Citation Nr: 21063821 Decision Date: 10/18/21 Archive Date: 10/18/21 DOCKET NO. 11-14 693 DATE: October 18, 2021 ORDER Entitlement to service connection for an acquired psychiatric disorder, claimed as posttraumatic stress disorder (PTSD) is denied. INTRODUCTION The Veteran served on active duty from August 1976 to September 1979. In March 2017, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A transcript of the hearing is of record. When this case was before the Board in May 2017, December 2018, and August 2020, the above-noted issue was remanded for additional development. The case has since been returned for further appellate review. FINDING OF FACT The most probative evidence indicates the Veteran's acquired psychiatric disorder is not etiologically related to his active service. CONCLUSION OF LAW The criteria for service connection for an acquired psychiatric disorder are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION Duty to Assist The Veterans Claims Assistance Act of 2000 (VCAA), codified in pertinent part at 38 U.S.C. §§ 5103, 5103A, and the pertinent implementing regulation, codified at 38 C.F.R. § 3.159, provide that VA will assist a claimant in obtaining evidence necessary to substantiate a claim but is not required to provide assistance to a claimant if there is no reasonable possibility that such assistance would aid in substantiating the claim. The record reflects that all pertinent available service treatment records (STRs) and post-service medical evidence identified by the Veteran have been obtained. The Veteran has been afforded several VA examinations to assess his claimed psychiatric disorder. He was also afforded a hearing before the Board, and a transcript of that proceeding is of record. Neither the Veteran nor his representative have identified any outstanding evidence that could be obtained to substantiate the claim; the Board is also unaware of any such evidence. Accordingly, the Board will address the merits of the Veteran's claim. Legal Criteria 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; 38 C.F.R. § 3.303. Service connection may be granted for any disease initially diagnosed after service, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d). Where a veteran served for at least 90 days of active and continuous service after December 31, 1946, and manifests a psychosis to a degree of 10 percent within one year from the date of termination of such service, such disease shall be presumed to have been incurred or aggravated in service, even though there is no evidence of such disease during the period of service. 38 U.S.C. §§ 1101, 1112; 38 C.F.R. §§ 3.307, 3.309. Every veteran shall be taken to have been in sound condition when examined, accepted, and enrolled for service, except as to defects, infirmities, or disorders noted at the time of the examination, acceptance, and enrollment, or where clear and unmistakable evidence demonstrates that the injury or disease existed before acceptance and enrollment and was not aggravated by such service. 38 U.S.C. § 1111. To rebut the presumption of soundness for disorders not noted on the entrance or enlistment examination, VA must show by clear and unmistakable evidence both: a) the disease or injury existed prior to service, and b) that the disease or injury was not aggravated by service. VAOPGCPREC 3-2003 (July 16, 2003). Burden of Proof Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits under laws administered by the Secretary. The Secretary shall consider all information and lay and medical evidence of record in a case before the Secretary with respect to benefits under laws administered by the Secretary. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). To deny a claim on its merits, the evidence must preponderate against the claim. Alemany v. Brown, 9 Vet. App. 518, 519 (1996), citing Gilbert, 1 Vet. App. at 54. Factual Background and Analysis Initially, the Board notes the Veteran has been diagnosed with a variety of psychiatric disorders, which include schizophrenia, adjustment disorder, anxiety disorder, depression, and other chronic stressor/trauma related disorder in the course of the appeal period. Though the Veteran underwent comprehensive VA examinations in June 2017, June 2020, and April 2021, each of those examiners found the Veteran did not warrant a clinical diagnosis of PTSD. The central issue in this case is whether the Veteran's variably diagnosed psychiatric disorders were either incurred or aggravated during his period of active duty service. A review of the Veteran's service treatment records (STRs) fails to show he was treated for or diagnosed with any acquired psychiatric disorders in service. Importantly, the Veteran's August 1976 entrance examination did not note the presence of a psychiatric disability, and as such, the presumption of soundness attaches in this case. In the course of the most recent VA examination, the examiner chronicled the Veteran's significant history of abuse by his mother and father as a child. In sum, the examiner found the Veteran did clearly and unmistakably warrant a diagnosis of both alcohol abuse disorder and other chronic stressor/trauma related disorder prior to his entrance into active duty, based on the Veteran's reports of manifestations prior to his active service. Though the examiner acknowledged the Veteran experienced some waxing and waning of his symptoms during his period of active duty, he found that to be typical and a natural progression of the disorders. The examiner also determined the evidence of record, including the Veteran's medical records and lay history, demonstrate his psychiatric disorders have maintained the same level of severity since the period prior to the Veteran's active duty service. Based on this evidence, the examiner concluded the Veteran's disabilities clearly and unmistakably were not aggravated during his period of active duty. With respect to the other diagnosed disabilities, including adjustment disorder with anxiety, depression, and schizophrenia, the examiner concluded these prior diagnoses were erroneous. The examiner explained that although the Veteran was initially diagnosed with adjustment disorder with anxiety and depression, the current diagnosis of other chronic stressor/trauma related disorder is more fitting and accurate, because this diagnosis better accounts for his characterological issues and reported symptoms. Likewise, with respect to the prior diagnosis of schizophrenia, the examiner explained the Veteran reported his hallucinations had existed since childhood. However, the Veteran lacked other negative symptoms that are commonly seen with schizophrenia. As such, the examiner found the Veteran's reports of hallucinations to be better explained as a consequence of flashbacks, which are also associated with his other chronic stressor/trauma related disorder rather than a true delusional belief. To date, the Veteran has not provided any credible evidence to question the April 2021 examiner's findings. Though the Board is sympathetic of the Veteran's assertions, the overwhelming credible evidence indicates the Veteran's acquired psychiatric disorders clearly and unmistakably existed prior to service, and clearly and unmistakably were not aggravated therein. Based on the foregoing, the Board finds no basis in which to establish service connection for the Veteran's claimed acquired psychiatric disorders. As such, the claim must be denied. T. REYNOLDS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board G. Fraser, 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.