Citation Nr: 21004587 Decision Date: 01/27/21 Archive Date: 01/27/21 DOCKET NO. 15-41 700 DATE: January 27, 2021 ORDER As new and material evidence has been received, the claim for entitlement to service connection for diabetes mellitus, type II, is reopened; the claim is granted to this extent only. As new and material evidence has been received, the claim for entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD), is reopened; the claim is granted to this extent only. Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD), is denied. REMANDED Entitlement to service connection for diabetes mellitus, type II, is remanded. FINDINGS OF FACT 1. A June 2005 rating decision denied the Veteran’s claim for entitlement to service connection for diabetes mellitus, type II. 2. The evidence received since the June 2005 rating decision is neither cumulative nor redundant, relates to an unestablished fact necessary to substantiate the claim, and raises a reasonable possibility of substantiating the claim for service connection for diabetes mellitus, type II. 3. A July 2007 rating decision denied the Veteran’s claims for entitlement to service connection for an acquired psychiatric disorder, to include PTSD. 4. The evidence received since the July 2007 rating decision is neither cumulative nor redundant, relates to an unestablished fact necessary to substantiate the claim, and raises a reasonable possibility of substantiating the claim for service connection for an acquired psychiatric disorder, to include PTSD. 5. The Veteran has been diagnosed with PTSD; however, his stressor has not been verified and is not credible. 6. The Veteran’s current acquired psychiatric disability was not incurred in, caused by, or otherwise related to a period of active service. CONCLUSIONS OF LAW 1. New and material evidence has been received sufficient to reopen the claim of entitlement to service connection for diabetes mellitus, type II. 38 U.S.C. § 5108; 38 C.F.R. §§ 3.102, 3.156(a), 3.159. 2. New and material evidence has been received sufficient to reopen the claim of entitlement to service connection for an acquired psychiatric disorder, to include PTSD. 38 U.S.C. § 5108; 38 C.F.R. §§ 3.102, 3.156(a), 3.159. 3. The criteria for service connection for an acquired psychiatric disorder, to include PTSD, have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304(f), 4.125(a). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had an initial period of active duty for training from November 1982 to May 1983; he had additional periods of active service from March 2002 to August 2002, and from September 2003 to June 2004. He also had additional service in the National Guard. These matters come before the Board of Veterans’ Appeals (Board) from an August 2009 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in San Diego, California. The Veteran testified at a Board hearing in January 2019. The transcript of the hearing is associated to the record. New evidence has been received in the form of VA treatment records and Social Security Administration (SSA) records since the October 2015 Statement of the Case (SOC). Generally, a Supplemental Statement of the Case (SSOC) must be issued by the Agency of Original Jurisdiction (AOJ) when new evidence is received. An exception to this general rule is when the additional evidence is either duplicative or not relevant to the issue on appeal. 38 C.F.R. § 20.1304(c). In the present case, this evidence indicates only ongoing treatment for his diabetes mellitus, type II, and his psychiatric disorders. The Board finds that this evidence is duplicative of evidence that was before the RO at the time that the October 2015 SOC was issued. Accordingly, the Board may proceed with the adjudication of the pending claim as a SSOC is not required. 38 C.F.R. § 19.37(b). The Board additionally notes that record reveals that, other than the Veteran’s DD 214, STRs and MPRs associated with his first period of active service from November 1982 to May 1983 are not available for review. The records reflect that all reasonable steps have been taken to obtain these records. Accordingly, the Board will base its decision on the evidence of record. See 38 C.F.R. § 3.159(c) and (e). When any service medical records are not available, such as in this case, VA has a heightened obligation to explain its findings and conclusions and carefully consider the benefit-of-the-doubt rule. See O'Hare v. Derwinski, 1 Vet. App. 365 (1991). The Board acknowledges that the Veteran has indicated that he had an additional period of active service from September 2002 to September 2003. Moreover, the Board also recognizes that the Veteran has submitted orders for federal active duty service for this period. The Board finds that a remand to attempt to obtain additional service records for this period is not necessary, however. Specifically, the Board notes that service treatment records (STRs) for this period are associated with the claims file. The Board therefore finds that all necessary development has been accomplished with regard to the period from November 2001, when he reenlisted in the National Guard, to his separation from service in June 2004, and appellate review may proceed without prejudice to the Veteran. See Bernard v. Brown, 4 Vet. App. 384 (1993). However, as discussed in further detail below, the Board finds that remand is necessary for the issue of entitlement to service connection for diabetes mellitus type II for an attempt to obtain National Guard STRs encompassing a reported period of active duty for training around 1994 or 1995. Specifically, the Veteran reported that in approximately 1995, during a period of ACDUTRA, he sought treatment and was told that he was pre-diabetic. There are no STRs available for this period, and it does not appear that an attempt to obtain these records has been made. Therefore, a remand is necessary with regard to the Veteran’s claim for service-connection for diabetes mellitus, type II, for an attempt to obtain these records. New and Material Evidence A rating action from which an appeal is not perfected becomes final. 