Citation Nr: 21074523 Decision Date: 12/15/21 Archive Date: 12/15/21 DOCKET NO. 16-32 732 DATE: December 15, 2021 ORDER Entitlement to service connection for posttraumatic stress disorder (PTSD) is granted. FINDING OF FACT 1. The Veteran had combat service in Southwest Asia. 2. The evidence is at least in relative equipoise as to whether the Veteran has a diagnosis of PTSD that is causally related to his combat stressors. CONCLUSION OF LAW The criteria for service connection for PTSD have been met. 38 U.S.C. §§ 1110, 1154(b), 5107(b); 38 C.F.R. §§ 3.303, 3.304. REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran served on active duty from September 1989 to May 2001, including service in Southwest Asia. As a result of his military service, the Veteran received the Combat Action Ribbon among other decorations. This matter comes before the Board of Veterans' Appeals (Board) from a January 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). This issue was previously remanded by the Board in May 2021 and has since been returned for further adjudication. Entitlement to service connection for PTSD is granted. The Veteran seeks entitlement to service connection for PTSD. The Board notes that the Veteran is already service connected for a psychiatric disorder other than PTSD, identified as persistent depressive disorder. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Establishing service connection generally requires competent medical or lay evidence of (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). 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). Satisfactory lay or other evidence that an injury or disease was incurred or aggravated in combat will be accepted as sufficient proof of service connection if the evidence is consistent with the circumstances, conditions or hardships of such service even though there is no official record of such incurrence or aggravation. 38 C.F.R. § 3.304(d); see also Collette v. Brown, 82 F.3d 389 (Fed. Cir. 1996) (under 38 U.S.C. §1154(b), a combat Veteran's assertions of an event during combat are to be presumed if consistent with the time, place and circumstances of such service). In this case, the Veteran was awarded the Combat Action Ribbon. The Board finds that this is sufficient to establish that he engaged in combat with the enemy for the purposes of the relaxed evidentiary standard accorded combat-related injuries under 38 U.S.C. § 1154(b). A claimant is entitled to the benefit of the doubt when there is an approximate balance of positive and negative evidence on any issue material to the claim. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102 (providing, in pertinent part, that reasonable doubt will be resolved in favor of the claimant). When the evidence supports the claim, or is in relative equipoise, the claim will be granted. See Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990); see also Wise v. Shinseki, 26 Vet. App. 517, 532 (2014). If the preponderance of the evidence weighs against the claim, it must be denied. See Id.; Alemany v. Brown, 9 Vet. App. 518, 519 (1996). The Veteran was afforded an Initial Post Traumatic Stress Disorder (PTSD) DBQ in December 2016, at which time the VA examiner noted diagnoses of alcohol use disorder; unspecified personality disorder; and substance induced depressive disorder. The examiner determined that the Veteran's symptoms did not meet the diagnostic criteria for PTSD under the DSM-5 criteria. The Veteran was hospitalized at VA in February 2019. A VA psychiatrist diagnosed the Veteran as having PTSD based upon his reported in-service stressors, to include witnessing friends kill themselves. In August 2021, a VA examiner determined that the Veteran did not suffer from PTSD but instead suffered from persistent depressive disorder. The examiner stated that conditions related to the Veteran's PTSD are less likely than not incurred in or caused by his service or conceded in-service combat stressors. Here, the service connection elements for PTSD are satisfied. The Veteran experienced a verified in-service stressor, he has a current diagnosis of PTSD, and the record supports the causal relationship between the verified stressor and the current diagnosis of PTSD. The Board acknowledges that there are unfavorable VA medical opinions of record. However, because the evidence is at least in equipoise, the Veteran's claim for service connection for PTSD will be granted. P.M. DILORENZO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Hofmeister 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.