Citation Nr: 21075644 Decision Date: 12/21/21 Archive Date: 12/21/21 DOCKET NO. 18-15 375 DATE: December 21, 2021 ORDER Entitlement to service connection for an acquired psychiatric disorder, variously diagnosed as posttraumatic stress disorder (PTSD), major depression, panic disorder, and anxiety disorder, is granted. FINDING OF FACT Resolving reasonable doubt in the Veteran's favor, his acquired psychiatric disorder, variously diagnosed as PTSD, major depression, panic disorder, and anxiety disorder, is related to his active service. CONCLUSION OF LAW The criteria for entitlement to service connection for an acquired psychiatric disorder have been met. 38 U.S.C. § 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 3.304, 4.125. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from December 1967 to October 1971. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a November 2016 rating decision issued by a Regional Office (RO) of the Department of Veterans Affairs (VA). As in prior adjudicative actions by VA, the Board has characterized the Veteran's claim for service connection for PTSD more broadly as claim for service connection for any acquired psychiatric disorder, to include PTSD. See Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009). In December 2021, the Veteran presented testimony at a virtual hearing before the undersigned Veterans Law Judge. A transcript of that testimony has not yet been added to the file, as this decision is being processed under the Board's "One Touch" hearing program. A copy of the transcript will be added to the Veteran's claims file in the ordinary course of business. 1. Entitlement to service connection for an acquired psychiatric disorder In an October 2015 statement, the Veteran reported he received orders to the U.S.S. Forrestal in 1969, and described, in part, traumatic incidents which he witnessed aboard the ship. Specifically, he reported, among other incidents, that he watched a fellow servicemember sucked up in the intake of a jet and a fellow servicemember decapitated. Similarly, in a February 2017 statement, that Veteran reported, in part, that between February 1971 and June 1971, there was an incident in which a flight deck officer stood up too soon, and had his head struck by an aircraft wing, and his helmet and part of his head rolled down the deck. He also reported a fellow servicemember walked into the propeller of a plane and was chopped to pieces. Additionally, in an October 2015 statement, the Veteran's spouse reported, in part, that although she was not aware of it until recently, the Veteran had had nightmares and difficulty sleeping. Also, in an April 2018 statement, the Veteran's spouse reported, in part, that she and the Veteran had been together since July 1988 and that he had always had night terrors about his time in the service as well as flashbacks. Generally, service connection may be established for disability resulting from disease or injury incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. To prevail on a service connection claim on a direct incurrence basis, there must be competent evidence of (1) a current disability, (2) in-service incurrence or aggravation of a disease or injury, and (3) a nexus between the in-service disease or injury and the current disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). 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. For cases certified to the Board on or after August 4, 2014, the diagnosis of PTSD must be in accordance with the American Psychiatric Association's Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5). 38 C.F.R. § 4.125 (a); Schedule for Rating Disabilities-Mental Disorders and Definition of Psychosis for Certain VA Purposes, 79 Fed. Reg. 45,093 (Aug. 4, 2014) (Applicability Date) (updating 38 C.F.R. § 4.125 to reference DSM-5). Jurisdiction over the present appeal was conferred to the Board in June 2018. The Veteran's application for benefits, which included a claim for service connection for PTSD was received by VA on October 26, 2015, thus the appeal period for consideration is from October 26, 2015. In terms of a demonstration of current disability for an acquired psychiatric disorder, VA medical letters dated in October 2015, August 2016, December 2016, January 2017, and March 2018, variously endorsed diagnoses of PTSD, major depression, panic disorder, and anxiety disorder. Also, an April 2018 VA medical letter endorsed a diagnosis of PTSD in accordance with the DSM-5. These diagnoses are generally consistent with the Veteran's VA treatment records. For example, proximate to the appeal period, a September 2015 VA treatment record endorsed diagnoses of acute stress disorder, depressive disorder, not otherwise specified, generalized anxiety disorder, panic disorder, and PTSD. Thus, for the purposes of the appeal, the Veteran is acknowledged to have an acquired psychiatric disorder, variously diagnosed but best characterized PTSD, major depression, panic disorder, and anxiety disorder, as reflected in the aforementioned VA medical letters. Concerning evidence of in-service incurrence or aggravation of an injury or disease, and more specifically, an in-service stressor, as discussed above, the Veteran alleges witnessing fellow servicemembers die, while aboard the U.S.S. Forrestal, is the stressor that caused his acquired psychiatric disorder. In this regard, the record reflects the Veteran served aboard the U.S.S. Forrestal from May 1970 to October 1971. In support of his claim, the Veteran submitted a November 1970 newspaper article which reflects a fellow servicemember was killed instantly on the past Thursday, on the carrier U.S.S. Forrestal, as he was struck by the wing of an A7 Corsair 11 jet being launched. In November 2021, the Veteran also submitted an internet printout, from the U.S. Naval Academy Virtual Memorial Hall, referencing this same fellow servicemember and citing the newspaper article discussed above. In this regard, in October 2016 and November 2017, the AOJ issued two memorandum, and each provided a formal finding that there was a