Citation Nr: 21073945 Decision Date: 12/13/21 Archive Date: 12/13/21 DOCKET NO. 18-28 793 DATE: December 13, 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 PTSD. 2. The Veteran's acquired psychiatric disorder, diagnosed as somatic symptom disorder and alcohol use disorder, did not begin during active service, or is otherwise related to an in-service injury, event, or disease. 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, 1131. 38 C.F.R. §§ 3.303, 3.304. REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran served on active duty from July 1986 to July 1989. He also served on active duty from March 1997 to March 1998, but that term of service was terminated with the issuance of an Other Than Honorable discharge. As such, VA compensation benefits based on this second term of service cannot be awarded. 38 C.F.R. § 3.12. In May 2019, the Veteran testified at a hearing before a Veterans Law Judge (VLJ) who is no longer with the Board. Given such, in an August 2021 notification letter, the Veteran was informed that the VLJ who conducted the May 2019 Board hearing is no longer with the Board and the Veteran has the right to another Board hearing. However, by not responding to the August 2021 notification letter within 30 days, the Veteran is deemed to waive his right to another Board hearing. In September 2019, the Board remanded this claim for further development. Service Connection Generally, to establish service connection 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." Davidson v. Shinseki, 581 F.3d 1313, 1315-16 (Fed. Cir. 2009); Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may also be granted for any injury or disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease or injury was incurred in service. 38 C.F.R. § 3.303(d). 1. Entitlement to service connection for PTSD There are particular requirements for establishing service connection for PTSD in 38 C.F.R. § 3.304(f) that are separate from those for establishing service connection generally. Arzio v. Shinseki, 602 F.3d 1343, 1347 (Fed. Cir. 2010). Service connection for PTSD requires: medical evidence diagnosing the condition in accordance with 38 C.F.R. § 4.125(a); a link, established by medical evidence, between current symptoms and an in-service stressor; and credible supporting evidence that the claimed in-service stressor occurred. 38 C.F.R. § 3.304(f). The PTSD diagnosis must be made in accordance with the criteria of the criteria of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). See 38 C.F.R. § 4.125(a). VA is required to give due consideration to all pertinent medical and lay evidence in evaluating a claim for disability benefits. 38 U.S.C. § 1154(a). Lay evidence can be competent and sufficient to establish a diagnosis of a condition when (1) a layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). After a review of the record, the Board finds that the most probative of record is against a finding that the Veteran has a current diagnosis of PTSD, and as such he does not meet the standards for service connection as the preponderance of the evidence supports a finding that there is no medical diagnosis of PTSD. The Veteran's STRs are silent for complaints of, treatment for, or a diagnosis of, PTSD. Prior to the period on appeal, the Veteran was diagnosed with PTSD under DSM-IV in an October 2012 VA treatment evaluation. Several VA treatment records document an assessment of PTSD based on the Veteran's reported diagnosis and an earlier diagnosis initially made in October 2012 under DSM-IV. An April 2019 VA treatment record specifically documents that the Veteran reported that he was previously diagnosed with PTSD. See April 2019 CAPRI. At the May 2019 Board hearing before a VLJ no longer with the Board, the Veteran narrowed down his alleged stressors to two. The first was that his best friend, a fellow sailor on ship, was killed in a car crash. While the Veteran was not with his friend at the time of the accident the friend's damaged car was displayed for 30 days where their ship was docked so that the sailors could absorb a lesson about drinking and driving. The Veteran also reported escorting the body of his friend home. The second was an assertion that he witnessed two fellow sailors be burned in a fire aboard ship and the Veteran saw their bodies being brought up on deck. In a March 2021 memorandum, the RO verified both of the Veteran's stressors that he verified to during the May 2019 Board hearing. On a June 2021 VA examination, the examiner found that the Veteran did not meet the criteria for a diagnosis of PTSD in accordance with DSM-5 criteria. The examiner concluded that the Veteran's description of the two stressors used for determination of criterion A did not meet the level of intensity and/or severity required for a diagnosis of PTSD. The examiner also noted that additional criteria of PTSD were also not met. The examiner then concluded that the criterion of persistent avoidance of stimuli associated with traumatic event, duration of the disturbance pertaining to other criteria, and the criteria pertaining to causation of significant impairment in social, occupational, or other important areas of functioning were not met. The initial threshold matter that must be addressed here (as in any claim seeking service connection) is whether there is competent evidence that the Veteran currently has (or during the pendency of