Citation Nr: 21005891 Decision Date: 02/02/21 Archive Date: 02/02/21 DOCKET NO. 14-31 836A DATE: February 2, 2021 ORDER Service connection for an acquired psychiatric disorder is granted. FINDING OF FACT The competent and probative evidence is at least in equipoise as to whether an acquired psychiatric disorder had its onset in or is otherwise related to the Veteran’s period of service. CONCLUSION OF LAW The criteria for service connection for an acquired psychiatric disorder are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from October 1986 to August 2007. This case is before the Board of Veterans’ Appeals (Board) on appeal from a June 2011 rating decision from a Department of Veterans Affairs (VA) Regional Office (RO). The Board remanded this case for further development in April 2018 and October 2019. As the requested development has been completed, no further action to ensure compliance with the remand directives is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). The evidence is at least in equipoise as to whether the Veteran has an acquired psychiatric disorder that began during active service. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. § 3.303(a). Service connection will be granted for a current disability that resulted from an injury, disease, or aggravation while in active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Generally, service connection requires (1) a present disability, (2) in-service incurrence or aggravation of a disease or injury, and (3) a nexus between the present disability and the in-service incurrence or aggravation of a disease or injury. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection for a psychiatric disorder requires medical evidence to diagnose the disorder per the American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders (5th ed. 2013) (DSM-5) (or where, as here, the appeal period is before August 4, 2014, the DSM-IV may be used), medical evidence to establish a medical link between the current symptoms and an in-service stressor, and credible supporting evidence that the claimed in-service stress occurred. 38 C.F.R. §§ 3.304(f), 4.125(a). The Veteran is competent to report symptoms and experiences he can observe. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); 38 C.F.R. § 3.159(a). Because a diagnosis of a psychiatric disorder requires specialized training, a Veteran cannot assess a diagnosis for himself. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). VA must give due consideration to all pertinent medical and lay evidence in evaluating a claim for disability benefits. Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed Cir. 2009). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49, 57-58 (1990); 38 C.F.R. § 3.102. The record contains a competent diagnosis of an acquired psychiatric disorder manifested in an adjustment disorder, recurrent major depression, alcohol use disorder, and an anxiety disorder; accordingly, competent evidence of a current disability is found. 07/30/2020, CAPRI; 02/05/2020, C&P Exam. The Veteran’s August 1986 enlistment examination indicates the Veteran was sound upon admission into the Army. 04/26/2014, STR–Medical. A January 2003 letter from the Army shows the Veteran actively participated in direct support of ground combat operations against hostile forces during Operation Enduring Freedom. 10/12/2010, Third Party Correspondence. During service, the Veteran reported he started having anxiety attacks “about 10 years ago” in a January 2007 examination. In July 2007, an adjustment disorder with anxiety and depressed mood was diagnosed. 04/26/2014, STR–Medical. In May 2007, before his separation from service, the Veteran submitted a claim for service connection for anxiety attacks. 05/09/2007, VA 21-526. Medical records demonstrate consistent and ongoing treatment, including medication, for mental health issues. 07/30/2020, CAPRI; 07/10/2007, C&P Exam. The April 2011 and November 2018 VA examiners observed exaggeration or feigning of symptoms; thus, finding no way to determine the Veteran’s legitimate symptoms and provide a diagnosis under the DSM-IV or DSM-5 criteria. See 11/30/2018, C&P Exam; 04/07/2011, VA Examination. A May 2013 VA psychology treatment note indicates a diagnosis of anxiety disorder under the DSM-IV diagnostic criteria, and a November 2015 VA psychology treatment note demonstrates a diagnosis for recurrent major depressions and alcohol use disorder. 07/30/2020, CAPRI. The February 2020 VA examiner observed multiple inconsistencies and over endorsement of symptoms but diagnosed an adjustment disorder under the DSM-5 criteria. The examiner opined the Veteran’s adjustment disorder is less likely related to any aspect of the Veteran’s active service, including any verified military stressors the Veteran reported. 02/05/2020, C&P Exam. With consideration of the totality of the relevant evidence, the competent and probative lay and medical evidence of a traumatic in-service event, an in-service acquired psychiatric disorder diagnosis, and ongoing treatment since service are at least in equipoise as to whether the current acquired psychiatric disorder had its onset in or is otherwise related to the Veteran’s period of active service. Any doubt on the material issue of nexus is resolved in the Veteran’s favor, and the claim of service connection for an acquired psychiatric disorder is granted. See 38 U.S.C. § 5107; 38 C.F.R. §§ 3.102. JAMES L. MARCH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Costa, 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.