Citation Nr: A21017372 Decision Date: 10/27/21 Archive Date: 10/27/21 DOCKET NO. 190320-4999 DATE: October 27, 2021 ORDER Entitlement to service connection for an acquired psychiatric disorder, diagnosed as adjustment disorder with depressive mood and depressive disorder, secondary to service-connected disabilities on a causation basis, is granted. FINDING OF FACT The Veteran's acquired psychiatric disorder is caused by service-connected disabilities. CONCLUSION OF LAW The criteria for service connection for an acquired psychiatric disorder diagnosed as adjustment disorder with depressive mood and depressive disorder, secondary to service-connected disabilities, on a causation basis, have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from April 1972 to April 1978. He also served in the National Guard from August 1978 to June 1999. This appeal to the Board of Veterans' Appeals (Board) arose from a July 2001 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) which, inter alia, denied service connection for major depression claimed as nervous condition. In August 2006, June 2008, and January 2015, the Board remanded the matter for further evidentiary development. In January 2018, the Veteran elected the modernized review system. 38 C.F.R. § 19.2(d)). The Veteran selected the Higher-Level Review (HLR) lane when he opted into the Appeals Modernization Act (AMA) review system by submitting a Rapid Appeals Modernization Program (RAMP) election form. 38 U.S.C. § 5108; 38 C.F.R. §§ 3.156(d), 3.2501. During HLR, a development error was discovered, and the case was assigned to Supplemental Review for additional development. In a January 2019 AMA rating decision, the RO denied entitlement to service connection for posttraumatic stress disorder (PTSD) also claim as acquired psychiatric disorder. In March 2019, the Veteran disagreed with the RO's determination and submitted a VA Form 10182 (Decision Review Request: Board Appeal (Notice of Disagreement) (NOD)) and elected a hearing with a Veterans Law Judge (VLJ). In April 2021 the Veteran testified during a virtual Board hearing before the undersigned. A transcript of the hearing is associated with the record. Acquired Psychiatric Disorder Service connection will be granted if the evidence demonstrates that current disability resulted from an injury or disease incurred in active military service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Establishing service connection generally requires competent evidence of three things: (1) current disability; (2) in-service incurrence of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018). Consistent with this framework, service connection is warranted for a disease first diagnosed after discharge when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Service connection may also be established on a secondary basis for a disability which is proximately due to, the result of, or aggravated by, service-connected disease or injury. 38 C.F.R. § 3.310 (a), (b). In the January 2019 rating decision, the RO found that the Veteran has a current diagnosis of adjustment disorder with depressive mood and depressive disorder. The Board is bound by these favorable findings. 38 U.S.C. § 5104A. The Veteran contends that his acquired psychiatric disorder is due to his military service. In an alternative theory, he contends that his acquired psychiatric disorder is secondary to service-connected disabilities. For the following reasons, the Board finds that service connection for an acquired psychiatric disorder, diagnosed as adjustment disorder with depressive mood, and depressive disorder is warranted. In a November 2001 letter, private doctor R.A. opined that the Veteran's depression is more likely than not secondary to service-connected disabilities. Dr. R.A. explained that the Veteran suffers from several service-connected disabilities that include laceration of the toes, right ankle, and degenerative disc disease of the lumbar spine. Dr. R.A. further explained that after the Veteran's retirement from active service he has been affected by constant pain in his back, right knee, feet, and ankles with the inability to obtain a job, since he cannot fulfill the obligations required. Dr. R.A. noted that the Veteran's physical problems do not allow him to fulfill the physical requirements of a job, and this has led to his depression. Dr. R.A. further noted that once one establishes the connection of the physical disabilities with the years in the service, we need to emphasize that the depression that he has at present is secondary to his physical problems. As Dr. R.A. explained the reasons for his conclusion based on an accurate characterization of the evidence, his opinion is entitled to substantial probative weight. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008) (most of the probative value of a medical opinion comes from its reasoning). There is no conflicting medical opinion in the evidence of record. The Board finds that the private nexus opinion indicating that the Veteran's acquired psychiatric disorder is caused by his service-connected right foot, right ankle, and back disabilities, provides a sufficient basis to grant service connection for an acquired psychiatric disorder. Thus, service connection for an acquired psychiatric disorder, diagnosed as adjustment disorder with depressive mood and depressive disorder, secondary to service-connected disabilities is warranted on a causation basis. As service connection is being granted on a secondary basis, consideration of other theories of entitlement is unnecessary. There are particular requirements for establishing service connection for PTSD in 38 C.F.R. § 3.304(f) that are separate from those for establishing service connection generally. Arzio v. Shinseki, 602 F.3d 1343, 1347 (Fed. Cir. 2010). The Veteran does not appear to have a diagnosis of PTSD consistent with 38 C.F.R. § 4.125 as required by 38 C.F.R. § 3.304(f), which would preclude service connection for PTSD. In any event, although the issue on appeal has previously been characterized as including PTSD, given that there is no indication that there are psychiatric symptoms clearly attributable to a psychiatric disorder other than general adjustment disorder with depressive mood and depressive disorder, for which service connection is being granted, further discussion of PTSD or any other psychiatric disorder is unnecessary. See Howell v. Nicholson, 19 Vet. App. 535, 540 (2006) (explaining that the Secretary must apply the benefit of the doubt doctrine and attribute the inseparable effects of a disability to the claimant's service-connected disability); Mittleider v. West, 11 Vet. App. 181, 182 (1998) (when it is not possible to separate the effects of the service-connected and non-service-connected disabilities, the benefit of the doubt doctrine described in 38 C.F.R. § 3.102 dictates that such signs and symptoms be attributed to the service-connected disability or disabilities); see also Amberman v. Shinseki, 570 F.3d 1377, 1381 (Fed. Cir. 2009) (considering the possibility that bipolar disorder and PTSD did not constitute the same disability, but rejecting this argument based on the facts of that case). Jenna Brant Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R. Walker, 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.