the claim has had) the disability for which service connection is sought, i.e., a clinical diagnosis of PTSD. See 38 U.S.C. § 1110; see also Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992); McClain v. Nicholson, 21 Vet. App. 319 (2007). As noted above, the October 2012 diagnosis was made under the outdated DSM-IV. The Board does note that several VA treatment records during the period on appeal assessed the Veteran with PTSD, however, these assessments were made based on the Veteran's reports of a diagnosis and based on the October 2012 provider's diagnosis. The evidence does not show that the Veteran has, or at any time during the pendency of the instant claim has had, a diagnosis of PTSD in accordance with DSM-5 provisions by a medical professional competent to diagnose mental disorders. The Board notes the Veteran's statements contending he has PTSD. While he is competent to describe lay discernible psychiatric symptoms, he is not competent to establish by his own opinion that the symptoms he has observed reflect an underlying diagnosis of PTSD. The diagnosis of a PTSD is a medical question beyond the scope of general knowledge and incapable or resolution by lay observation; it requires medical training/expertise. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). The Veteran has not submitted any competent (medical, opinion or treatise) evidence showing he does have a diagnosis of PTSD in accordance with DSM-5. The Board notes that the conclusion of the June 2021 VA examiner was made by a medical professional who is competent to provide it, and that his opinion is probative and persuasive evidence weighing against a finding that the Veteran has a diagnosis of PTSD in accordance with the criteria in the governing regulation. As there is no adequate competent evidence to the contrary, it is persuasive. In the absence of proof of a current diagnosis of PTSD, there is no valid claim of service connection for such disability. See Brammer v. Derwinski, 3 Vet. App. at 225; see also Gilpin v. West, 155 F.3d 1353 (Fed. Cir. 1998), cert. denied, 526 U.S. 1144 (1999). The preponderance of the evidence is against this claim. The appeal in this matter must be denied. Gilbert v. Derwinski, 1 Vet. App. at 55. (The Veteran is advised that future evidence that he has a diagnosis of PTSD in accordance with DSM-V may present a basis for reopening this claim.) 2. Entitlement to service connection for an acquired psychiatric disorder other than PTSD. The Veteran contends that he has an acquired psychiatric disorder other than PTSD that is related to service. He has further contended that the disorder is related to the in-service incidents discussed above. As also discussed above, the RO has verified these incidents. However, the Board notes that the Veteran's STRs are silent for complaints of, treatment for, or a diagnosis of an acquired psychiatric disorder. Multiple VA treatment records as well as a June 2021 VA examination report have documented the Veteran's treatment and diagnosis of alcohol dependence. However, service connection may not generally be granted for alcohol or drug abuse. See 38 U.S.C. §§ 105, 1110; 38 C.F.R. §§ 3.1(n), 3.301(c) (2020); see also VAOPGPREC 2-97 (January 16, 1997). In a June 2021 VA examination, the Veteran was diagnosed with somatic symptom disorder. In the corresponding opinion, the examiner opined that the Veteran's acquired psychiatric disability was less likely than not related to service. The examiner concluded that for somatic symptom disorder, the many disorders associated with the Veteran's disorder were developed many years after service. The Board finds that service connection is not warranted for an acquired psychiatric disorder, to include somatic symptom disorder and alcohol use disorder. As noted, service treatment records do not show a psychiatric disorder was diagnosed in service. Further, the competent and probative June 2021 VA opinion does not demonstrate that the Veteran's an acquired psychiatric disorder is related to service. Further, the Veteran has not made any statements relating his somatic symptom disorder to service. Specifically, the Veteran did not discuss any somatic symptom disorder during his May 2019 Board hearing. The Veteran has not submitted any competent (medical, opinion or treatise) evidence relating his somatic symptom disorder to service. (Continued on the next page) The Board acknowledges an October 2012 diagnosis of major depressive disorder during a VA mental health evaluation. However, such diagnosis was under the outdated DSM-IV criteria. Moreover, the June 2021 VA examiner did not find such after a thorough mental health examination, and no such finding has been made during the period on appeal. As such, the Board finds the October 2012 finding of major depressive disorder to be of no probative value as to whether the Veteran has an acquired psychiatric disorder other than PTSD that is related to service. Thus, the preponderance of the evidence weighs against a nexus between the Veteran's current acquired psychiatric disorder other than PTSD and military service. There is no doubt to be resolved. See Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Service connection for an acquired psychiatric disorder other than PTSD is denied. Arif Syed Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Hammad Rasul, 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.