Citation Nr: 21068698 Decision Date: 11/12/21 Archive Date: 11/12/21 DOCKET NO. 15-04 871 DATE: November 12, 2021 ORDER Service connection for an acquired psychiatric disorder is denied. FINDINGS OF FACT 1. The Veteran had active duty from March to July 1976 and March to April 1979, and National Guard service from November 1977 to March 1983 and August 1983 to August 1990, to include active duty from March to July 1976, July to August 1987, and July 1988; he has been in receipt of total disability based on unemployability (TDIU) since December 2015 and has subsequently been rendered incompetent. 2. The Veteran reported psychiatric symptoms during periods of inactive duty for training (INADCTURA); however, an acquired psychiatric disorder, diagnosed as schizophrenia, anxiety, and depression, is not causally or etiologically related to service. CONCLUSION OF LAW An acquired psychiatric disorder was not incurred in service. 38 U.S.C. §§ 1101, 1110, 1112, 1131, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303(a), 3.309, 3.310, 3.317 (2021). REASONS AND BASES FOR FINDINGS AND CONCLUSION As a procedural matter, the Board reopened the claim of service connection for an acquired psychiatric disorder in 2019 based on the receipt of new and material evidence and remanded the claim for additional development. These actions stem the basis for the current appeal. Service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus using a three-element test: (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 in or aggravated by service. See 38 C.F.R. §§ 3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). In addition to the laws and regulations outlined above, active military, naval, or air service includes any period of active duty for training (ACDUTRA) during which the individual concerned was disabled from a disease or injury incurred or aggravated in the line of duty, and any period of INACDUTRA during which the individual concerned was disabled from an injury incurred or aggravated in the line of duty. 38 U.S.C. § 101(21) and (24); 38 C.F.R. § 3.6(a). ACDUTRA is defined as full-time duty in the Armed Forces performed by Reserves for training purposes, and includes full-time duty performed by members of the National Guard of any State. 38 U.S.C. § 101(22); 38 C.F.R. § 3.6(c)(1). Thus, service connection may be granted for a disability resulting from disease or injury incurred or aggravated while performing ACDUTRA or from an injury incurred or aggravated while performing INACDUTRA. 38 U.S.C. §§ 101(24), 106, 1110, 1131. As to a current disorder, the Veteran has been diagnosed with schizophrenia, depression, and anxiety. Therefore, the first element of service connection is met. As to an in-service incurrence, in a November 1984 clinical record, the Veteran stated that his first psychiatric treatment was in 1987. In a November 1993 clinical record, he reported having symptoms of depression and hallucinations since service. Further, in a December 2002 statement, he explained that he began hearing voices in 1988 while in the National Guard. In a May 2006 statement, the Veteran stated that he began hearing voices in 1987; however, at a March 2011 Board hearing, he reported that he began receiving treatment for schizophrenia in 1981 or 1982. Further, in an August 2015 clinical record, he first stated that he initially began having mental health difficulties in 1987 but then later in the interview said that they began in 1976 while on leave from the Army. Service treatment records (STRs) reflect that in a December 1979 periodic examination, the Veteran marked that he experienced nervous trouble. Further, in a March 1988 periodic examination, he marked that he experienced depression and excessive worry as well as nervous trouble. In addition, in a July 1989 periodic examination, he marked that he experienced nervous trouble. However, STRs showed that the Veteran was not on active duty at the time that he reported experiencing psychiatric symptoms. To the extent that the Veteran asserts that an acquired psychiatric disorder began during active duty, he has submitted medical evidence in support of his claim. Specifically, in an August 2018 clinical record, the clinician opined that an acquired psychiatric disorder began in service. She reasoned that records showed that the Veteran was hospitalized in 1985 while in service and that he had been receiving outpatient treatment since 1987. Further, in a December 2019 clinical record, the clinician opined that an acquired psychiatric disorder began in service. While she acknowledged that scientific consensus showed that genetic and biological factors are likely a cause of schizophrenia, she reasoned that schizophrenia typically presented in males with first time psychotic breaks in late adolescence or early 20s. As the Veteran was first hospitalized in 1987, a year after leaving service, this was consistent with age of onset. Further, she explained that he reported that symptoms of paranoia and anxiety began in service. She concluded that the worsening of symptoms during stressors, such as would be present in military training, is consistent with known aggravators of schizophrenia. However, evidence has also been submitted weighing against the claim. Specifically, in a January 2016 VA examination, the examiner opined that an acquired psychiatric disorder was less likely than not incurred in service. He reasoned that the Veteran reported that his mental health problems manifested well after service and that there was no relationship between his symptoms and service. Further, in a December 2019 VA examination, the examiner opined that an acquired psychiatric disorder was less likely than not incurred in service. She reasoned that Veteran did not seek mental health treatment in service and that available records showed adequate job performance in service. Further, while he first reported seeking psychiatric care in 1987, the first documented report was in 1997. In addition, in a March 2020 VA opinion, the clinician opined that an acquired psychiatric disorder was less likely than not incurred in service. She reasoned that the STRs were absent of psychiatric complaints or behavioral concerns. Further, she explained that clinical records were absent of a 1987 hospitalization and that the first documented psychiatric treatment was seven years after separation. Based on the above, the weight of the medical evidence does not support that an acquired psychiatric disorder was incurred in service. While the Veteran reported being hospitalized in 1987 while on active duty, STRs are absent of a record of a hospitalization on this date or any other time during active duty. Further, all reports of psychiatric symptoms occurred during periods of INACDUTRA. In addition, clinical records showed that the Veteran did not report psychiatric symptoms until 1994, six years after separation from active service. Therefore, the medical evidence does not support the claim of service connection. The Board has considered the Veteran's lay statements and testimony that an acquired psychiatric disorder began in service. While he is competent to report symptoms because this requires only personal knowledge as it comes to him through his senses, he is not competent to offer an etiology of this disorder due to the medical complexity of the matters involved. Such competent evidence has been provided by the service records, clinical evidence, and examinations obtained and associated with the claims file. Here, the Board attaches greater probative weight to the clinical findings than to his statements. In light of the above, the preponderance of the evidence is against the claim and there is no doubt to be otherwise resolved. As such, the appeal is denied. Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board's consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). L. HOWELL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Ragofsky, 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.