38 U.S.C. § 7105; 38 C.F.R. § 20.1103. The governing regulations provide that an appeal consists of a timely filed notice of disagreement in writing, and after a statement of the case has been furnished, a timely filed substantive appeal. 38 C.F.R. § 20.200. In order to reopen a claim which has been denied by a final decision, new and material evidence must be received. 38 U.S.C. § 5108. New and material evidence means evidence not previously submitted to agency decision makers; which relates, either by itself or when considered with previous evidence of record, to an unestablished fact necessary to substantiate the claim; which is neither cumulative nor redundant of the evidence of record at the time of the last prior final denial of the claim sought to be reopened, and which raises a reasonable possibility of substantiating the claim. 38 C.F.R. § 3.156(a). The threshold for determining whether new and material evidence raises a reasonable possibility of substantiating a claim is low. Shade v. Shinseki, 24 Vet. App. 110 (2010). Moreover, in determining whether that low threshold is met, consideration need not be limited to consideration of whether the newly submitted evidence relates specifically to the reason why the claim was last denied, but instead should ask whether the evidence could reasonably substantiate the claim were the claim to be reopened, either by triggering VA’s duty to assist or through consideration of an alternative theory of entitlement. 1. As new and material evidence has been received, the claim for entitlement to service connection for diabetes mellitus, type II, is reopened; the claim is granted to this extent only. In a June 2005 rating decision, the RO denied the Veteran’s claim for service connection for diabetes mellitus, type II, finding that the Veteran’s diabetes existed as early as 1994, prior to his period of active service, and was not aggravated by his active service. The evidence of record included service treatment records (STRs) dated from October 2001 to August 2004, military personnel records (MPRs), treatment records dated from October 2002 to June 2005, and VA examinations dated January 2005 and May 2005. The Veteran was notified of the rating decision in July 2005. However, the Veteran took no further action. Therefore, the June 2005 decision is final. 38 U.S.C. § 7105; 38 C.F.R. §§ 3.104(a), 3.156(b), 3.160(d), 20.302, 20.1103. Since the June 2005 rating decision became final, in pertinent part, a statement from the Veteran’s treating physician was received, indicating that the Veteran was diabetic and on oral medications prior to his reactivation in October 2001, and he had progressive worsening of his diabetes between November 2001 and June 2004. The physician explained that the Veteran had poor control of his diabetes while on active duty which substantially and significantly contributed to him developing diabetic related complications. Further, the physician indicated that stress and lack of sleep during service contributed to significant deterioration in diabetic control while on active duty. The Board finds that the low threshold requirement for new and material evidence is satisfied with respect to the claim for diabetes mellitus, type II. Shade v. Shinseki, 24 Vet. App. 110 (2010). When considering the new evidence in conjunction with the evidence already of record, it raises a reasonable possibility of substantiating the claims. Thus, the Board finds that new and material evidence has been submitted and the petition to reopen the claim of entitlement to service connection for diabetes mellitus, type II, must be granted. 2. As new and material evidence has been received, the claim for entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD), is reopened; the claim is granted to this extent only. In a July 2007 rating decision, the RO denied the Veteran’s claim for service connection for PTSD, indicating that the evidence did not demonstrate that the Veteran had an established clinical diagnosis of PTSD. Notably, the RO indicated that although the Veteran’s records reflected a possible diagnosis of PTSD, there was no confirmed diagnosis of record. The evidence of record included service treatment records (STRs), military personnel records (MPRs), and post-service treatment records dated from April 2006 to March 2007. The Veteran was notified of the July 2007 rating decision. However, the Veteran took no further action. Therefore, the July 2007 decision is final. 38 U.S.C. § 7105; 38 C.F.R. §§ 3.104(a), 3.156(b), 3.160(d), 20.302, 20.1103. Since the July 2007 rating decision became final, in pertinent part, medical evidence has been received indicating diagnoses of PTSD, depressive disorder, and mood disorder. Additionally, a statement from the Veteran’s treating physician was received, indicating that the Veteran suffered from PTSD, dysthymic disorder, phobia to needles, and mood disorder. The physician indicated that his PTSD stemmed from a traumatic event that occurred around December 2002 while on active duty and his symptoms were amplified by an event in December 2003 when he jumped from a hummer injuring his back and leg, fearing that he would be hit by enemy fire. The Board finds that the low threshold requirement for new and material evidence is satisfied with respect to the claim for an acquired psychiatric disorder, to include PTSD. Shade v. Shinseki, 24 Vet. App. 110 (2010). When considering the new evidence in conjunction with the evidence already of record, it raises a reasonable possibility of substantiating the claims. Thus, the Board finds that new and material evidence has been submitted and the petition to reopen the claim of entitlement to service connection for a psychiatric disorder, to include PTSD, must be granted. Service Connection Establishing