lack of information, as required to corroborate the Veteran's reported PTSD stressors, in order to send a request for verification of his reported stressors to any official source. However, these memoranda do not address the Veteran's recollection of the death of a fellow servicemember, due to being struck by a wing of an aircraft, which as discussed above, other evidence reflects, occurred in November 1970, when the Veteran was aboard the U.S.S. Forrestal. Further, the statement of the case, relying on evidence received on March 8, 2017, stated that the fellow servicemember struck by the wing of a plane died in January 1970, before the Veteran arrived on the ship. However, the Board can find no evidence of record of that date which indicates the fellow servicemember died in January 1970. -here is no reason to doubt the Veteran's credibility with regard to his description of witnessing this event, and as discussed, it is supported by other evidence of record. Thus, the Board finds there is satisfactory evidence of service incurrence for this stressor; however, as the Veteran's other reported stressors have not been corroborated by supporting evidence, such will not be further discussed in this decision. The Board also finds that the Veteran's acquired psychiatric disorder, variously as PTSD, major depression, panic disorder, and anxiety disorder, are related to the verified stressor. Specifically, in an August 2016 medical letter, Aileen Camacho, a VA staff psychiatrist, noted the Veteran had PTSD as well as secondary diagnoses of major depression and panic disorder. Dr. Camacho also explained the Veteran served on an aircraft carrier during the Vietnam war, where he was exposed to significant events, which promoted severe trauma, and further described specific deaths the Veteran reported he has witnessed, including the death of a servicemember due to close contact with an aircraft. Also, in December 2016 and January 2017 letters, Dr. Camacho explained the Veteran managed the conditions he had been dealing with most of his life, which were PTSD, major depressive disorder, and anxiety disorder, as well as panic disorder, and only after he lost his home in the Valley Fire in 2015, did his primary care physician suggest he get care for his mental health symptoms. In a March 2018 letter, Dr. Camacho also documented the Veteran's current acquired psychiatric diagnoses and explained his life had not been the same since his involvement in the Navy and the horrific life-threatening accidents and events that occurred while serving in combat in Vietnam. The preponderance of the evidence is against a finding that the Veteran had combat service as combat service is not identified in the service records. Similarly, in an April 2018 letter, Erik Shumaker, a VA staff psychologist, described the Veteran had pervasive effects of traumatic events from his service in the Navy during the Vietnam War, including having witnessed fatal accidents on the flight deck of his carrier, and based on the available information, he had diagnosed with the Veteran with PTSD. Thus, while the evidence is not unequivocally clear, it is at least in equipoise, that the Veteran's acquired psychiatric disorder, variously diagnosed as PTSD, major depression, panic disorder, and anxiety disorder, is related to his service. Further, while these VA medical letters are not wholly accurate, for example, there is no evidence the Veteran served in combat, and relied also upon stressors that cannot be verified, they are generally consistent with the other evidence of record. For example, VA treatment records dated in August 2017, September 2017, and November 2017 documented the Veteran was administered the PTSD checklist for a DSM-5 diagnosis and he had scores indicative of severe PTSD symptoms, consistent with prior administration, in reference to life-threatening experiences and witnessing deadly accidents on a flight deck during Vietnam. Further, although the record also reflects the Veteran sought treatment for his psychiatric symptomology after a fire which destroyed his home in 2015, it also reflects his psychiatric symptomotology preceded the fire, and was aggravated by the fire, rather than caused by it. For example, a September 2015 VA treatment record noted the Veteran had a past history of PTSD, undiagnosed, and never sought help due to trying to be strong. The September 2015 VA treatment record further noted the Veteran just lost his home in a fire, and the fire had exacerbated flashbacks, memories and nightmares from his trauma in the aircraft carrier, including major trauma from witnessing specific deaths of fellow servicemembers. Similarly, an October 2015 VA treatment record noted, in part, the Veteran had increased depressive and anxiety symptoms as well as panic attacks and very exacerbated PTSD symptoms secondary to losing his home in a fire. Moreover, prior to 2015, the Veteran had a diagnosis of PTSD. Specifically, a June 2009 VA treatment record provided a diagnosis of PTSD, albeit due to a medical condition. However, notably, the June 2009 VA treatment record also documented the Veteran reported he witnessed deaths during his service, which he thought about quite bit. He also reported, as a result of his military experience, he had always been extremely vigilant about safety, that he did not like crowds or confined spaces, that he sat with his back to a wall in a public place, and avoided being anywhere near aircraft. Thus, the June 2009 VA treatment record also supports the Veteran's claim as it reflects he experienced PTSD related symptomology due his service. Accordingly, upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran's acquired psychiatric disorder, variously diagnosed as PTSD, major depression, panic disorder, and anxiety disorder, is etiologically related to service. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection is warranted. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). M. C. GRAHAM Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Espinoza, 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.