Citation Nr: 21068816 Decision Date: 11/15/21 Archive Date: 11/15/21 DOCKET NO. 17-58 130 DATE: November 15, 2021 ORDER Service connection for a psychiatric disorder, specific phobia, is granted. FINDINGS OF FACT 1. Resolving all reasonable doubt in the Veteran's favor, his specific phobia disorder is at least as likely as not related to active service. 2. The Veteran does not have a diagnosis of PTSD based on a verified in-service stressor. CONCLUSION OF LAW The criteria for service connection for specific phobia disorder have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran served in the Navy Reserves with periods of active duty for training (ACDUTRA) from June 1964 to July 1964, August 2, 1964, to August 14, 1964; and August 15, 1965 to August 27, 1965. He also served on active duty in the U.S. Navy from June 1966 to June 1968. This matter comes before the Board of Veterans' Appeals (Board) from February 2015 and May 2015 rating decisions of a Department of Veterans Affairs (VA) Regional Office (RO). In December 2020, the Veteran testified before the undersigned Veterans Law Judge at a virtual hearing. A transcript is of record. Service connection for specific phobia disorder is granted. While the RO has adjudicated two separate issues- service connection for PTSD and 'anxiety disorder related to exposure to small spaces with excessive heat.' However, the Board finds it appropriate to recharacterize the issue on appeal as entitlement to service connection for a psychiatric disorder. See Clemons v. Shinseki, 23 Vet. App. 1 (2009). The Veteran contends he has a psychiatric disorder, to include anxiety and PTSD, related to events that occurred military training in 1964 and 1965, a storm in 1965 and/or 1967, riots in 1968, and/or being in hot confined spaces throughout service. As an initial matter, the preliminary determination in any claim for veterans' benefits is whether the claimant is considered a "veteran" as defined under VA law. See Dingess v. Nicholson, 19 Vet. App. 473, 484 (2006). Special rules apply to National Guard and Reserve service. Service in the Reserves, even during period of Active Duty for Training (ACDUTRA) without more, will not suffice to give one "veteran" status. Donnellan v. Shinseki, 24 Vet. App. 167, 172 (2010). A veteran is "a person who served in the active military, naval, or air service, and who was discharged or released there from under conditions other than dishonorable." 38 U.S.C. § 101 (2); 38 C.F.R. § 3.1 (d). ACDUTRA) is, among other things, full-time duty in the Armed Forces performed by Reserves for training purposes or by members of the National Guard of any state. 38 U.S.C. § 101 (22); 38 C.F.R. § 3.6 (c)(1). Thus, in order to establish "veteran status" with respect to service in the Reserves or National Guard, and therefore eligibility for service connection, the record must establish that a claimant was disabled due to a disease or injury incurred or aggravated in the line of duty during a period of ACDUTRA, or that he or she was disabled from an injury incurred or aggravated in the line of duty during a period of INACDUTRA. See Mercado-Martinez, 11 Vet. App. at 419; Paulson v. Brown, 7 Vet. App. 466, 470 (1995); Biggins v. Derwinski, 1 Vet. App. 474, 478 (1991); see also 38 U.S.C. § 101 (24); 38 C.F.R. § 3.6 (a). Currently, service connection is not in effect for any disabilities incurred or aggravated in the line of duty during a period of ACDUTRA. Generally, service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 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 for PTSD requires: (1) medical evidence diagnosing PTSD; (2) credible supporting evidence that the claimed in-service stressor occurred; and (3) medical evidence of a link between current symptomatology and the claimed in-service stressor. 38 C.F.R. § 3.304 (f). If the evidence establishes that the veteran engaged in combat with the enemy and the claimed stressor is related to that combat, in the absence of clear and convincing evidence to the contrary and provided that the claimed stressor is consistent with the circumstances, conditions, or hardships of the veteran's service, the veteran's lay testimony alone may establish the occurrence of the claimed in-service stressor. If a stressor claimed by a veteran is related to the veteran's fear of hostile military or terrorist activity and a VA psychiatrist or psychologist, or a psychiatrist or psychologist with whom VA has contracted, confirms that the claimed stressor is adequate to support a diagnosis of PTSD and that the veteran's symptoms are related to the claimed stressor, in the absence of clear and convincing evidence to the contrary, and provided the claimed stressor is consistent with the places, types, and circumstances of the veteran's service, the veteran's