service connection generally requires (1) evidence of a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship, i.e., a nexus, between the claimed in-service disease or injury and the current disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). The Board must assess the credibility and weight of all evidence, including the medical evidence, to determine its probative value, accounting for evidence, which it finds to be persuasive or unpersuasive, and providing reasons for rejecting any evidence favorable to the appellant. Equal weight is not accorded to each piece of evidence contained in the record; not every item of evidence has the same probative value. When all the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the appellant prevailing in either event, or whether a preponderance of the evidence is against a claim, in which case, the claim is denied. See Gilbert v. Derwinski, 1 Vet. App. 49 (1990). 3. Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD), is denied. The Veteran contends that his acquired psychiatric disorder, to include PTSD, is due to active service. In this regard, the Board notes that the Veteran has reported experiencing a traumatic event in service, in approximately 2002 or 2003 in Utah. Service connection for PTSD specifically requires: (1) a medical diagnosis of PTSD utilizing the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders criteria, in accordance with 38 C.F.R. § 4.125(a); (2) credible supporting evidence that the claimed in-service stressor actually occurred; and (3) medical evidence of a causal nexus between current symptomatology and the specific claimed in-service stressor. See 38 C.F.R. § 3.304(f); Cohen v. Brown, 10 Vet. App. 128, 138 (1997). The Board notes that the DSM-IV has been updated with a Fifth Edition (DSM-5). Effective August 4, 2014, VA issued an interim rule amending the portion of its Schedule for Rating Disabilities dealing with mental disorders and its adjudication regulations to refer to certain mental disorders in accordance with the DSM-5. The provisions of the interim final rule only apply, however, to all applications for benefits that are received by VA or that are pending before the AOJ on or after August 4, 2014. Since the Veteran’s claim was received prior to that date, the DSM-IV is applicable. The Board notes that, with regard to stressor verification, on July 13, 2010, VA published a final rule that amended its adjudication regulations governing service connection for PTSD by liberalizing, in certain circumstances, the evidentiary standard for establishing the occurrence of in-service stressors involving “fear of hostile military or terrorist activity.” See 75 Fed. Reg. 39843 (July 13, 2010), and 75 Fed. Reg. 41092 (July 15, 2010) (correcting the effective and applicability dates from July 12, 2010 to July 13, 2010). In pertinent part, 38 C.F.R. § 3.304(f) notes that a Veteran’s lay testimony alone may establish the occurrence of the claimed in-service stressor if a stressor claimed by a veteran is related to the veteran’s fear of hostile military or terrorist activity and a VA psychiatrist or psychologist, or a psychiatrist or psychologist with whom VA has contracted, confirms that the claimed stressor is adequate to support a diagnosis of PTSD and that the veteran’s symptoms are related to the claimed stressor, in the absence of clear and convincing evidence to the contrary, and provided the claimed stressor is consistent with the places, types, and circumstances of the Veteran’s service. 38 C.F.R. § 3.304(f). “Fear of hostile military or terrorist activity” means that a veteran experienced, witnessed, or was confronted with an event or circumstance that involved actual or threatened death or serious injury, or a threat to the physical integrity of the veteran or others, such as from an actual or potential improvised explosive device; vehicle-imbedded explosive device; incoming artillery, rocket, or mortar fire; grenade; small arms fire, including suspected sniper fire; or attack upon friendly military aircraft, and the veteran's response to the event or circumstance involved a psychological or psycho-physiological state of fear, helplessness, or horror. Id. The question of whether a veteran was exposed to a stressor in service is a factual one, and VA adjudicators are not bound to accept uncorroborated accounts of stressors or medical opinions based upon such accounts. Wood v. Derwinski, 1 Vet. App. 190 (1991), aff'd on reconsideration, 1 Vet. App. 406 (1991). Hence, whether a stressor was of sufficient gravity to cause or support a diagnosis of a psychiatric disorder, to include PTSD, is a question of fact for medical professionals and whether the evidence establishes the occurrence of stressors is a question of fact for adjudicators. A November 2001 retention physical notes a normal psychiatric evaluation and the Veteran denied experiencing any psychiatric symptoms on his associated Report of Medical History. A January 2003 STR notes that the Veteran reported experiencing significant anxiety in reaction to dental appointments; a problem list notes a “temporary (minor) problem” of “anxiety attack” in January 2003. A June 2003 Report of Medical History notes that the Veteran denied ever experiencing any memory loss, amnesia, or loss of consciousness; nervous trouble of any sort; frequent trouble sleeping; receiving any counseling; depression or excessive worry; or any other symptoms related to any psychiatric disorder. A Medical Board Evaluation, dated in July 2003, notes a normal psychiatric examination. Another July 2003 STR notes that the Veteran denied any psychiatric symptoms, including nervousness, depression, excessive worry, or memory problems. A November 2003 STR notes that the Veteran’s brother had recently passed away, but a breakup with his significant other was upsetting him much more. He had trouble sleeping because he was “thinking about things” but did not appear to