Citation Nr: 21064830 Decision Date: 10/21/21 Archive Date: 10/21/21 DOCKET NO. 16-37 535 DATE: October 21, 2021 ORDER Service connection for acquired psychiatric disability, to include posttraumatic stress disorder (PTSD) and major depressive disorder (MDD), is granted. FINDINGS OF FACT 1. The preponderance of the evidence supports finding a link established by medical evidence between PTSD and a corroborated in-service stressor. 2. The preponderance of the evidence supports finding the Veteran's MDD manifested during service. CONCLUSION OF LAW The criteria for service connection for acquired psychiatric disability, to include PTSD and MDD, have been met. 38 U.S.C. §§ 1101, 1110, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 4.125. REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran served active duty from June 1986 to November 1990. Entitlement to service connection for acquired psychiatric disability, to include PTSD and MDD The Veteran contends his mental health symptoms began during service and are related to months of racial harassment by a supervisor and members of his squadron in 1989, to include describing a specific threatening incident. See July 2010 statement, September 2010 statement, September 2010 Statement in Support of Claim for PTSD, and July 2021 hearing transcript. Generally, to establish service connection a Veteran must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Davidson v. Shinseki, 581 F.3d 1313, 1315 (Fed. Cir. 2009); Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may also be granted for any injury or disease diagnosed after discharge, when all the evidence establishes that the disease or injury was incurred in service. 38 C.F.R. § 3.303(d). Service connection for PTSD specifically requires medical evidence establishing a diagnosis of the disability in accordance with the DSM-V, credible supporting evidence that the claimed in-service stressor occurred, and a link, established by medical evidence, between the current symptomatology and the claimed in-service stressor. 38 C.F.R. §§ 3.304 (f), 4.125(a). If a PTSD claim is based on military sexual trauma or personal assault in service, evidence from sources other than the Veteran's records may corroborate the Veteran's account of the stressor incident. 38 C.F.R. § 3.304(f)(5). Examples of such evidence include, but are not limited to, the following: records from law enforcement authorities, rape crisis centers, mental health counseling centers, hospitals or physicians; pregnancy tests or tests for sexually transmitted diseases; and statements from family members, roommates, fellow service members, or clergy. Id. Evidence of behavior changes following the claimed assault is also relevant evidence that may be found in the mentioned sources. Examples of behavior changes that may constitute credible evidence of a stressor include, but are not limited to, the following: a request for a transfer to another assignment; deterioration in work performance; substance abuse; episodes of depression, panic attacks, or anxiety without an identifiable cause; or unexplained economic or social behavior changes. Id. The Veteran reported months of racial harassment by a supervisor and members of his squadron in 1989. Service records do not officially document this reported stressor. The Veteran points to service treatment records (STR) showing sleep impairment, depression, increased headaches, referrals to a sleep clinic and stress management clinic, as well as buddy statements submitted by fellow servicemembers and positive nexus medical opinions by VA and private clinicians. See August 2016 VA Form 9. A review of the claims file documents a May 1989 STR showing increased headaches with depressed mood. The Veteran was prescribed Elavil, an antidepressant. A June 1989 STR noted increased stress and referred the Veteran to a stress management clinic. An August 1989 STR noted sleep impairment and referred the Veteran to a sleep clinic. In October 1990, the Veteran was medically discharged from the Navy due to headache disability. An October 2008 buddy statement from C.B., a fellow servicemember, reported the Veteran told him during service about his supervisor making racial remarks and threats toward him. A February 2011 buddy statement from F.F., a fellow servicemember, described witnessing racial harassment of the Veteran during service. A June 2016 buddy statement from E.H., a fellow servicemember, recalled the Veteran being upset and telling him during service about threating statements made by an individual in his unit. A March 2015 VA examination diagnosed PTSD and MDD. The clinician stated the Veteran's reported stressor of racial harassment during service meets the criteria for PTSD and is related to personal assault. The clinician opined the Veteran's PTSD was more than 50 percent likely due to this in-service stressor. The clinician noted the markers in STR of increased headaches, new-onset depression and sleep disturbance, which are consistent with the reported stressor. The clinician noted his emotional response during the examination interview was consistent. The clinician noted his MDD should be service connected for the same reasons. An April 2021 private treatment letter stated that based on review of in-service and post-service records, the Veteran's chronic depression started while on active duty and his chronic PTSD was more likely than not caused by service. The clinician noted the Veteran was seen and diagnosed with depression in May 1989. The clinician noted the Veteran had a supervisor who ridiculed and threatened him during active duty. The clinician opined this stressful environment more likely than not caused his PTSD. Resolving reasonable doubt in favor of the Veteran, the Board finds the Veteran meets the criteria for entitlement to service connection for PTSD. 38 C.F.R. §§ 3.304 (f), 4.125(a). First, a PTSD diagnosis in accordance with the DSM-V is established. Next, the Board finds credible supporting evidence to support the claimed in-service stressor occurred. If a PTSD claim is based on a personal assault in service, evidence from sources other than the Veteran's records may corroborate the account of the stressor incident, to include evidence of behavior changes and statements from fellow servicemembers. 38 C.F.R. § 3.304(f)(5). Here, the March 2015 VA medical examiner noted behavioral markers in service of increased headaches, onset depression, and sleep impairment. STR noted increased stress and referral to a stress management clinic. The Veteran provided buddy statements from fellow servicemembers who witnessed harassment or were told during service about the harassment. Lastly, the preponderance of the evidence shows a link established by medical evidence between the current symptomatology and the reported in-service stressor. The Board gives probative weight to the March 2015 VA medical opinion and April 2021 private treatment opinion finding the Veteran's PTSD was more likely than not related to his reported in-service stressor of harassment. Both examiners reviewed the medical evidence and discussed the reported stressor. The opinions are consistent with VA psychiatric treatment visits throughout the appeal period discussing the Veteran's reported in-service stressor and diagnosing "PTSD related to military service." See August 2012, November 2012, December 2012, January 2013, February 2013, March 2013, December 2013, September 2014, November 2014, March 2015, July 2015, October 2015, February 2016, June 2016, September 2016, January 2017, April 2017, September 2017, October 2017, January 2018, April 2018, and May 2018 VA treatment notes. In sum, resolving reasonable doubt in favor of the Veteran, the criteria for entitlement to service connection for PTSD are met. The preponderance of the evidence supports finding entitlement to service connection for MDD. The Board gives probative weight to the April 2021 private treatment opinion finding the Veteran's chronic depression started while on active duty. The opinion is based on an accurate medical history and provided a clear conclusion and supporting data. The clinician reviewed the claims file and noted the May 1989 STR reporting depression and prescribing Elavil. The opinion is consistent with the March 2015 VA medical examiner finding the Veteran's MDD was related to his reported in-service stressor. Accordingly, entitlement to service connection for acquired psychiatric disability, to include PTSD and MDD, is granted. KELLI A. KORDICH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Winkler, 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.