Citation Nr: 21064593 Decision Date: 10/20/21 Archive Date: 10/20/21 DOCKET NO. 12-30 680A DATE: October 20, 2021 ORDER Service connection for the cause of the Veteran's death is granted. Compensation under 38 U.S.C. § 1151 for the cause of the Veteran's death is dismissed. FINDINGS OF FACT 1. The Veteran had continuous symptoms of paranoid schizophrenia dating back to active service. 2. The claim for compensation under 38 U.S.C. § 1151 for the cause of the Veteran's death is moot. CONCLUSIONS OF LAW 1. The criteria for service connection for the cause of the Veteran's death have been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. § 3.312. 2. The criteria for dismissal of the claim for compensation under 38 U.S.C. § 1151 for the cause of the Veteran's death are met. 38 U.S.C. §§ 7104, 7105; 38 C.F.R. § 20.104. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service in the U.S. Army from January 1968 to December 1969. He died in March 1992. The appellant is his surviving spouse. This matter comes before the Board of Veterans' Appeals (Board) on appeal from July 2011 and November 2012 rating decisions. In August 2019, the Board remanded the 1151 claim and denied the service connection claim. The appellant appealed that denial to the U.S. Court of Appeals for Veterans Claims (Court). Pursuant to a Joint Motion for Remand (JMR), the Court remanded the service connection claim back to the Board in September 2020. The Board then remanded it for additional development in March 2021. Service connection for the cause of the Veteran's death Service connection for the cause of a veteran's death is warranted if a service-connected disability either caused or contributed substantially or materially to the cause of a veteran's death. 38 U.S.C. § 1310; 38 C.F.R. § 3.312(a). Historically, the Veteran was admitted to the Salem VA medical center (VAMC) for paranoid schizophrenia on December 30, 1991 and was placed on suicide observation status (SOS) on January 27, 1992. He remained on SOS until February 4, when he denied any suicidal or homicidal ideation. His medication was adjusted, and his privileges were gradually returned as he became more cooperative. He advanced to full privileges on February 18, which he handled well. However, he did not report for an evening meal on February 22. He was placed on unauthorized absence status, and the VAMC grounds were searched without success. His bed was held for 30 days, but he failed to return and was considered discharged on March 24. On March 25, his body was found in the woods on the Salem VAMC grounds. His death certificate shows he died as a result of suicide by hanging. Generally, for the purpose of service connection, a disability or death cannot be the result of a Veteran's willful misconduct. For suicide to constitute willful misconduct, the act of self-destruction must be intentional. A person of unsound mind is incapable of forming intent (mens rea, or guilty mind, which is an essential element of crime or willful misconduct). 38 C.F.R. § 3.302(a). Whether a person, at the time of suicide, was so unsound mentally that he or she did not realize the consequence of such an act, or was unable to resist such impulse is a question to be determined in each individual case, based on all available lay and medical evidence pertaining to his or her mental condition at the time of suicide. The act of suicide or a bona fide attempt is considered to be evidence of mental unsoundness. Therefore, where no reasonably adequate motive for suicide is shown by the evidence, the act will be considered to have resulted from mental unsoundness. A reasonably adequate motive for suicide may be established by affirmative evidence showing circumstances which could lead a rational person to self-destruction. 38 C.F.R. § 3.302(b). In this case, the Veteran was admitted for paranoid schizophrenia, had a long history of prior mental illness, and was placed on SOS during his admission. A May 2019 VA opinion stated that schizophrenia led to the Veteran's death. Therefore, the Board reasonably concludes that the Veteran's suicide was the result of an unsound mind and not willful misconduct. Service connection may be granted for disability or death resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 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. Certain chronic diseases, including psychoses, will be presumed related to service, absent an intercurrent cause, if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service (or within an applicable presumptive period) with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309. Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013). As discussed, the Veteran had a current diagnosis of paranoid schizophrenia (a type of psychosis) at the time of his death. During service, he was seen in February 1968 for nervousness and prescribed Librium. Social Security Administration (SSA) records from November 1974 show that the Veteran reporting having his first attack of "nerves" in 1968. He reported that these attacks had since increased in frequency. In May 1975, he was diagnosed with passive-aggressive personality with conversion type symptoms. However, a March 2021 VA examiner noted that this diagnosis could be interpreted as prodromal schizophrenic symptoms. Subsequent records show a diagnosis of schizophrenia in 1982, with subsequent hospitalizations in 1983, 1984 and 1987. When resolving any doubts in the appellant's favor, the Board finds that this evidence establishes that the Veteran first experienced psychiatric symptoms in service which continued after service and were eventually diagnosed as paranoid schizophrenia. Compensation under 38 U.S.C. § 1151 for the cause of the Veteran's death (Continued on the next page) A veteran who becomes disabled or dies due to VA medical treatment may receive compensation for a qualifying additional disability in the same manner as if such additional disability were service-connected. 38 U.S.C. § 1151(a) (emphasis added). As discussed above, service connection for the cause of the Veteran's death has been established. Therefore, the issue of compensation under 38 U.S.C. § 1151 for his death is moot. JOHN Z. JONES Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Shamil Patel, 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.