Citation Nr: 21068980 Decision Date: 11/17/21 Archive Date: 11/17/21 DOCKET NO. 15-42 562 DATE: November 17, 2021 ORDER Entitlement to service connection for an acquired psychiatric disorder, other than posttraumatic stress disorder (PTSD) and to include depressive disorder, is denied. FINDING OF FACT An acquired psychiatric disorder, other than PTSD and to include depressive disorder, did not manifest during service and has not been shown to be related to service. CONCLUSION OF LAW The criteria for service connection for an acquired psychiatric disorder, other than PTSD and to include depressive disorder, have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from February 1986 to January 1989. This matter is before the Board of Veterans' Appeals (Board) on appeal of a July 2015 rating decision of the Muskogee, Oklahoma, Regional Office (RO) of the Department of Veterans Affairs (VA). The Veteran appeared at a hearing before the undersigned Veterans Law Judge in November 2018. In March 2019, October 2020, and in May 2021, the Board remanded the case for further development. Stegall v. West, 11 Vet. App. 268, 271 (1998). Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. "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" the so-called "nexus" requirement." Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2010) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). The Veteran contends that he has an acquired psychiatric disorder that was caused by his active duty service. He has noted being irritable with his family, having trouble sleeping and having trouble driving. At his November 2018 hearing, the Veteran reported that he witnessed seeing a female service member getting run over by a truck. Service treatment records are silent for any acquired psychiatric disorder, to include depressive disorder. The Board notes that when no preexisting injury or disease is noted upon entry into service, the Veteran is presumed to have been sound upon entry. 38 U.S.C. § 1111; 38 C.F.R. § 3.304(b); see also Wagner v. Principi, 370 F.3d 1089, 1096 (Fed. Cir. 2004); Horn v. Shinseki, 25 Vet. App. 231, 234 (2012). A July 2013 VA treatment record shows an assessment of mood disorder and an April 2015 VA treatment record shows an assessment of depressive disorder. The Veteran was afforded a VA examination in December 2019. A diagnosis of unspecified depressive disorder was provided. The VA examiner noted that the Veteran had occasional insomnia, nightmares and intrusive thoughts which may be triggered if he was driving. He noted witnessing a motor vehicle accident while in service in which a woman died. The VA examiner opined the Veteran's claimed condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The VA examiner noted a review of the Veteran's claims file, to include indicating that the Veteran's entrance and discharge medical examinations were not remarkable for mental illness. The VA examiner stated that the Veteran's current diagnosis met the DSM criteria, but that there was no evidence that it was related to the Veteran's military service. The VA examiner also stated that the Veteran had preexisting depression with a suicide attempt at the age of 17, and that his continued depression had not progressed beyond that level of severity. As it was unclear whether the VA examiner believed that the Veteran had an acquired psychiatric disorder which preexisted his service, the Board remanded the issue in October 2020. The Veteran was afforded a VA examination in March 2021. A diagnosis of moderate stimulant use disorder-amphetamines was provided. It was noted that the Veteran experienced depressed mood, anxiety, chronic sleep impairment, mild memory loss, and disturbances of motivation and mood. The VA examiner opined that the claimed condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The VA examiner also stated that the Veteran's current use of both marijuana on a daily basis and regular use of methamphetamines made it impossible for the examiner to distinguish symptoms of depression from the substance abuse. The VA examiner opined that the claimed condition, which clearly and unmistakably existed prior to service, was clearly and unmistakably not aggravated beyond its natural progression by an in-service injury, event, or illness and stated that the Veteran's mental health history prior to the military did not suggest a history of depression that required treatment. The Veteran reported one episode of suicidal thoughts that was situational and not ongoing. The Board again remanded the issue in May 2021, noting that an accurate assessment of the Veteran's depression symptoms had not been obtained and that it remained unclear as to whether the Veteran had a diagnosis of an acquired psychiatric disorder which preexisted his service. The Veteran was afforded a VA examination in June 2021. A diagnosis of moderate stimulant use disorder-amphetamine was provided. The VA examiner opined that the claimed condition of "psychiatric disorder" was less likely than not incurred in or caused by the claimed in-service injury, event or illness. Service treatment records were silent for any complaints, diagnosis, or treatment of psychiatric issues. The VA examiner stated that regarding the Veteran's claimed condition of mood disorder, there was no diagnosis because there were no findings, signs, and/or symptoms to support a diagnosis. For the Veteran's claimed depressive disorder, there was no diagnosis because there were no findings, signs, and/or symptoms to support a diagnosis. The VA examiner also stated that the Veteran's use of methamphetamines started many years after military service and was not service connected. It was noted that the medical entrance examination was silent for any mental health issues prior to entering the military, that the military medical records were silent for any mental health issues while serving in the military, and that the military medical separation examination was silent for any mental health concerns at the time of discharge. Additionally, when asked about any mental health treatment prior to military service, the Veteran stated that he did not have mental health issues, diagnosis, or treatment prior to military service. Therefore, there was no psychiatric disorder that was service connected. Based on a review of the entire record, the Board concludes that service connection is not warranted. The June 2021 VA examiner indicated there was no preexisting condition of a mental disorder. Therefore, the claim becomes one of direct service connection. In this case, the evidence of record shows that there is no medical opinion linking the Veteran's current mental disorders to service. See Prejean v. West, 13 Vet. App. 444, 448-49 (2000). In rendering the opinion, the VA examiner reviewed the claims file, examined the Veteran, and provided a rationale that considered the Veteran's in-service medical records, post-service medical records, and self-reported history. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 302-04 (2008). The Board is to weigh the evidence, and it finds the VA examiner's opinions to be the most probative. Further, there is no competent medical opinion to the contrary. To the extent that the Veteran himself believes that his current disability is connected to an in-service incident, as a lay person, he has not shown that he has specialized training sufficient to render such an opinion as to the etiology of psychiatric disorders. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). In this regard, mental health disorders require medical testing to diagnose and can arise from many different causes, thereby requiring medical expertise to determine the etiology. Accordingly, his opinion as to the etiology of the disorder is not competent medical evidence. As the preponderance of the evidence is against the claim of service connection for an acquired psychiatric disorder, other than PTSD and to include depressive disorder, the benefit of the doubt doctrine is not applicable in the instant appeal, and the claim is denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. A. C. MACKENZIE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Evans, A-L 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.