have significant depression stigmata. The record notes that the Veteran was observed to appear somewhat anxious and a little down. The assessment notes anxiety with probably some depression. A subsequent record during the same month reflects that the Veteran was working on his feelings and he was feeling calmer and less upset. A January 2004 STR notes that the Veteran admitted anxiety as a result of his reactivation and subsequent loss of a relationship. A February 2004 STR notes that the Veteran had good affect except a little anxiety. No psychiatric symptoms or disorders were noted on his March 2004 Medical Evaluation Board report, and the Veteran denied any psychiatric symptoms in his August 2004 post-deployment assessment, including any kind of memory loss or amnesia. A September 2005 post-service treatment record notes that the Veteran reported that he was extremely anxious about having two episodes of lightheadedness. He indicated that he felt that he needed to see a psychiatrist to deal with issues related to his service. He indicated that he did not feel he was coping well. The record notes that the Veteran was having a lot of difficulty coping with a lot of issues and his episodes of lightheadedness happened when he was in stressful situations, which may represent anxiety. A referral to psychiatry would be made. A May 2006 medical treatment record notes that the Veteran reported that he felt like he was “hitting bottom.” He was unaware of any triggers except thoughts of the military, such as sending people out in the vehicles and helicopters and the immense responsibility of having them come back intact. He reported that he avoided television or reading anything regarding the military. He reported that he felt like a failure and that nothing he did mattered. The assessment notes Depression NOS; possible dysthymic disorder; possible PTSD regarding confrontations with deaths/injuries of those in the military. A November 2006 medical treatment record reflects a positive PTSD screening. Subsequently, a February 2007 record notes that the Veteran stated that he did not experience an event that involved actual or threatened death or serious injury to the Veteran or someone else that caused him to experience intense fear, helplessness, or horror. Evaluation of the positive PTSD screen indicates a false positive screen for PTSD. No further evaluation was needed at this time. In a June 2007 statement in support of his claim for PTSD, the Veteran reported that during his period of active service from September 2002 to June 2003, specifically in December 2002, he jumped out of a hummer into a hole causing severe leg and lower back pain. A December 2007 medical record notes a provisional diagnosis of PTSD and dysthymic disorder. An April 2008 medical record notes a diagnosis of PTSD without any explanation provided. A buddy statement, dated in November 2008, from an individual who had known the Veteran for approximately three years, notes that the Veteran had two different demeanors. One was described as up-tight, argumentative, unsettled, over-talkative, self-centered, rude, paranoid, and cynical. Then other times, he was “the nicest guy”. Another buddy statement from the Veteran’s mother notes that the Veteran was very frustrated since service. He raised his voice and acted like he was still in the military. A statement from the Veteran’s treating psychiatrist, dated in December 2009, indicates that the Veteran had been under the psychiatrist’s care since October 2005. The Veteran suffers from PTSD, dysthymic disorder, phobia to needles, and mood disorder. The provider indicated that dysthymic disorder had its onset prior to active duty; PTSD stems from an unusual traumatic event in possibly December 2002 while on active duty, in which the Veteran described an encounter that he perceived to constitute a serious threat, under very mysterious, intensely frightening circumstances. He was, at that time, told by Post Command that he and his unit should not be encountering vehicles in their area, yet the Veteran and his men encountered some sort of vehicle with lights that resulted in him and his men circling their vehicle with guns locked and loaded, at which time all power both in their vehicle and in the mysterious vehicle that they encountered went dead for a number of minutes. The provider indicated that “this experience has, obsessively, been told and retold to me in vivid, terrifying detail - at least those parts that are remembered: he also reports peritraumatic amnesia for up to 45 minutes after the time of the traumatic event.” The record indicates that not knowing what it was that he and his men encountered made the experience more frightening, and he had sometimes wondered whether this was an alien vehicle. The note also indicates that his symptoms were amplified in December 2003 by trauma when jumping from hummer, hurting back and leg, fearing he would be hit by enemy fire. The psychiatrist indicated that the Veteran clearly meets the DSM-IV criteria for PTSD. Another statement from his physician, received in August 2011, addresses each of the criteria for a diagnosis of PTSD, noting that in 2002, while serving in Utah, the Veteran and his unit were patrolling when they encountered an unidentified vehicle. He called into his command and was informed that no other vehicles had been sent out, so they should not be encountering anything. He stated that the lights continued to close in on them without stopping. He braced for impact, but instead of being struck, they became encased in complete blackness for approximately 10 minutes. The electronic and lights on their vehicle stopped working during this time so he had no way to communicate with his command center. He was extremely fearful for his life during this encounter (Criterion A). Afterwards, the. lights returned and the unidentified vehicle was nowhere to be found. When he returned to his base, he has lost 45 minutes of