Citation Nr: 21003270 Decision Date: 01/21/21 Archive Date: 01/21/21 DOCKET NO. 18-28 786 DATE: January 21, 2021 ORDER Service connection for posttraumatic stress disorder (PTSD) is granted. FINDING OF FACT Resolving all doubt in the Veteran’s favor, he has a current diagnosis of PTSD, and the record evidence corroborates his account of in-service stressors which have been medically related to his PTSD. CONCLUSION OF LAW The criteria for entitlement to 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 August 1966 to August 1968, including service in the Republic of Vietnam. This matter is before the Board on appeal from an August rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran contends that he has a PTSD diagnosis which is related to stressors in service. Specifically, the Veteran has reported that during the performance of his duties repairing and cleaning combat vehicles while stationed in Okinawa, Japan, he often saw the remains of soldiers on the vehicles, including hair, blood, fingertips and some personal affects. 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 a stressor event during active service; and credible supporting evidence that the claimed in-service stressor occurred. 38 C.F.R. § 3.304(f). As provided by 38 U.S.C. § 1154(a), VA is required to give due consideration to all pertinent medical and lay evidence in evaluating a claim for disability benefits. With specific regard to lay evidence, the type of evidence that will suffice to demonstrate entitlement to service connection, and the determination of whether lay evidence may be competent to satisfy any necessary evidentiary hurdles, depends on the type of disability claimed. Barr v. Nicholson, 21 Vet. App. 303, 308 (2007). For example, lay evidence can be competent and sufficient to establish a diagnosis of a condition when a layperson is competent to identify the medical condition, the layperson is reporting a contemporaneous medical diagnosis, or lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). Regarding nexus, although without describing specific situations, the Federal Circuit also has explicitly rejected the view that medical evidence is necessarily required when the determinative issue is etiology. See id., at 1376-77. In short, the Board cannot determine that lay evidence as to diagnosis and nexus lacks credibility merely because it is unaccompanied by contemporaneous medical evidence. Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006). Where there is an approximate balance of positive and negative evidence regarding the merits of any outstanding issues, VA is statutorily required to resolve any doubt in favor of the Veteran. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. The Veteran’s service treatment records (STRs) are silent as to any psychiatric disorders. Both his entrance and separation exams were negative for any psychiatric disorders and there are no records indicating he sought help or treatment for any psychiatric symptoms during service. The Veteran’s primary specialty in service was welding. Military personnel records indicate that the Veteran was in Okinawa, Japan in 1968. In lay statements submitted by the Veteran’s wife, his wife indicated that the Veteran was different after returning from service, including symptoms such as increased anger, aggression, avoidance, withdrawal, paranoia and flashbacks. She has also reported that the Veteran did not discuss his military service for many years after service and relayed instances where the Veteran talked and became emotional about his service while intoxicated or under anesthesia. She also stated that the Veteran had stated he did not believe he deserved benefits because he was not on the frontline. She reported he only filed for benefits after much persuading that he was deserving of benefits. VA and private medical records indicate that the Veteran was diagnosed with depression and took oral medications for treatment. VA medical records show that the Veteran reported difficulty with guilt and war-related news or shows and could not stop thinking about the war. At a December 2019 VA examination, the examiner diagnosed PTSD, finding that the Veteran met the criteria for stressor and symptoms under the diagnostic criteria. Specifically, the examiner found that the experience of seeing human body parts, hair and blood while repairing combat tanks and feeling overwhelmed, helpless and guilty thereafter, met Criterion A for PTSD. The Veteran also exhibited psychiatric symptoms, including avoidance, irritability, exaggerated startle response, and hypervigilance, which met the other criteria for a PTSD diagnosis. The examiner also diagnosed other specified depressive disorder, which he found was intertwined with the Veteran’s PTSD diagnosis. The examiner opined that it was at least as likely as not that the Veteran’s psychiatric disorders were related to the claimed in-service stressor. The examiner reasoned that the Veteran did not have mental health issues prior to service and that he now had clear symptoms of PTSD directly related to his reports of seeing blood and fragments of bodies of other soldiers on vehicles he worked on during service. After thorough review of the evidence, the Board finds that service connection for PTSD is warranted. As noted above, service connection for PTSD requires a current diagnosis, a link between current symptoms and a stressor during service; and finally, credible evidence that the claimed in-service stressor occurred. The record clearly shows psychiatric diagnoses, including PTSD. Regarding a link between current symptoms and a stressor during service, the VA examiner indicated that the Veteran directly experienced a traumatic event. The Veteran has consistently and credibly reported that he developed psychiatric symptoms after seeing body fragments of soldiers on combat vehicles during the performance of his duties. Military records indicate that the claimed stressor is consistent with the Veteran’s MOS, dates and scope of his duties. Therefore, resolving all reasonable doubt in the Veteran’s favor, service connection for PTSD is granted. JOHN Z. JONES Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board H. Ahmad, 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.