lay testimony alone may establish the occurrence of the claimed in-service stressor. "Fear of hostile military or terrorist activity" means that a veteran experienced, witnessed, or was confronted with an event or circumstance that involved actual or threatened death or serious injury, or a threat to the physical integrity of the veteran or others, such as from an actual or potential improvised explosive device; vehicle-imbedded explosive device; incoming artillery, rocket, or mortar fire; grenade; small arms fire, including suspected sniper fire; or attack upon friendly military aircraft, and the veteran's response to the event or circumstance involved a psychological or psycho-physiological state of fear, helplessness, or horror. 38 C.F.R. § 3.304 (f)(3). If a veteran did not engage in combat with the enemy, or the claimed stressors are not related to combat or to "fear of hostile military or terrorist activity," then the veteran's testimony alone is not sufficient to establish the occurrence of the claimed stressors and his testimony must be corroborated by credible supporting evidence. Cohen v. Brown, 10 Vet. App. 128 (1997). Furthermore, service records must support, and not contradict, the claimant's testimony regarding non-combat stressors. Doran v. Brown, 6 Vet. App. 283 (1994). In rendering a decision on appeal, the Board must also analyze the credibility and probative value of the evidence, account for the evidence which it finds to be persuasive or unpersuasive and provide the reasons for its rejection of any material evidence favorable to the claimant. Gabrielson v. Brown, 7 Vet. App. 36, 39-40 (1994); Gilbert v. Derwinski, 1 Vet. App. 49, 57 (1990). Competency of evidence differs from weight and credibility. Competency is a legal concept determining whether testimony may be heard and considered by the trier of fact, while credibility is a factual determination going to the probative value of the evidence to be made after the evidence has been admitted. Rucker v. Brown, 10 Vet. App. 67, 74 (1997); Layno v. Brown, 6 Vet. App. 465, 469 (1994). When all the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the veteran prevailing in either event, or whether a preponderance of the evidence is against a claim, in which case, the claim is denied. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. The question of whether a veteran was exposed to a stressor in service is a factual one, and VA adjudicators are not bound to accept uncorroborated accounts of stressors or medical opinions based upon such accounts. Wood v. Derwinski, 1 Vet. App. 1991 (1991). Hence, whether a stressor was of sufficient gravity to cause or support a diagnosis of PTSD is a question of fact for medical professionals, and whether the evidence establishes the occurrence of stressors is a question of fact for adjudicators. The Veteran's military personnel records reflect he served on ACDUTRA while in the Navy Reserves from: June 1964 to July 1964; August 2, 1964, to August 14, 1964 ; and from August 15, 1965 to August 27, 1965. His enlisted classification for the first period of ACDUTRA was "SR' (seaman recruit); for the second it was 'FA' (firemans apprentice) and he served aboard the U.S.S. Fulton; and for the third, 'SN' seaman. The Veteran's Reserve records are silent for a psychiatric disorder. His November 1963 Reserve enlistment report of medical examination reflects a normal clinical psychiatric evaluation. Service treatment records from the Veteran's period of active duty are also silent for a psychiatric disorder. The Veteran denied frequent trouble sleeping, frequent or terrifying nightmares, depression or excessive worry, and nervous trouble of any sort on his June 1966 Report of Medical History. Reports of Medical Examination at entrance in June 1966, and upon separation in June 1968 reflect a normal clinical psychiatric evaluation. After service, private medical records from the Veteran's physician, A.A., M.D., reflect a provisional diagnosis of depression and 'heat intolerance.' See, e.g., August 2010 private treatment record. A January 2012 private treatment record notes the Veteran reported nightmares at night and restlessness. The file includes a PTSD disability benefits questionnaire (DBQ) completed in November 2014 by E.T., Ph.D., the Veteran's private psychologist. Dr. E.T. provided a diagnosis of 'chronic delayed PTSD.' She did not identify any specific in-service stressors on the DBQ. Along with the DBQ, Dr. E.T. submitted a copy of a psychosocial assessment conducted conjunction with the DBQ. This November 2014 psychosocial assessment shows the Veteran has had difficulty with sweating and feeling frightened in the past with almost daily intrusive and involuntary thoughts regarding his time in service. Dr. E.T. indicates being in