time. Unlike his normal routine, he did not conduct a debriefing with his men afterwards. Apparently, one of his men committed suicide later, for which he still carries guilt. The Veteran endorsed having intrusive memories of the event, and he still becomes emotionally and physiologically distressed when he encounters trauma cues that remind him of the incident (Criterion B). He has spent a great deal of time avoiding talking about the incident. He avoids crowds and most social venues. He is detached from others and has emotional numbing (Criterion C). With respect to hyperarousal symptoms, the Veteran has great difficulty sleeping, especially at night; he is hypervigilant; and he still has an exaggerated startle response (Criterion D). He acknowledged that he has struggled with these symptoms since he returned from his deployment in 2002 (Criterion E). The symptoms have also presented as a barrier to him working, developing and maintaining social relationships, and engaging in personally fulfilling activities (Criterion F). Given the severity of his symptoms, he was admitted to the PCT Program and began receiving treatment for his PTSD in March 2010. He is currently undergoing individual counseling on a weekly basis. A January 2012 VA examination notes that the Veteran had received a diagnosis of PTSD and major depressive disorder. The examiner indicated that it was not possible to differentiate between the symptoms attributable to each diagnosis due to the close interaction between the two disorders. The examination notes that the Veteran reported that he had a traumatic incident in Utah and developed symptoms of anxiety; he was diagnosed with anxiety in 2003. The Veteran reported that, while stationed in Utah in 2003, the Veteran and a group of soldiers encountered a strange vehicle during night patrol. They feared they were going to be attacked by terrorists since control stated that no vehicles should be in the area. Strange lights were shining from the vehicle and then it went black and the soldiers, although armed and ready to fire, could not see the enemy but feared for their lives. The Veteran reported that he was convinced that they were under attack since he was activated for service after the attacks in 2001 and had subsequent anti-terrorist training. The examiner found that the Veteran met the criteria for PTSD due to the traumatic incident in Utah around 2003, and his PTSD was therefore at least as likely as not caused by or a result of his military duty. Additionally, the examiner opined that the Veteran was further diagnosed with mood disorder, major depressive disorder, recurrent, chronic, moderate, which was best explained as at least as likely as not caused by or a result of his PTSD. A correspondence received from the Veteran in March 2012 describes the occurrence in Utah, believed to have occurred at the end of October or beginning of November 2003. The Veteran again describes what appeared to be approaching headlights while patrolling at night where no other known activity was occurring. He described that when the lights came close enough to their vehicle that contact should have been made, everything went dark and their vehicle lost all power. He indicated that he ordered the men to exit the vehicle and stand guard, at which time power was restored in their vehicle. He called in to command and was told to return to base. The Veteran reported that it took an hour to return to return to base; however, he later learned that they were an hour late getting back to base. He indicated that he gave his report, but he never spoke to command about it or ever saw any of his men again. A formal finding of lack of information required to corroborate stressors associated with a claim for service connection for PTSD in February 2014. This memorandum indicates that the Veteran’s record reflects that he was stationed in Washington around November 2003. Furthermore, although he reported that he turned in a report, he was unable to provide the names of those he served with who allegedly witnessed the same event. Thus, there was insufficient evidence to verify his stressor by the Joint Services Records Research Center (JSRRC). The Veteran was afforded another VA examination in March 2014, which provided diagnoses of other specified depressive disorder and dependent personality traits. The examiner determined that the Veteran did not have a diagnosis of PTSD that conformed to the DSM-5 criteria. The examiner noted review of the Veteran’s STRs and post-service medical treatment records, including the diagnosis of PTSD. The examiner acknowledged that the 2012 VA examiner assigned diagnoses of PTSD and Major Depressive Disorder and that the Veteran has been diagnosed with PTSD by his various mental health providers. The examiner indicated, however, that although his fear of a terrorist attack technically met criteria for a traumatic event that would qualify for a diagnosis of PTSD with inclusion of other symptoms, the Veteran’s response to this incident has been out of proportion to the nature of the trauma. His perception of the impact has consumed his life and contributed to his anger. He speculated on how the other soldiers with him during the patrol might have suffered similar life struggles without knowledge of their actual adjustments. Although he learned that a fellow Veteran committed suicide several years ago, the Veteran implied his conclusion that the event in Utah was likely a factor without knowledge of precipitating events. He discussed another Veteran who died of a heart attack. In spite of the knowledge that this individual suffered from a heart condition, the Veteran also implied a possible causal factor, possibly seeking validation of the impact of his traumatic experience. He endorsed some valid symptoms of trauma response, but some of his current symptoms, particularly anger is also attributable to the denial of his claim and his feeling of entitlement for