Citation Nr: 21064854 Decision Date: 10/21/21 Archive Date: 10/21/21 DOCKET NO. 14-11 645 DATE: October 21, 2021 ORDER Entitlement to service connection for an acquired psychiatric disability other than posttraumatic stress disorder (PTSD), to include alcohol dependence, anxiety, depression, and sleep problems, is denied. FINDING OF FACT The record evidence shows that the Veteran's current acquired psychiatric disability other than PTSD, to include alcohol dependence, anxiety, depression, and sleep problems, is not related to active service. CONCLUSION OF LAW The criteria for service connection for an acquired psychiatric disability other than PTSD, to include alcohol dependence, anxiety, depression, and sleep problems, have not been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.303, 3.304 (2020). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from November 1991 to November 1995. This appeal has a long procedural history. It comes before the Board of Veterans' Appeals (Board) on appeal from a March 2013 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Milwaukee, Wisconsin, which denied, in pertinent part, the Veteran's claim of service connection for an acquired psychiatric disability other than PTSD, to include alcohol dependence, anxiety, depression, and sleep problems (which was characterized as mental health condition to include alcohol dependence, anxiety, depression, and sleep problems). In January 2018, the Board remanded the currently appealed claim to the Agency of Original Jurisdiction (AOJ) for additional development. The Board then denied this claim in October 2019. The Veteran, through an attorney, and VA's Office of General Counsel appealed the Board's October 2019 decision to the United States Court of Appeals for Veterans Claims (Court) by filing a Joint Motion for Remand (Joint Motion). In April 2021, the Court granted the Joint Motion which vacated and remanded the Board's October 2019 decision. In July 2021, the Board again remanded the currently appealed claim to the AOJ for additional development. A review of the claims file shows that there has been substantial compliance with the Board's remand directives. The Board directed that the AOJ schedule the Veteran for examination to determine the nature and etiology of his acquired psychiatric disability other than PTSD. This examination occurred in August 2021. See Stegall v. West, 11 Vet. App. 268 (1998); see also Dyment v. West, 13 Vet. App. 141 (1999) (holding that another remand is not required under Stegall where the Board's remand instructions were substantially complied with), aff'd, Dyment v. Principi, 287 F.3d 1377 (2002). Having reviewed the record evidence, the Board finds that the issue on appeal should be characterized as stated above. The Board finds that the preponderance of the evidence is against granting the Veteran's claim of service connection for an acquired psychiatric disability other than PTSD, to include alcohol dependence, anxiety, depression, and sleep problems. He essentially contends that he incurred an acquired psychiatric disability other than PTSD during active service, including as a result of being involved in an altercation at a bar, and experienced continuous post-service disability. The record evidence does not support his assertions regarding an etiological link between any acquired psychiatric disability and active service. It shows instead that, although he complained of and sought treatment for a variety of acquired psychiatric disabilities other than PTSD since his service separation, no current acquired psychiatric disability is related to active service. The available service treatment records show that, at his pre-enlistment physical examination in June 1991, prior to his entry on to active service in November 1991, clinical evaluation was within normal limits and he denied any relevant pre-service medical history. On outpatient treatment in January 1995, the Veteran reported incurring a lip laceration after being "jumped" at a local bar. These records also show that he received counseling for marital problems and for a "lack of initiative" in his work performance. At his separation physical examination in July 1995, prior to his separation from service in November 1995, clinical evaluation was within normal limits. He had a "poorly healing lacerated lower lip." He denied any relevant in-service medical history. The Board notes that the absence of contemporaneous records does not preclude granting service connection for a claimed disability. See Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006) (finding lack of contemporaneous medical records does not serve as an "absolute bar" to the service connection claim); Barr v. Nicholson, 21 Vet. App. 303 (2007) ("Board may not reject as not credible any uncorroborated statements merely because the contemporaneous medical evidence is silent as to complaints or treatment for the relevant condition or symptoms"). The post-service evidence also does not support granting service connection for an acquired psychiatric disability other than PTSD, to include alcohol dependence, anxiety, depression, and sleep problems. It shows instead that, although the Veteran experiences current acquired psychiatric disability other than PTSD, it is not related to active service. The Board notes initially that VA examinations dated in January 2013 and in May 2019 previously were found inadequate for adjudication purposes. The Board found a January 2013 VA examination inadequate in the January 2018 remand. The Court found a May 2019 VA examination inadequate when it granted the Joint Motion in April 2021. Neither of these examinations were reviewed or relied upon in adjudicating the currently appealed claim. The Veteran's post-service VA and private outpatient treatment records reflect ongoing complaints of and treatment for a variety of acquired psychiatric disabilities, to include anxiety and depression. On VA mental disorders Disability Benefits Questionnaire (DBQ) in August 2021, the Veteran's complaints included "variable levels of depression," passing suicidal ideation "around 1 2 times per month," and minimal to moderate "variable levels of anxiety." He reported being married and divorced twice and currently married to his third wife since 2011. He slept 4 hours per night. The VA examiner reviewed the Veteran's electronic claims file, including service treatment records and post-service VA treatment records. The Veteran had no children. He reported that Marine Corps boot camp was stressful because "he was overweight and picked on." He developed anxiety and "felt stressed out" after boot camp. He received in-service marriage counseling and anger management. He sought mental health treatment in 2011 from VA but not since that time. He drank 6 8 beers every other day "for the last 10 years." His symptoms were a depressed mood, anxiety, suspiciousness, panic attacks more than once a week, chronic sleep impairment, disturbances of motivation and mood, difficulty in adapting to stressful circumstances, inability to establish and maintain effective relationships, and suicidal ideation. Mental status examination of the Veteran showed adequate grooming and hygiene, normal speech, full orientation, "no clinically significant indications of cognitive dysfunction," adequate abstractions, and "no indications of mania or psychosis." The VA examiner opined that it was less likely than not that the current acquired psychiatric disability is related to active service. The rationale was based on a review of the claims file. The rationale also was that the claimed in-service stressor "is not a sufficient basis for his current psychiatric condition." The rationale further was that the in-service marital counseling and reported "trust issues since boot camp" were "also not sufficient to be considered causal factors for his present psychiatric condition." The VA examiner noted that the medical evidence showed that the Veteran's anxiety "was linked to 'current daily situations and events such as work'" and not active service. This examiner next noted that the Veteran's reported anxiety symptoms "do not meet the diagnostic threshold for a clinically significant anxiety disorder." This examiner further noted that the Veteran's reported depressive symptoms "were primarily attributed to current life circumstances." This examiner also further noted that the Veteran himself reported that "his psychiatric condition is not causing any social or occupational impairments." The diagnosis was unspecified depressive disorder. Contrary to the Veteran's lay statements, the record evidence shows that his current acquired psychiatric disability other than PTSD, to include alcohol dependence, anxiety, depression, and sleep problems, is not related to active service. The August 2021 VA examiner specifically opined that it was less likely than not that this disability is related to active service or any incident of service, to include the Veteran's described in-service stressor of being involved in an altercation at a bar or receiving marital counseling. This opinion was fully supported. See Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) (finding that a medical opinion "must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions"). He otherwise has not identified or submitted any evidence demonstrating his entitlement to service connection for an acquired psychiatric disability other than PTSD, to include alcohol dependence, anxiety, depression, and sleep problems. In summary, the Board finds that service connection for an acquired psychiatric disability other than PTSD, to include alcohol dependence, anxiety, depression, and sleep problems, is not warranted. R. FEINBERG Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Michael T. Osborne, 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.