any type of overheated environment or confined space can cause flashbacks and/or intrusive thoughts for the Veteran. Based on her clinical evaluation, the Veteran was diagnosed with 'chronic delayed PTSD.' Dr. E.T. opined that the Veteran's traumas in service are the nexus between his current symptoms and his military experience. She also noted the Veteran outlined several incidences wherein he was kept in close quarters, which caused him high anxiety. A December 2014 private treatment record shows the Veteran was diagnosed with PTSD related to his military training. A March 2015 personal statement and a March 2015 buddy statement from the Veteran's former fellow serviceman indicate the Veteran rode out a storm in February 1967. The statements indicate they were in the Bermuda Triangle and/or the Caribbean. In a March 2015 statement, the Veteran also reported being in Washington, D.C. during the April 1968 'race riots.' The Veteran also submitted several articles discussing the riots, including a Wikipedia article. In a November 2015 VA Form 21-0781, the Veteran reported having to undergo firefighting training from June 1964 to July 1964, which required going into confined spaces to put out fires. He also reported being aboard the U.S.S. Keller in August 1964 where he was temporarily assigned to the engine room, which also required him to go into confined spaces without ventilation. In an additional November 2015 VA Form 21-0781, the Veteran reported having to go through emergency drills while on the U.S.S. Fulton in August 1965. The Veteran reported having to do damage control procedures for firefighting, which required being in the interior passageway somewhere near the boiler with the ventilation turned off for hours. Another VA Form 21-0782 indicates that the Veteran reported going through a storm while aboard the U.S.S. Arcadia during which he thought the ship would sink and he would drown. He also reported being in Washington, D.C. during the April 1968 riots. The Veteran's November 2015 notice of disagreement indicates that he learned 'early on not to complain to anyone' and did his duty 'without complaining.' Another January 2017 PTSD DBQ completed by another one of the Veteran's private psychologists, E.P., Ph.D., reflects diagnoses of chronic PTSD and specific phobia. Dr. E.P. noted the Veteran is reactive to warm temperatures, which are triggers for an anxiety reaction or heat phobia. Dr. E.P. did not identify any specific in-service stressors. A July 2017 Defense Personnel Records Information Retrieval System (DPRIS) response indicates the U.S.S. Fulton 1965 command history, and the August 1965 deck logs were reviewed. In late February and March 1965, the records indicate that the U.S.S. Fulton was supporting submarines in the Caribbean. However, the August 1965 deck logs indicate the U.S.S. Fulton was moored in Connecticut through the end of August 1965. The event described by the Veteran was not recorded. An additional DPRIS response indicates the U.S.S. Arcadia 1967 command history and February 1967 deck logs were reviewed, and they indicate the U.S.S. Arcadia departed San Juan, Puerto Rico in February 1967; departed Key West, Florida in May 1967; and Mayport, Florida in October 1967. However, the ship history and deck logs do not record any storms, including the event described by the Veteran. Finally, a DPRIS response indicates the Naval History and Heritage Command, the custodian of Naval Ship histories, does not maintain a 1968 command history for the U.S.S. Arcadia. Records indicate the U.S.S. Arcadia was decommissioned in June 1968. The February 1968 deck logs indicate the U.S.S. Arcadia was moored in Rhode Island; however, a civil disturbance history record reflects rioting and looting were reported in Washington, D.C. in April 1968. The Veteran's presence at the riots could not be confirmed. A January 2019 VA treatment record reflects 'a diagnosis or provisional diagnosis or R/O of' PTSD. The Veteran testified before the undersigned at a hearing held in December 2020. He described participating in firefighter training while on ACDUTRA in 1964. He recalled that he was in a hot and smoke-filled bunker that he and the trainees had to find their way out of. Part of the training reportedly included use of tear gas and gas masks. The Veteran testified that he believes this was the start of his current condition. The Veteran also discussed his training aboard USS Fulton during his second period of ACDUTRA. He indicated that during a damage control drill, there was a simulated an attack of the ship being on fire. The Veteran reported that he several other trainees were put in an interior passageway without port holes or windows. They were locked in and had to stay there for hours. The Veteran recalled that this occurred