compensation related to the patrol event. The nature of his efforts to seek validation for his trauma and the impact also manifest as dependent traits as the Veteran described his notable reliance on his providers, stating that his doctors know everything that he goes through. Upon review of the records that noted his anxiety to dentist appointments, depression/anxiety related to the loss of his brother and termination of a relationship, etc., the examiner concluded that the Veteran has struggled with normalizing his reaction to different stressors and attributes nearly all of his life’s difficulties to the patrol incident in Utah. As the Veteran sought mental health assistance for his symptoms in 2005 and indicated that his depression symptoms emerged “2 years ago” related to the events in Utah, the examiner concluded that the initially diagnosed condition of Depressive Disorder NOS is related to the in-service complaints of anxiety and depression in military service. For these reasons, the examiner indicated concurrence with the initially assigned diagnosis of Depressive Disorder NOS in 2005, which is now diagnosed as Other Specified Depressive Disorder. A VA addendum opinion was rendered in August 2015. The examiner indicated that, based on a thorough review of all the pertinent available information regarding this case, the Veteran’s history of anxiety and depression that have been mentioned in his service treatment records are likely situational in nature (e.g., anxiety in relation to dentist appointment, and anxiety related to loss of relationships). Other than situational anxiety and depression, his main mental health diagnosis has been related to his diagnosis of PTSD based on an unconfirmed event in Utah in either 2002 or 2003. Therefore, it is less likely that the Veteran’s current mental health diagnoses of depression, provided by the March 2014 VA examiner and his VA psychiatrist, and PTSD, provided by his VA psychologist and psychiatrist, are related to the Veteran’s in-service complaints of anxiety and depression. At his January 2019 Board hearing the Veteran again described his in-service stressor, which occurred in Utah. He reported that, on an evening patrol, he and his unit encountered what appeared to vehicle headlights approaching, losing all power in their vehicle, and then the lights disappearing. He reported that he filed a report with his command, but he never received a response. He indicated that he believed that “whatever happened there had either to do with the government testing or something went wrong” because there is no two-way traffic there. He indicated that he finally became paranoid enough that he sought treatment, which he believed was in November 2003, and he sought mental health treatment approximately four months after his separation from active service. At the outset, the Board acknowledges that the Veteran’s reported period of service from September 2002 to September 2003 has not been verified; however, even if the Board concedes that the Veteran had a period of active service from September 2002 to September 2003 which included service in Utah, as will be discussed in detail below, the Board does not find the reports of the in-service stressor event to be credible evidence, and therefore, although the Veteran indeed has a diagnosis of an acquired psychiatric disorder, including PTSD, service connection is not warranted for either PTSD or an acquired psychiatric disorder. While it is unclear the exact dates that the Veteran was in Utah during his deployment, service records indicate that the Veteran received medical care in Utah in November 2002 and March 2003, and he had been transferred from Utah to Washington as early as June 2003. The Board finds that there are material inconsistencies in the various accounts of the claimed stressors, and that the reports of these stressors are, therefore, not credible evidence. As an initial matter, although the Veteran has reported various in-service stressor events, the Board notes that his STRs and MPRs, including his post deployment assessment and Medical Evaluation Board report, do not contain any corroboration of these reported events. The Board finds the Veteran’s post-deployment assessment particularly probative in this regard, which encompasses the relevant period at issue; however, the Veteran specifically noted that, during this deployment, he never felt he was in great danger of being killed. Moreover, despite his reports in September 2005 that he felt that he needed to see a psychiatrist to deal with issues related to his service and the provider’s note in May 2006 that he had possible PTSD regarding confrontations with deaths/injuries of those in the military, a February 2007 record notes that the Veteran stated that he did not experience an event that involved actual or threatened death or serious injury to the Veteran or someone else that caused him to experience intense fear, helplessness, or horror. Upon filing his initial claim for service connection, the Veteran submitted a stressor statement in which he reported that he jumped out of a hummer into a hole causing severe leg and lower back pain. However, in December 2009, after his initial claim for PTSD had been denied, the Veteran stated that he jumped from a hummer, hurting back and leg, fearing he would be hit by enemy fire. It seems unlikely that that the Veteran would not have reported that he was receiving enemy fire in his June 2007 statement in support of his claim for PTSD. This is a material inconsistency regarding basic facts which undermine the credibility of the stressor event as a whole. Moreover, a June 2003 STR notes that, while the Veteran indeed reported back pain with a gradual onset during deployment during Desert Storm, he denied any trauma. Therefore, the Board finds that the Veteran’s reports regarding this claimed stressor are not credible evidence. Nevertheless, also in December 2009, the Veteran reported another