Citation Nr: 21071912 Decision Date: 12/01/21 Archive Date: 12/01/21 DOCKET NO. 19-03 257A DATE: December 1, 2021 ORDER Entitlement to service connection for a respiratory disorder is denied. Entitlement to service connection for an acquired psychiatric disability is granted. FINDINGS OF FACT 1. The preponderance of the evidence of record is against finding that the Veteran has had a respiratory disorder at any time during or approximate to the pendency of the claim. 2. Resolving reasonable doubt in the Veteran's favor, his acquired psychiatric disorder, diagnosed as an unspecified trauma- or stressor-related disorder is at least as likely as not related to insert in-service event. CONCLUSIONS OF LAW 1. The criteria for service connection for a respiratory disorder are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for an acquired psychiatric disorder, diagnosed as an unspecified trauma- or stressor-related disorder, are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from November 1981 to November 1984. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2016 rating decision of a VA Regional Office (RO). The Veteran's claims have a long procedural history. Most recently, the Veteran's claims were previously remanded by the Board in a July 2021 decision. The Board finds that the RO has substantially complied with the July 2021 Board remand directives. See Stegall v. West, 11 Vet. App. 268 (1998). While the Veteran has initially filed a claim for entitlement to service connection for PTSD, in light of Clemons v. Shinseki, 23 Vet. App. 1 (2009), the Board finds that it is appropriate to recharacterize the claim more broadly as one of entitlement to service connection for an acquired psychiatric disorder, to include PTSD. Service Connection 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). 1. Entitlement to service connection for a respiratory disorder The Veteran contends that he has a current respiratory disorder, claimed as COPD or asthma, that is related to documented wheezing experienced during service and reportedly related to an episode of pneumonia during service. 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. The Board concludes that the Veteran does not have a current diagnosis of a respiratory disorder, to include COPD and asthma, and has not had one at any time during the pendency of the claim or recent to the filing of the claim. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). The April 2020 VA examiner evaluated the Veteran and determined that, while the Veteran had a history of wheezing, he did not have any current complaints of wheezing or other respiratory issues and did not have a diagnosis of COPD or any other respiratory disorder. In September 2021, another VA examiner provided several opinions in response to a Board remand. The examiner concluded that there was clearly and unmistakably no current documented respiratory condition. As rationale, the examiner noted that the Veteran's February 2020 chest X-ray and pulmonary function tests were normal and service treatment records were negative for any diagnosis of pneumonia. The examiner also indicated that there were no diagnostic testing results noted in Dr. P.J.Y.'s letter that would support a diagnosis of a respiratory condition. The Board notes that the Veteran's December 2020 medical records list a past medical history of COPD, but there is no current evidence of any symptoms related to COPD. For example, in September 2016 and November 2019 treatment notes, the Veteran denied wheezing, shortness of breath, or cough. Furthermore, February 2020 chest x-rays showed no acute cardiopulmonary abnormalities and pulmonary function tests were within normal limits. While private practitioner Dr. P.J.Y. stated in a November 2015 letter that the Veteran had COPD, there is no indication that A.B. performed a physical examination or any diagnostic tests to confirm the presence of COPD or other respiratory disorder. Instead, the statement appears to be based on the Veteran's self-reported medical history, which is inconsistent with VA treatment records that show no respiratory symptoms. Consequently, the Board gives more probative weight to the April 2020 and September 20201 VA examiners' findings. While the Veteran believes he has a current diagnosis of COPD, he is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education and the ability to interpret complicated diagnostic medical testing. 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 including the April 2020 and September 2021 VA examinations. 2. Entitlement to service connection for an acquired psychiatric disability The Veteran contends that his acquired psychiatric disability is a result of multiple stressors experienced while on active-duty service. The Board concludes that the Veteran has a current disability that is related to various stressors experienced during his active-duty service. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). November 2015 treatment notes show the Veteran has a current diagnosis of an unspecified trauma and stressor related disorder. Thus, the question becomes whether the current disability is related to service. On this question there are probative opinions in favor of and against the claim. The evidence in favor of the claim includes a September 2021 VA examiner's opinion that the Veteran's unspecified trauma- and stressor-related disorder is related to an in-service injury, event, or disease. As rationale, the examiner noted there is evidence in the claim's file to support the in-service stressor that a soldier died in service by suicide while the Veteran was in service as claimed by the Veteran. The examiner further noted that the stressor of witnessing a Goer flip over and kill a person is consistent with the circumstances and hardships of the Veteran's MOS while stationed in Germany. Further, the examiner noted that the Veteran's alleged stressors have been consistently reported to providers. The examiner also noted that while it would not count as a Criterion A stressor for the purposes of a PTSD diagnosis, the Veteran's feelings of mistreatment and discrimination due to his race during service would count as a stressor that could cause an unspecified trauma- and stressor-related disorder. The examiner also opined that the Veteran's alcohol use disorder and tobacco use disorder began during his military service. The Board notes that the September 2021 VA examiner also opined that the Veteran's other specified depressive disorder and adjustment disorder with mixed anxiety and depressed mood were less likely than not related to or caused by an in-service injury, event, or disease, but were instead related to unemployment-related issues occurring in 2016, decades after his active-duty service. In November 2015, Dr. P.J.Y. provided a private medical opinion indicating that the Veteran had symptoms of PTSD that would support a referral to an appropriate specialist. Dr. P.J.Y. opined that the Veteran's PTSD is far more likely than not directly and causally related to his military service. The Board finds this opinion less probative because it does not provide a conclusive diagnosis of an acquired psychiatric condition. The evidence against the claim includes prior VA medical opinions opining that the Veteran's conditions either pre-existed service or were less likely than not related to an inservice injury, event, or occurrence. Upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran's current acquired psychiatric disorder, diagnosed as an unspecified trauma- or stressor-related disorder, service. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for an acquired psychiatric disorder is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. L. M. BARNARD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Taylor, Matthew David 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.