in August and it was very hot and 'not a good experience' for him. The Veteran also described a third event that he believes contributed to his current condition, and asserted that all of these events had an effect on him. See December 2020 Board hearing transcript, pages 5-8. The Veteran also described having to paint in the bowels of the ship and going to the tropics on the U.S.S. Arcadia. He indicated his reaction to 'extreme conditions' did not start until later but has worsened over time. In January 2021, the Veteran submitted photos of the U.S.S. Fulton, the forward crew compartment of the U.S.S. Slater, the forward fire room of the U.S.S. Foss, servicemen putting out fires, and a vest. The Veteran also submitted an newspaper article discussing the conditions on Navy ships, including 120-degree bunkrooms. In a January 2021 correspondence Dr. E.P. provided diagnoses of PTSD and specific phobias. Dr. E.P. indicated the Veteran was originally seen in April 2016 for a history of anxiety attacks that dated from his experience in the Navy. Dr. E.P. indicated that the Veteran described being confined in small, hot spaces while performing duty on naval vessels. His symptoms include anxiety attacks and phobic-like responses; however, he did develop PTSD-like symptoms over time. While his secondary symptoms were PTSD-like, E.P. indicated that his primary problem was the development of a specific phobia associated with small, hot spaces where he was confined. After a review of the evidentiary record, the Board finds the preponderance of the evidence weighs in favor of entitlement to service connection for a psychiatric disorder, diagnosed as 'specific phobia,' which is related to the Veteran's active service and specifically his time spent in small, hot enclosed spaces while training and serving aboard various naval vessels. The evidence of record confirms that the Veteran served aboard various naval vessels. The Veteran is competent to report that while he was aboard these vessels, he was often in small, cramped spaces that were hot and humid. His testimony is generally credible, and the Board finds no evidence of record to discredit his general description of the events he experienced in service. Indeed, the Board observes that the Veteran did serve as a fireman apprentice during one of his ACDUTRA periods. Additionally, the competent medical evidence of record supports the Veteran's credible lay report of chronic phobia and other psychiatric symptoms related to his history of being confined to small, hot spaces in service. Dr. E.P. and Dr. E.T. both generally associate the Veteran's current psychiatric symptoms to being confined in small, hot spaces while performing duty on the naval vessels he served on. Dr. E.P.'s clinical findings in particular link the Veteran's currently diagnosed specific phobia disorder to such events during active military service. For this reason, the Board finds sufficient competent evidence to link the Veteran's current specific phobia disorder to military service. In contrast, the preponderance of the evidence weighs against entitlement to service connection for PTSD, specifically. The Veteran's reported stressors have not been corroborated by official service department records. Attempts to verify many of his reported stressors were not verified by DPRIS. Further, the Veteran's reported stressors of experiencing a storm at sea and seeing the aftermath of a race riot in Washington, D.C. are not independently capable of verification. Thus, any diagnosis of PTSD was not based on any verified in-service stressor and is not sufficient to warrant service connection. As none of the Veteran's reported stressors are based upon combat, fear of hostile military or terrorist activity, being a prisoner-of-war, or personal assault, and because PTSD based on these stressors was not diagnosed during service, the Veteran's lay evidence, alone, cannot establish their occurrences. 38 C.F.R. § 3.304 (f)(1)-(5). The Board acknowledges that a VA psychiatric examination has not been obtained but finds one is not warranted in this case. The Veteran's reported stressors are either insufficient to support a diagnosis of PTSD or unverifiable. The private treatment records showing diagnoses of PTSD are based upon various uncorroborated stressor events and lack sufficient rationale. The criteria of 38 C.F.R. § 3.304 (f) have not been met. In conclusion, the preponderance of the evidence weighs against entitlement to service connection for PTSD. Resolving all reasonable doubt in the Veteran's favor, service connection for a specific phobia disorder is granted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. D. JOHNSON Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M.Aoughsten, 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.