stressor, an unexplained event in Utah. In this regard, although this reported in-service stressor event has been largely unchanged since it was first reported in 2009, the reports contain material inconsistencies, particularly regarding his reported fears, which clinicians have relied upon in providing the subsequent PTSD diagnoses and positive nexus opinions for his PTSD and psychiatric disorders throughout the record. Specifically, the December 2009 record contains the first description of this in-service stressor while on patrol in Utah and notes a diagnosis of PTSD based on the Veteran’s report of this event described as a possible encounter with an “alien vehicle”. Later, at a January 2012 VA examination, the Veteran received a diagnosis of PTSD based on his reported fear of terrorists during his reported event in Utah. Then, at his January 2019 Board hearing, the Veteran suggested that the claimed event in Utah may have been related to government testing. Importantly, however, as previously indicated, in his August 2004 post-deployment assessment, the Veteran denied ever feeling that he was in danger of being killed during his deployment, and he denied experiencing any psychiatric related symptoms in the last month, including nightmares or difficulty sleeping, recurring thoughts of a frightening experience, hypervigilance, or feelings of detachment; he further denied having any unresolved medical problems that developed during the deployment. Moreover, a February 2007 post-service treatment record notes that the Veteran stated that he did not experience an event that involved actual or threatened death or serious injury to him or someone else that caused him to experience intense fear, helplessness, or horror. Furthermore, the Board notes that the December 2009 record indicates that the Veteran described experiencing amnesia for up to 45 minutes after the time of the claimed traumatic event, which the Veteran again alluded to in his March 2012 statement. However, in this regard, the Board points out that he denied experiencing any memory loss in STRs dated in June 2003 and July 2003, following his service in Utah, and in the August 2004 post-deployment assessment, the Veteran denied experiencing any memory loss, difficulty remembering, unconsciousness, or related symptoms during or since his deployment from 2002 to 2004, and his STRs are otherwise silent for any related symptoms. Therefore, based upon these inconsistencies, the Board finds that the Veteran’s reports regarding the event in which he jumped from a hummer into a hole and the event in Utah between 2002 and 2003 are not credible. Consequently, as the December 2009, August 2011, January 2012 medical opinions provided opinions linking his PTSD to the event in Utah as described by the Veteran at that time, the opinions are also non-credible evidence. As such, the Board affords these opinions no probative value. The Board is cognizant that a Veteran’s lay testimony alone may establish the occurrence of the claimed in-service stressor in certain circumstances. 38 C.F.R. § 3.304(f). Specifically, the Board recognizes the VA opinions which have indicated that the Veteran’s hear of terrorist activity would meet the criteria to establish a diagnosis of PTSD; however, even if the Board had found that the Veteran’s statements regarding this event in Utah were credible, the Board finds that the Veteran’s report of fear is not consistent with the places, types, and circumstances of the Veteran’s service. In this regard, the Veteran indicated that, in light of the events of September 11, 2001 and his anti-terrorist training, he thought the unusual events that occurred in Utah in December 2002 could have been terrorist related. However, there is no indication in the record that he was in an area where terrorist attacks had occurred or that there was otherwise a threat of terrorist attacks in Utah at this time to support his reported fear. Therefore, although the records reflect that the Veteran has received a diagnosis of PTSD, as the Board finds that there is no credible evidence, lay or otherwise, that the claimed in-service stressor actually occurred, the Board finds that service connection for PTSD is not warranted. See 38 C.F.R. § 3.304. The Veteran has, however, also received diagnoses of dysthymic disorder, mood disorder, a specific phobia to needles, and various diagnoses related to depression. Nevertheless, after a review of the evidence, the Board finds that service connection is not warranted for his acquired psychiatric disorder. Regarding the diagnoses of dysthymic disorder and mood disorder, the Board notes that there is no medical opinion relating any of these disabilities to his active service. Indeed, neither the May 2006 record noting “possible dysthymic disorder” or the December 2007 record noting a diagnosis of dysthymic disorder provided an indication that the disorder was related to his active service, and the December 2009 opinion suggested that dysthymic disorder had its onset prior to active service. Moreover, the December 2009 opinion, providing diagnoses of mood disorder and a phobia to needles, did not provide a nexus opinion relating these to his active service. Additionally, the May 2006 medical treatment record which provided a diagnosis of depression, while noting that the Veteran may have PTSD due to his reports of sending people out in the vehicles and helicopters and the immense responsibility he felt having them come back intact, did not provide a nexus opinion or otherwise indicate that depression was related to active service. The January 2012 VA examiner opined that the Veteran’s major depressive disorder was secondary to his nonservice-connected PTSD. In this regard, the Board notes that an acquired psychiatric disorder cannot be service-connected secondary to a nonservice-connected disability. 