Citation Nr: 21075855 Decision Date: 12/21/21 Archive Date: 12/21/21 DOCKET NO. 18-46 774 DATE: December 21, 2021 ORDER Entitlement to service connection for persistent depressive disorder is granted. FINDING OF FACT The Veteran's persistent depressive disorder had its onset in service. CONCLUSION OF LAW The criteria for service connection for persistent depressive disorder have been met. 38 U.S.C. §§ 1110, 1131; 38 U.S.C. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from December 1965 to May 1969. This case comes before the Board of Veterans' Appeals (Board) on appeal from an August 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO), which denied service connection for persistent depressive disorder claimed as posttraumatic stress disorder (PTSD). The Veteran disagreed with the RO's determination, and a statement of the case (SOC) was issued in August 2018 addressing the matter. The Veteran timely appealed. In December 2021, the Veteran testified during a virtual hearing before the undersigned Veterans Law Judge (VLJ). Although a transcript of that hearing has not yet been made, one is not necessary in this case as the benefits sought are being granted in full. Service Connection Service connection will be granted if the evidence demonstrates that current disability resulted from an injury or disease incurred in the active military, naval, air, or space service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Establishing service connection generally requires competent evidence of three things: (1) current disability; (2) in-service disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018). Consistent with this framework, service connection is including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Persistent Depressive Disorder In this case, the evidence of record demonstrates that the requirement for a current disability has been met. Specifically, an August 2016 VA examination report shows a diagnosis of persistent depressive disorder. Thus, the first element of service connection has been met. At the Veteran's November 1965 enlistment examination, his psychiatric examination was noted as normal. Service treatment records (STRs) are negative of complaints, treatment, or diagnosis of depressive disorder. At the Veteran's April 1969 separation examination, no pertinent abnormalities were noted. In an June 2018 Informal Conference Report, the Veteran reported that he has struggled with depression and substance abuse since his service in the Republic of Vietnam. In his October 2018 Substantive Appeal (VA Form 9), the Veteran asserted that he became very depressed in 1967 while serving in Vietnam, to the point of drinking the whole time while he was over there, and still experiencing this condition today. The Veteran noted that at the time he did not know what was happening to him, until later in life. At his December 2021 Board hearing, the Veteran testified that while serving in Vietnam as security police, he became depressed and started drinking. Here, the competent and credible lay statements from the Veteran demonstrates that he exhibited symptoms during service. This is sufficient to establish the second element of service connection claim. In an August 2016 VA examination report, the examiner opined that the Veteran's persistent depressive disorder is less likely than not a result of an in-service stressor related event. The examiner's rationale was the Veteran reported struggling with depression in his childhood. In an October 2011 letter, private psychiatrist S.L. opined that the Veteran's depressive disorder is highly likely a direct result of his military service. Psychiatrist S.L. explained that he reviewed the pertinent medical records and have noted the circumstances and events of the Veteran's military service. Psychiatrist further explained that the Veteran has no other known risk factors that may have precipitated his current condition. The Board finds that the August 2016 VA opinion that the Veteran's depressive disorder in not related to service is of little probative value. Specifically, every Veteran is presumed to have been in sound condition at entry into service except as to defects, infirmities, or disorders noted at the time of such entry, or where clear and unmistakable evidence demonstrates that the injury or disease existed before entry and was not aggravated by such service. 38 U.S.C. § 1111. As noted above, at the Veteran's November 1965 enlistment examination, his psychiatric evaluation was noted as normal. Thus, the Veteran was presumed sound when he entered service and that presumption can only be rebutted with clear and unmistakable evidence of both preexistence and lack of aggravation. There is no evidence of lack of aggravation in this case. Moreover, the VA examiner failed to consider the Veteran's competent and credible statements of the onset of depression in service, and the continuation of symptoms in the years since service. Private psychiatrist S.L. opined that the Veteran's depressive disorder is highly likely a direct result of his military service. He explained the reasons for his conclusions based on an accurate characterization of the evidence, this opinion is entitled to substantial probative weight. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008) (most of the probative value of a medical opinion comes from its reasoning). There is no conflicting medical opinion in the evidence of record. For the foregoing reasons, the current diagnosis, the Veteran's competent and credible lay statements, and private opinion provide a sufficient basis to grant service connection for persistent depressive disorder. Thus, service connection for persistent depressive disorder is warranted. Although the issue on appeal has previously been characterized as including PTSD, given that there is no indication that there are psychiatric symptoms clearly attributable to a psychiatric disorder other than persistent depressive disorder, for which service connection is being granted, further discussion of PTSD or any other psychiatric disorder is unnecessary. See Howell v. Nicholson, 19 Vet. App. 535, 540 (2006) (explaining that the Secretary must apply the benefit of the doubt doctrine and attribute the inseparable effects of a disability to the claimant's service-connected disability). Thus, all psychiatric symptoms are considered part of the service-connected diagnosis. Id. Jonathan Hager Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R. Walker, 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.