Citation Nr: 21077161 Decision Date: 12/28/21 Archive Date: 12/28/21 DOCKET NO. 17-35 697 DATE: December 28, 2021 ORDER Service connection for the cause of the Veteran's death is granted. FINDINGS OF FACT 1. The Veteran died in October 2016 from a brain hemorrhage and laceration from a self-inflicted gunshot wound to the head, with acute ethanol alcohol intoxication and chronic alcoholism listed on the death certificate as significant conditions that contributed to death. 2. At the time of his death, the Veteran was not in receipt of service connection for any disability. 3. The Veteran's acquired psychiatric disorder was the underlying cause of the Veteran's death and a result of his active military service. CONCLUSION OF LAW The criteria for service connection for the cause of the Veteran's death are met. 38 U.S.C. §§ 1110, 1154(b), 1310, 5107; 38 C.F.R. §§ 3.102, 3.302, 3.303, 3.312. REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran served on active duty from October 2004 to November 2009. He died in October 2016. The appellant was deemed to be the Veteran's surviving spouse for purposes of VA benefits in February 2017. This matter is before the Board on appeal from a March 2017 rating decision. In August 2021, the appellant testified at a Board hearing. Entitlement to service connection for cause of death is granted. The appellant is seeking service connection for the Veteran's cause of death. Specifically, she contends that the Veteran's suicide was the result of a psychiatric disorder, to include PTSD, that was incurred during service in Iraq. Service connection for cause of death may be awarded to a veteran's surviving spouse for death resulting from a service-connected disability or a disability related to service. 38 U.S.C. § 1310; 38 C.F.R. § 3.312. To establish service connection for the cause of the Veteran's death, the evidence must show that a disability incurred in or aggravated by service either caused or contributed substantially or materially to cause death. The death of a veteran will be considered as having been due to a service-related disability when the evidence establishes that such disability was either the principal or the contributory cause of death. Id. In the instant case, after reviewing the evidence of record, the Board concludes that the Veteran could have been service-connected for a psychiatric disorder, to include PTSD with a secondary alcohol use disorder, during his lifetime and that it was one of the causes of his death. In support of this determination, the Board relies upon the opinions of two different individuals with competence to determine the Veteran's mental state prior to his death. In this regard, a school psychologist who had known the Veteran since he was 15 years old and remained close with him and his family after his deployment, opined that the Veteran had been suffering with PTSD, noting that he had witnessed and directly experienced traumatic events, had recurrent distressing memories and dreams of those events, and avoided situations that reminded him of such memories, thoughts, and feelings. See August 2021 Statement of J.S. Furthermore, she found that it was the Veteran's mental struggle that led him to become self-destructive and reckless. Id. In a separate statement, the Veteran's brother-in-law, who is also a captain in the fire department and a paramedic, and who knew the Veteran since he was 16 years old, also opined that the Veteran was dealing with PTSD and depression after he got out of the Marines. See August 2021 Statement of B.M. In terms of competency, B.M. noted that as a paramedic and firefighter, he was familiar with PTSD as it was becoming one of the highest causes of deaths for firefighters and because there had been a big push in the fire service in terms of education and resources regarding PTSD. Id. Additionally, the Board finds probative the other competent, consistent, and credible statements submitted by family, friends, a co-worker, and another veteran supporting the appellant's claim. Layno v. Brown, 6 Vet. App. 465, 470 (1994). In written statements submitted in August 2021, various individuals stated that they knew the Veteran prior to and/or during service, and that his personality and/or behavior changed after his deployment. Generally, they wrote that prior to his service, the Veteran was humorous, vibrant, upbeat, motivated, outgoing, animated, positive, charismatic, loved to joke and play pranks, and/or the "life of the party." However, after service, he was a "completely different person" who was withdrawn, angry, paranoid, irritable, had a flat affect, avoided social settings, and did not reach out to family and friends as he had in the past. See, generally, August 2021 Buddy/Lay Statements. Of note, a former marine and friend who served with the Veteran in San Diego after his Iraq deployment, wrote that he observed the Veteran in service to be "anxious or stressed, unless he was drinking." See August 2021 Statement of J.D. He further wrote that he had talked to the Veteran about seeking treatment, but that the Veteran refused saying "nothing was wrong," though he observed that after service, the Veteran seemed sad and stressed. A separate statement from an individual who served with the Veteran and called him his good friend, former roommate, and battle buddy, described how the Veteran had inner struggles in service and would open up after a few drinks. See August 2021 Statement of J.S. He opined that the Veteran's drinking was his way of self-medicating and coping with the "unsightly horrors one experiences in a combat environment." The medical evidence in this case is extremely limited. However, the evidence that does exist tends to support the appellant's claim. Specifically, a June 2014 VA treatment note shows that the Veteran sought treatment after being a victim of armed robbery the night before. He specifically reported feeling scared and helpless and noted that having a gun pointed at his face "brought back a lot of memories and feelings about my time in Iraq." The Board is cognizant that the Veteran elsewhere denied psychiatric symptoms or complaints related to his military service, including in the service treatment records and a June 2014 Vet Center visit. However, the lay statements of those closest to the Veteran explain his hesitancy to seek treatment and further include competent and credible lay observations of psychiatric symptoms exhibited by the Veteran in service, after his separation, and at the time of his death. Moreover, to the extent that the Veteran denied psychiatric symptoms at separation, the Board notes that he also did not report a rash or skin symptoms at separation, but in seeking treatment for a skin condition (psoriasis) at VA in November 2009 (just weeks after separation), the Veteran reported that the onset of his psoriasis was in service. Thus, it is entirely plausible that the Veteran did experience psychiatric symptoms in service that he simply did not report them at the time. The foregoing evidence weighs in favor of a finding that the Veteran had a psychiatric disorder, to include PTSD, as a result of his military service and that such disorder ultimately resulted in his death by suicide. Significantly, there is no competent evidence to the contrary. Thus, resolving any existing doubt raised by the record in favor of the appellant, the Board finds that the evidence regarding whether the Veteran had a psychiatric that was related to service is at least in equipoise. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. Accordingly, service connection for the Veteran's cause of death is warranted. S. C. Krembs Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Fagan 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.