resulting from a mental disorder superimposed upon a personality disorder may be service-connected. 38 C.F.R. § 4.127. Here, however, the Board relies on the opinion of the VA examiner that the Veteran’s acquired psychiatric disability is related to his June 2015 workplace incident and not his military service. Consequently, the Board gives more probative weight to the September 2020 VA examiner’s opinion. As such, the preponderance of the evidence is against the finding that the Veteran’s acquired psychiatric disorder is a result of, or related to, military service. The Board has carefully reviewed and considered the Veteran’s statements regarding his disabilities on appeal. The Board also acknowledges that the Veteran, in advancing this appeal, believes in the merits of his appeal. Moreover, the Veteran is competent to report observable symptoms. Layno v. Brown, 6 Vet. App. 465 (1994). In this case, however, the competent medical evidence offering detailed specific specialized determinations pertinent to the claims are the most probative evidence with regard to evaluating the disabilities on appeal. As the preponderance of the evidence is against the claims, the benefit of the doubt   doctrine is not for application, and the Veteran’s claims must be denied. See 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102, 4.3; Gilbert, 1 Vet. App. at 55. L. M. BARNARD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M.D. Taylor, 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.