Citation Nr: 21064517 Decision Date: 10/20/21 Archive Date: 10/20/21 DOCKET NO. 16-49 269 DATE: October 20, 2021 ORDER Entitlement to an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD) and associated alcohol dependence, depression, and anxiety is granted. FINDING OF FACT The evidence shows that the Veteran's acquired psychiatric disorders including PTSD manifested during and were caused by events from his active duty military service. CONCLUSION OF LAW The criteria for service connection for an acquired psychiatric disorder, to include PTSD and secondary alcohol dependence are met. 38 U.S.C. §§ 1110, 1154, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from September 1969 to April 1972. This appeal comes to the Board from a December 2014 rating decision. The Veteran testified before the undersigned Veterans Law Judge (VLJ) at a November 2019 hearing. The Board denied the Veteran's claim in a January 2020 decision, and the Veteran appealed to the United States Court of Appeals for Veterans Claims (CAVC). In September 2020, the CAVC remanded this matter for action consistent with a Joint Motion for Partial Remand (JMPR). The JMPR found the Board erred by limiting its analysis to PTSD without adequately addressing diagnoses of depression and anxiety. Further, it noted the August 2014 VA examiner failed to discuss whether alcohol abuse and behavioral problems documented in the Veteran's service records could have been symptoms of PTSD. Finally, it found that the Board failed to adequately consider the Veteran's hearing testimony that he began drinking and went AWOL during service because of his friend's death. Service connection is granted on a direct basis when there is competent, credible evidence of (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury. 38 U.S.C. §§ 1110, 1131; Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a), (d). Service connection may also be granted for a disability that is proximately due to or the result of an established service-connected disability. 38 C.F.R. § 3.310. This includes disability made chronically worse by a service-connected disability. Allen v. Brown, 7 Vet. App. 439 (1995). In Ward v. Wilkie, 31 Vet. App. 233 (2019), the CAVC clarified that incremental increase in disability (any additional impairment of earning capacity) in non-service-connected disabilities resulting from a service-connected condition regardless of its permanence may be a basis for secondary service connection under 38 C.F.R. § 3.310. 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 an in-service stressor, and credible supporting evidence that the claimed in-service stressor occurred. 38 C.F.R. § 3.304(f). Lay testimony is sufficient to corroborate an in-service stressor (absent clear and convincing evidence to the contrary) when evidence establishes that Veteran engaged in combat with the enemy and the claimed stressor is related to that combat. 38 U.S.C. § 1154(b). See also 38 C.F.R. § 3.304(f)(2). In Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990), the Court stated that "a veteran need only demonstrate that there is an 'approximate balance of positive and negative evidence' in order to prevail." To deny a claim on its merits, the preponderance of the evidence must be against the claim. See Alemany v. Brown, 9 Vet. App. 518, 519 (1996) (citing Gilbert, 1 Vet. App. at 54). After reviewing the totality of the evidence including additional medical opinion evidence submitted with a brief from the Veteran's attorneys in August 2021, the Board finds the elements for service connection are met. As noted in the JMPR and the Board's prior decision, the Veteran's treatment records show several diagnoses of mental disabilities to include symptoms of anxiety and depression. See August 2016 Mental Health Outpatient Note from the Southern Nevada VA Healthcare System. Additionally, as noted in the JMPR, the service records show changes in behavior during the Veteran's service, and the Veteran presented for a psychological evaluation in January 1972 to assess his behavioral problems. As noted in the Board's prior decision, the Veteran's service records show the Veteran received a combat action ribbon, and the Board has conceded the Veteran experience in-service stressors consistent with combat including being under enemy fire. See also 38 C.F.R. § 3.304(f)(2). In the August 2021 brief, the Veteran's attorneys requested that the Board grant the Veteran's claim based on the additional medical opinion evidence without remanding for further development. The Board ultimately finds the July 2021 opinion from J.S., Ph.D., a licensed psychologist, attached to the brief from the Veteran's attorneys addresses the deficiencies in the JMPR. It confirms that the Veteran does have a current disability of PTSD and secondary alcohol dependence under both the DSM-IV and DSM-5 and finds the Veteran's disabilities are related to his claimed stressors. The examination is based on a thorough review of the Veteran's current symptoms, treatment history, claimed stressors, in-service symptoms, lay statements, and another pertinent evidence. The Board finds no competent and credible evidence contrary to the opinion that adequately considers the pertinent evidence noted in the JMPR. Therefore, the Board grants the Veteran's claim for entitlement to an acquired psychiatric disorder, to include PTSD and associated alcohol dependence, anxiety, and depression. A. C. MACKENZIE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Michael Duffy 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.