Citation Nr: 21070371 Decision Date: 11/23/21 Archive Date: 11/23/21 DOCKET NO. 17-27 967 DATE: November 23, 2021 ORDER Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD), is denied. FINDINGS OF FACT 1. The Veteran does not have a current diagnosis of PTSD per requirements of DSM-V. 2. The Veteran's acquired psychiatric disorders did not have their onset in, nor were they caused by or otherwise due to his military service. CONCLUSION OF LAW The criteria for service connection for an acquired psychiatric disorder, to include PTSD, have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 4.125. REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran served on active duty with the U.S. Air Force from May 1971 to June 1979. He provided testimony at a Board hearing in December 2018 before the undersigned Veterans Law Judge. A transcript is associated with the record. 1. Entitlement to service connection for an acquired psychiatric disorder, to include PTSD. The Veteran contends that he was arrested during service and spent several months in jail. During his sentence, he was traumatized and constantly feared for his life. Specifically, he reported being assaulted by another inmate with a hot iron and having to fight to protect himself. 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). The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. VA issued a rule update which updated 38 C.F.R. § 4.125 to use of DSM-V, but only for claims pending before the AOJ on or after August 4, 2014. See 80 Fed. Reg. 14,308 (Mar. 19, 2015). As the current claim was pending before the AOJ on that date, the DSM-V is appropriate. PTSD The Board finds that the Veteran does not have a DSM-V diagnosis of PTSD during the appeal period. The March 2020 VA examiner evaluated the Veteran and specifically found that the Veteran did not have a DSM-V diagnosis of PTSD, but did note diagnoses of unspecified depressive disorder and unspecified anxiety disorder. The examiner noted his reports of traumatic events during his incarceration, which may have met criterion A, but ultimately found that he did endorse any of the other, required PTSD-related symptoms. Treatment records show both negative and positive screenings for PTSD throughout the appeal period. He attended therapy and was also given medication to manage his symptoms. A diagnosis of PTSD was indicated in a March 2017 VA psychiatry note. Although the private practitioner W.R. stated in a November 2015 letter that the Veteran had PTSD, (as well as depressive disorder, anxiety, and insomnia,) there is no indication that W.R. conducted a full evaluation as it related to the DSM-V, which delineates the required criteria for a diagnosis of PTSD. Based on the foregoing, the preponderance of the evidence is against the finding that the Veteran has a current diagnosis of PTSD. Instead, a diagnosis appears to be solely based on the Veteran's report of symptoms, which is inconsistent with VA treatment records that show ongoing diagnoses and symptoms related to anxiety and depression, but no diagnosis of PTSD based on DSM-V. Consequently, the Board gives more probative weight to the March 2020 VA examiner's findings. Although the Veteran believes he has a current diagnosis of PTSD, he is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education. 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. Acquired Psychiatric Disorder The Board concludes that although the Veteran has current diagnoses of unspecified anxiety and unspecified depressive disorder, and evidence shows that he experienced trauma during his incarceration, the preponderance of the evidence weighs against finding that the Veteran's diagnosis of psychiatric disorders began during service or are otherwise related to an in-service injury, event, or disease. In a March 2014 statement in support his claim, the Veteran indicated he was traumatized from his time in prison as he constantly feared for his life. He also noted that his family abandoned him at this time. During the September 2018 hearing, the Veteran indicated that he first began experiencing symptoms immediately after service. He and wife noticed he had trouble sleeping and began drinking. He felt that his psychiatric symptoms impacted his family life and marriage. He believes it led to feelings of depression and an increase in drinking alcohol. He experienced nightmares and flashbacks to the bullying he suffered in prison. He did not seek any treatment until the late-1980s VA treatment records show the Veteran was first diagnosed with depression in February 2009, approximately 30 years after separation from service. He was seen in December 2008 to establish primary care with VA physician and reported no history of mental health concerns. Specifically, the record noted that he did not endorse depression, bipolar disorder, anxiety disorder, or PTSD. Further, the March 2020 VA examiner opined that the Veteran's anxiety and depressive disorders were not at least as likely as not related to an in-service injury, event, or disease, including the assault and bullying he experienced while in prison. The rationale was that both conditions appeared to manifest after his rather significant alcohol and drug use history. Moreover, the Veteran did not report the stressor from his incarceration during the examination. As such, the examiner concluded that it was not present. The examiner's opinion is probative, because it is based on an accurate medical history and provides an explanation that contains clear conclusions and supporting data. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). The Veteran's ex-wife submitted a statement in August 2017 confirming the Veteran's statement regarding the attack he sustained during his incarceration and the ongoing issue he had with another inmate. When he returned home, he was often unable to sleep and when he did, he would awake from nightmares about the bullying in prison. The Veteran began drinking, which led to arguments between the two. Due to lack of sleep, his work performance also began to suffer. The Veteran and his wife believe his psychiatric disorder is related to an in-service injury, event, or disease. And they are certainly competent to describe the Veteran's post-service symptoms. However, neither the Veteran nor his wife are competent to provide a nexus opinion regarding this issue. The issue is medically complex, as it requires knowledge of interpretation of complicated diagnostic medical testing. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Therefore, it is outside the competence of the Veteran and his examination-wife because the record does not show that they have the medical training or credentials to make such a determination. Id.; see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). Consequently, the Board gives more probative weight to the treatment records which showed the onset of his condition and the March 2020 VA examination which did not indicate a nexus between his diagnoses and service. As such service connection for a psychiatric disorder, to include PTSD, is not warranted. H.M. WALKER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Price, Esq. 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.