Citation Nr: 21011334 Decision Date: 03/01/21 Archive Date: 03/01/21 DOCKET NO. 10-41 080 DATE: March 1, 2021 ORDER Entitlement to service connection for an acquired psychiatric disorder is denied. FINDINGS OF FACT 1. The objective medical evidence does not show that an acquired psychiatric disorder is caused by an event, injury, or illness during active service, nor did a psychosis manifest to a compensable degree within one year of separation from active service. 2. The Veteran has been clinically diagnosed with schizotypal personality disorder; personality disorders are not diseases or injuries for VA compensation purposes. CONCLUSION OF LAW The criteria for service connection for an acquired psychiatric disorder have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 1137, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.307, 3.309, 4.9, 4.127. REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran served on active duty from August 1979 to March 1986. A Board of Veterans’ Appeals (Board) hearing was held in Washington, D.C. in November 2017. A transcript of the hearing is included in the claims file. The Board previously remanded this matter in June 2014, February 2018, and October 2020 for further evidentiary development. The case has now returned to the Board for appellate review. Entitlement to service connection for an acquired psychiatric disorder Service connection will be granted if the evidence demonstrates that a current disability resulted from a disease or injury incurred in active service or that a preexisting injury or disease was aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303 (a). Establishing service connection generally requires: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred in or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Certain chronic diseases, including a psychosis, may be service connected on a presumptive basis if manifested to a compensable degree in a specified period after service. 38 U.S.C. §§ 1112, 1113; 38 C.F.R. §§ 3.307, 3.309. That period is usually one year. 38 C.F.R. § 3.307 (a)(3). For the showing of chronic disease in service there is required a combination of manifestations sufficient to identify the disease entity and sufficient observation to establish chronicity at the time. 38 C.F.R. § 3.303 (b). Under 38 C.F.R. § 3.303 (b), an alternative method of establishing an in-service disease or injury and a nexus for chronic diseases is through a demonstration of continuity of symptomatology. Barr v. Nicholson, 21 Vet. App. 303 (2007); see Savage v. Gober, 10 Vet. App. 488, 495-97 (1997); see also Clyburn v. West, 12 Vet. App. 296, 302 (1999). Continuity of symptomatology may be established if a claimant can demonstrate (1) that a condition was "noted" during service; (2) evidence of post-service continuity of the same symptomatology; and (3) medical or, in certain circumstances, lay evidence of a nexus between the present disability and the post-service symptomatology. Savage, 10 Vet. App. at 495-96; see Hickson v. West, 12 Vet. App. 247, at 253 (lay evidence of in-service incurrence sufficient in some circumstances for purposes of establishing service connection); 38 C.F.R. § 3.303 (b). Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits. VA shall consider all information and lay and medical evidence of record in a case and 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; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). To deny a claim on its merits, the evidence must preponderate against the claim. Alemany v. Brown, 9 Vet. App. 518, 519 (1996). The Veteran is seeking entitlement to service connection for an acquired psychiatric disorder. Regarding a present disability, the December 2020 examiner confirmed the Veteran’s diagnosis of schizotypal personality disorder. However, as stated above, a threshold requirement for the granting of service connection is evidence of a present disability, see Brammer, 3 Vet. App. at 225, and VA regulations expressly exclude personality disorders from the list of psychiatric disorders eligible for compensation. See 38 C.F.R. §§ 3.303, 4.127. Therefore, any disability resulting from a personality disorder is, as a matter of law, ineligible for service connection. See Winn v. Brown, 8 Vet. App. 510, 516 (1996). The Board notes that a February 2007 medical note shows a diagnosis of adjustment disorder with anxiety. No other psychiatric disorders have been clinically diagnosed. This reported finding was not linked in any way to any in-service occurrence or event. Regarding an in-service event, the Veteran’s service treatment records (STRs) are absent complaints of or treatment for a psychiatric disorder. Specifically, the Veteran’s April 1979 entrance examination, September 1980 periodic examination, and December 1985 re-up examination all indicate a normal psychiatric evaluation. Regarding a causal relationship between any current psychiatric pathology and the Veteran’s military service, post-service medical treatment records show an October 1997 VA emergency room psychiatric note following a reported personal assault that occurred earlier that month. An assessment was not made as a result of this visit because the Veteran refused to give her medical history. An assumption of a psychosis or a personality disorder was made as a result of the Veteran’s behavior during this visit. Records show a February 2007 diagnosis of adjustment disorder, anxious from medical treatment records provided by the Social Security Administration (SSA). At this visit, the Veteran reported no history of psychiatric symptoms aside from a misunderstanding in 2000. She reported never seeing a psychiatrist or therapist or taken any psychiatric medications for past anxiety and worries. The Veteran stated that work discrimination was the cause of her worries at that time. Pursuant to the October 2020 Board remand, the Veteran was afforded a VA examination in December 2020. The December 2020 VA examiner stated she reviewed the Veteran’s claims file and opined that the Veteran’s schizotypal personality disorder is not related to her military service. The examiner provided the rationale that the Veteran’s STRs are silent for a psychiatric diagnosis and she did not report a clear relation to service. Additionally, the examiner noted there were no other psychiatric diagnoses. The Board finds this opinion well-reasoned and thoroughly considered the Veteran’s complete medical history and is accordingly afforded high probative value. See Prejean v. West, 13 Vet. App. 444, 448-9 (2000) (a factor for assessing the probative value of a medical opinion includes the thoroughness and detail of the opinion). The Board notes that there is no opinion in the record to the contrary. The Board further notes that lay assertions may serve to support a claim for service connection by establishing the occurrence of observable events or the presence of disability or symptoms of disability subject to lay observation. 38 U.S.C. § 1154 (a); 38 C.F.R. § 3.303 (a); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); see also Buchanan v. Nicholson, 451 F. 3d 1331, 1336 (Fed. Cir. 2006). The Veteran contends that she believes her psychiatric disorder to be due to her military service. The Board acknowledges the Veteran’s lay statements regarding the nature and etiology of her psychiatric disorder. However, while the Veteran is competent to report (1) symptoms observable to a layperson, e.g., pain, wincing; (2) a diagnosis that is later confirmed by clinical findings; or (3) a contemporary diagnosis, the Veteran is not competent to independently render a medical diagnosis or opine as to the specific etiology of a condition. See Davidson v. Shinseki, 581 F.3d 1313 (2009). Consequently, lay assertions of medical diagnosis or etiology alone cannot constitute evidence upon which to grant the claim for service connection. Latham v. Brown, 7 Vet. App. 359, 365 (1995). Accordingly, the Board assigns little probative value to these lay assertions of the etiology of her psychiatric disorder. There is no clinical evidence that supports an existence of a psychiatric disorder other than schizotypal personality disorder or a nexus between any psychiatric pathology and her military service. The December 2020 examiner provided a comprehensive opinion after review of all the pertinent evidence. Reference was made to pertinent studies, statements, and clinical history. This is, in the Board’s view, persuasive, especially with consideration given to the entire record. Accordingly, based on the evidence discussed above, the Board concludes that the preponderance of the evidence is against the claim of entitlement to service connection for an acquired psychiatric disorder. The benefit of the doubt rule does not apply, and the appeal must be denied. See 38 U.S.C. § 5107. MICHAEL D. LYON Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Frazier, Associate Attorney 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.