Citation Nr: 21065241 Decision Date: 10/25/21 Archive Date: 10/25/21 DOCKET NO. 15-13 405 DATE: October 25, 2021 ORDER Entitlement to service connection for an acquired psychiatric disorder, to include bipolar disorder and/or major depressive disorder is denied. FINDING OF FACT The preponderance of the evidence shows the Veteran's acquired psychiatric disorder, to include bipolar disorder, and/or major depressive disorder, were not present in service and are not related to service or to an incident of service origin. CONCLUSION OF LAW The criteria for entitlement to service connection for an acquired psychiatric disorder to include bipolar disorder, and/or major depressive disorder have not been met. 38 U.S.C. § 1131, 5107(b); 38 C.F.R. § 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from July 1972 to July 1974. This appeal comes to the Board of Veterans' Appeals (Board) from a July 2014 rating decision of the Department of Veterans' Affairs (VA) regional office (RO). The Board previously remanded the instant matter for additional development in June 2018 and June 2021. Entitlement to service connection for an acquired psychiatric disorder, to include bipolar disorder and/or major depressive disorder Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303(a). To establish a right to compensation for a present disability, 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, 1315-16 (Fed. Cir. 2009); Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection for posttraumatic stress disorder (PTSD) requires the following three elements: (1) a current medical diagnosis of PTSD (presumed to include the adequacy of the PTSD symptomatology and the sufficiency of a claimed in-service stressor in accordance with 38 C.F.R. § 4.125(a)); (2) credible supporting evidence that the claimed in-service stressor occurred; and (3) medical evidence of a causal relationship between the current symptomatology and the specific claimed in-service stressor. 38 C.F.R. § 3.304(f). In adjudicating a claim for service connection for PTSD, the Board is required to evaluate evidence based on places, types, and circumstances of service, as shown by military records and all pertinent medical and lay evidence. See Hayes v. Brown, 5 Vet. App. 60, 66 (1993); see also 38 U.S.C. § 1154(a); 38 C.F.R. § 3.304(f). The evidence necessary to establish the occurrence of an in-service stressor for PTSD will vary depending on if the veteran "engaged in combat with the enemy." Id Here, the Veteran was not in combat and the only reported stressor was exposure to Camp Lejeune contaminated drinking water (CLCW). The Veteran has presumed exposure to contaminated drinking water based on the time he was stationed in Camp Lejeune. 38 C.F.R. § 3.307(a)(7). Upon review of the entire record, the evidence does not show that the Veteran's psychiatric disorders existed in service, had onset in service, or are otherwise related to service. Service treatment records do not reflect any complaints, symptoms, diagnoses, or treatment for any psychiatric disorders, and a July 1974 service separation examination report shows the Veteran was found to be psychiatrically normal. The Veteran contends his psychiatric disorder is related to his active service. In July 2014 the instant matter was denied by the RO. In June 2018 the matter was remanded by the Board for further development because the Veteran asserted his psychiatric condition was related to contaminated drinking water at Camp Lejeune. Per the Board remand, the Veteran was afforded a VA examination in May 2019. There, the examiner stated the Veteran did not meet the diagnostic criteria for PTSD under DSM-5 criteria. The examiner noted the Veteran's stressors did not meet the criteria for PTSD, and that he has lived a successful marital, parenting, social, and occupational life. He completed a bachelors, masters, and doctorate program, worked for 27 years, and raised a big family. The examiner stated these achievements are not related to a PTSD diagnosis. The examiner however did state the Veteran has a diagnosis of bipolar disorder, Type II. The examiner concluded the bipolar disorder was not due, related, incurred, or associated in any way to the Veteran's military service. The examiner further explained the Veteran sought formal psychiatric treatment around 2008, which was almost 35 years after active military discharge. He noted, that per the Veteran, he received more responsibility at work after receiving his doctorate, and he "could not handle it." The Veteran also noted he saw three private providers before working with the VA. See, May 2019 C&P. VA treatment records reflect various diagnoses of bipolar depression/bipolar disorder, mood disorder, and major depressive disorder. There is no diagnosis of PTSD of record. VA treatment records indicate that the Veteran has a history of psychological trauma, however it is not service-related. Specifically, a hurricane destroyed his home in Puerto Rico and he moved to Texas to be with his adult daughter. See June 2018 VA treatment record. The Board finds that the Veteran has established a current acquired psychiatric disability to include bipolar disorder and major depressive disorder. In April 2020, a Deferred Rating was issued because the examiner did not provide a specific opinion regarding whether a mental condition is etiologically linked to exposure to chemicals at Camp Lejeune, as required by the Board remand. As such, an addendum opinion was obtained in January 2021. There the examiner confirmed it was less likely than not the Veteran's bipolar disorder was related to his active service. See, January 13, 2021 C&P. In March 2021 an additional addendum opinion was obtained and there the examiner opined it was less likely than not the Veteran's bipolar disorder/major depression was caused by or the result of the Veteran's exposure to contaminated water at Camp Lejeune, explaining the Veteran's high-risk factors such as family history and high stress. See March 4, 2021 C&P. The examiner cited to numerous medical articles and addressed the Veteran's medical history, available modeled water contamination levels at Camp Lejeune, toxicological data on Trichloroethylene, Tetrachloroethylene or Perchloroethylene, Benzene, and Vinyl Chloride along with studies on CLCW veterans and his CLCW exposure history, to support his opinion. The Board finds this opinion probative, as it provided a clear conclusion with supporting data, and reasoned medical explanations connecting the two. Stefl v. Nicholson, 21 Vet. App. 120, 124-25 (2007); Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (28 In June 2021 the Board remanded the instant matter for more development, to obtain identified private records. On July 1, 2021 the Veteran was sent a notice to release these records, however, the Veteran did not respond. See, July 1, 2021 Subsequent Development Letter. The Board finds that there has been substantial compliance with the prior Board remand directives, as the AOJ requested releases from the Veteran for the private treatment records, and obtained medical opinions regarding the raised theories of service connection. The Veteran did not submit any medical nexus evidence in support of his claim. While the Veteran may believe his acquired psychiatric disorders are related to an in-service injury, event, or disease, he is not competent to provide a nexus opinion in this case. This issue is also medically complex, as it required specialized medical knowledge and the Veteran has not shown he has the requisite training or experience. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Consequently, the Board gives more probative weight to the competent medical evidence. As the preponderance of the evidence is against the claim for service connection for an acquired psychiatric disorder, to include bipolar disorder, and/or major depressive disorder, the benefit of the doubt doctrine is not for application, and the Veteran's claim must be denied. See 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102, 4.3. LAURA E. COLLINS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Brewer, 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.