Citation Nr: 21065191 Decision Date: 10/25/21 Archive Date: 10/25/21 DOCKET NO. 19-09 059 DATE: October 25, 2021 ORDER Entitlement to service connection for an acquired psychiatric disorder, post- traumatic stress disorder and major depressive disorder, to include as secondary to service-connected colon cancer, is granted. FINDINGS OF FACT 1. The evidence is at least in equipoise as to whether the Veteran's depression developed due to his service-connected colon cancer. 2. The evidence is at least in equipoise as to whether the Veteran's posttraumatic stress disorder (PTSD) is related to his active service stressor. CONCLUSION OF LAW The criteria for service connection for an acquired psychiatric disorder, PTSD and major depressive disorder to include as secondary to service-connected colon cancer, have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.304, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran served on active duty from June 1970 to May 1972, with additional Reserve service. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In September 2020, the Veteran testified before the undersigned Veterans Law Judge. A transcript of the proceeding has been associated with the claims file. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1131, 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. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Service connection may also be established on a secondary basis for a disability that is proximately due to or the result of service-connected disease or injury. 38 C.F.R. § 3.310(a). Any increase in severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice-connected disease, will be service-connected. 38 C.F.R. § 3.310(b). Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists and (2) that the current disability was either (a) proximately caused by or (b) proximately aggravated by a service-connected disability. See Allen v. Brown, 7 Vet. App. 439, 448 (1995). 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 in-service stressor occurred. 38 C.F.R. § 3.304 (f). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107(b). The Veteran contends that he has depression secondary to his service connected colon cancer, and that he has PTSD. A January 2019 private examination shows the Veteran has PTSD and major depressive disorder. Earlier, the Veteran was afforded a VA examination in December 2015. The December 2015 VA examiner diagnosed the Veteran with intermittent explosive disorder but opined that the Veteran's symptoms did not meet the diagnostic criteria for PTSD. However, the examiner noted that the Veteran experienced stressors while in service that supported a diagnosis of PTSD. The examiner provided a medical opinion that addressed itself to whether the Veteran had PTSD due to service, but in doing so implied a relationship between the Veteran's psychiatric symptoms and his colon cancer. A March 2019 statement of the case issued by the RO conceded the Veteran's stressor, (which concerned fatalities on the flight deck of the aircraft carrier on which the Veteran served). However, service connection was denied as the Veteran did not have a clinical diagnosis of PTSD at that time. The Veteran was granted service connection for colon cancer in a June 2020 Board decision. The Veteran underwent a private psychological evaluation in January 2019, which was received in March 2019. The January 2019 private examiner considered the Veteran to have PTSD and major depressive disorder with anxiety and opined that given the events the Veteran had experienced in service; it was as likely as not that his disorder was causally related to his military service. The examiner noted that the Veteran experienced traumatic events resulting in avoidant behaviors of reliving and reexperiencing, which were solely the result of his military experiences. The examiner also linked the Veteran's depression to his service-connected colon cancer diagnosis. Considering that both examiners linked the Veteran's depression to his service-connected colon cancer, the Board considers the evident to be at least in equipoise as to whether that that condition, major depressive disorder, may be considered to have been caused by the cancer illness. Therefore, service connection for the Veteran's major depressive disorder is warranted. Furthermore, although the VA examiner did not consider the Veteran to have PTSD, since the Veteran's stressors have been conceded, and the private evaluation found PTSD due to service, the Board finds the evidence to be at least in equipoise as to whether PTSD was incurred in service. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. MICHAEL KILCOYNE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board V. Geer, 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.