38 C.F.R. § 3.310. However, both the March 2014 and August 2015 VA examiners noted diagnoses of depression and provided medical nexus opinions regarding whether it was related to his in-service complaints of anxiety and depression. Regarding the March 2014 opinion, although the examiner provided a positive opinion linking the Veteran’s diagnosis of depressive disorder to his in-service reports of depression and anxiety, the Board notes that the rationale relies, in part, on the in-service event in Utah, which the Board has found is not credible evidence. Nevertheless, to the extent that the opinion is relying on the Veteran’s reports of onset of symptoms, the examiner did not appear to also consider the pertinent, and contrary, STRs noting that the Veteran denied experiencing any psychiatric related symptoms after his deployment. Thus, the Board affords this opinion only minimal probative value. By contrast, the August 2015 VA examiner thoroughly reviewed all of the pertinent available information, including his STRs noting anxiety and depression and his post-deployment assessment, and found that the Veteran’s history of anxiety and depression mentioned in his service treatment records are likely situational in nature (e.g., anxiety in relation to dentist appointment, and anxiety related to loss of relationships). Other than situational anxiety and depression, the examiner indicated that the Veteran’s mental health diagnosis has been related to his diagnosis of PTSD. Therefore, the examiner opined that it is less likely that the Veteran’s current mental health diagnoses are related to the Veteran’s in-service complaints of anxiety and depression. The Board finds that this opinion is highly probative because it is based on a thorough review of the Veteran’s STRs and prior VA examinations, which include sufficient facts and data as well as the Veteran’s lay reports, and the rationale is supported by the competent and credible evidence of record. Therefore, the Board finds that the weight of the evidence is against a finding that the Veteran’s current acquired psychiatric disorder is related to his active service. The Board has considered the lay statements regarding the Veteran’s symptoms, and acknowledges that a lay person is competent to report observable symptoms; however, to the extent that such assertions purport to establish a current disability or the etiology of any such disability, such assertions do not provide persuasive support for the claim, as neither the Veteran, his friend, or his mother is shown to possess the medical training to render competent opinions about such complex medical matters. See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F. 3d 1372 (Fed. Cir. 2007); Buchanan v. Nicholson, 451 F. 3d 1331 (Fed. Cir. 2006). Thus, to the extent that these lay statements attempt to establish that the Veteran’s current psychiatric disorder is related to his active service, to include the in-service reports of anxiety and depression, the Board finds that these statements are outweighed by the more probative medical opinion of the August 2015 VA examiner. In light of these findings, the Board concludes that service connection for an acquired psychiatric disorder, to include PTSD, is not warranted. In reaching this conclusion, the Board has considered the applicability of the benefit-of-the-doubt doctrine. However, as the preponderance of the evidence is against the claim, that doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert, 1 Vet. App. at 53-56. REASON FOR REMAND At his January 2019 Board hearing, the Veteran testified that he had a kidney stone “attack” after a physical fitness test while on ACDUTRA in 1994 or 1995 at Fort Lee, Virginia and was hospitalized for four days. He indicated that, upon testing, he was told that he was borderline diabetic, and approximately two to three months later, he sought private treatment and received a diagnosis of diabetes. Available MPRs reflect a period of 14 weeks for MOS training in 1995; records additionally indicate that the Veteran separated from National Guard service in 1998; however, no STRs are available for this period, and it does not appear that an attempt to obtain these records has been made. Therefore, an attempt should be made to obtain the Veteran’s STRs. The appropriate records agency, to include the Joint Services Records Research Center (JSRRC) and the NPRC should be contacted for the purpose of obtaining the Veteran’s STRs for the Veteran’s National Guard service, particularly around 1995. Additionally, National Guard records are normally maintained by the military service or the Adjutant General's Office in the state in which service was performed, and as such, this office should also be contacted. Efforts to obtain federal records must be made until they are either obtained or it is determined they do not exist or that continuing efforts would be futile. 38 C.F.R. § 3.159 (c)(2). The matters are REMANDED for the following action: (1) Contact the appropriate records agency and office, to include the NPRC, JSRRC, and Adjutant General’s office, and request that it obtain and associate with the claims file copies of the Veteran’s National Guard STRs, to include the period from approximately 1994 to 1998. (2) All documentation of such efforts and responses should be added to the electronic file. Any recommendations provided by the NPRC, JSRRC, and/or Adjutant General’s office in obtaining relevant records from alternate sources should be followed. All requests and responses with respect to the above actions, both positive and negative, should be associated with the electronic file. (3) Upon receipt of any additional evidence and completion of the request for STRs, complete any additional development necessary with regard to the Veteran’s claim for service connection for diabetes mellitus, type II, including obtaining a new medical opinion, if deemed necessary. Thomas H. O'Shay Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Hite, 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.