Citation Nr: 21013585 Decision Date: 03/09/21 Archive Date: 03/09/21 DOCKET NO. 10-37 180 DATE: March 9, 2021 ORDER Entitlement to service connection for an acquired psychiatric disorder, including but not limited to attention deficit/hyperactive disorder (ADHD) and posttraumatic stress disorder (PTSD) due to personal assault, but not including schizophrenia or bipolar disorder, is denied. FINDING OF FACT The preponderance of the evidence is against finding that the Veteran has a current diagnosis of an acquired psychiatric disorder, to include ADHD and PTSD, but not to include schizophrenia or bipolar disorder. CONCLUSION OF LAW The criteria for entitlement to service connection for an acquired psychiatric disorder (not to include schizophrenia or bipolar disorder) have not been met. 38 U.S.C. §§ 1131, 1131, 5107; 38 C.F.R. §§ 3.303, 3.304, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from December 1983 to December 1986. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a March 2010 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge during a July 2012 hearing. This matter was before the Board in March 2015, March 2017, November 2018, and December 2020. Each time, the Board issued a remand for further development. This matter has now come back before the Board for final adjudication. On appeal in February 2018, the RO issued a rating decision granting service connection for schizophrenia and assigned a 100 percent disability rating effective August 26, 2009. Service Connection Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303(a). Service connection may also be granted for any disease diagnosed after discharge when all of the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). To prevail on the issue of service connection, there must be (1) medical evidence of a current disability; (2) medical, or in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the current disability. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). 1. Acquired Psychiatric Disorder The Board has reviewed the Veteran’s record and finds no current diagnosis of an acquired psychiatric disorder. The Veteran was afforded a VA examination in June 2017 and February 2019. The examination report provided negative findings for any mental disorder other than service-connected schizophrenia, also noted as schizoaffective disorder, bipolar type. The examiners reviewed the Veteran’s entire claims file, and found no evidence of any additional mental disorders, to include ADHD and PTSD. The Veteran has not provided any probative medical evidence to support a positive diagnosis for PTSD, ADHD, or any other mental disorder. Pursuant to the December 2020 Board remand, two additional medical opinions were obtained in December 2020. Here, the examiner explained that the there is no overwhelming evidence that the Veteran’s symptoms meet the criteria for a mental disorder other than schizoaffective disorder, bipolar type/schizophrenia during the appeal period. It was further explained that ADHD symptoms are difficult to separate from symptoms of other mental disorders, but in order for a diagnosis of ADHD there must be symptoms prior to age 12, which the record does not reflect. Therefore, there is no basis for a diagnosis of ADHD. See December 2020 VA Medical Opinion Disability Benefits Questionnaire (DBQ). In addition, the examiner stated that while the record included treatment for trauma related symptoms, positive PTSD screens, and diagnosis of PTSD, these were considered when evaluating the Veteran during the 2017 and 2019 VA examinations. It was determined that the criteria were not met for PTSD. Lastly, the Veteran’s symptoms that the Veteran claims are a result of an acquired psychiatric disorder were accounted for by the diagnosis of schizoaffective disorder, bipolar type, to include anxiety and depression. See December 2020 VA Medical Opinion DBQ. In arriving at this conclusion, the Board acknowledges that various psychiatric disorders such as PTSD have been previously diagnosed by the Veteran’s treating medical providers. However, greater probative value is placed on the conclusions of the VA examiners’ determination that a diagnosis for these disorders is not warranted. The United States Court of Appeals for the Federal Circuit (Federal Circuit) has recognized the unique probative value of opinions provided by VA psychiatric examiners in the context of VA examinations for a number of reasons, to include the special training VA practitioners receive in conducting such examinations, the amount of quality review these examination reports receive, the ability to review the claims file, and VA programs to ensure consistency. See Nat’l Org. of Veterans’ Advocates, Inc. v. Sec. Of Veterans Affairs, 669 F.3d 1340 (Fed. Cir. 2012) (citing 75 Fed. Reg. 39,843, 39,847-48 (July 13, 2010)). Moreover, and while not outcome determinative, the Board notes that the rating criteria for the Veteran’s schizophrenia/schizoaffective disorder, bipolar type (Diagnostic Code 9201) and the rating criteria for PTSD are identical under the General Rating Formula for Mental Disorders. See 38 C.F.R. § 4.130. The Federal Circuit has held that two defined diagnoses constitute the same disability for purposes of section 4.14 if they have overlapping symptomatology. See Amberman v. Shinseki, 570 F.3d 1377 (Fed. Cir. 2009). While it is possible for two mental disabilities to have different symptoms and therefore be evaluated separately, if the manifestations of the two mental disabilities were the same, a separate evaluation was not warranted. Here, as in Amberman, the Veteran’s service-connected schizoaffective disorder and his alleged other acquired psychiatric disorder (e.g. PTSD, ADHD) are evaluated under the same rating criteria. The symptomatology associated with the disorders would be consequently and necessarily duplicative and overlapping. The Veteran’s schizoaffective disorder is rated as 100 percent disabling and there are no psychiatric symptoms that have been excluded from that rating. There would simply be no basis for separate evaluations. See Amberman v. Shinseki, 570 F.3d 1377 (Fed. Cir. 2009); see also Clemons v. Shinseki, 23 Vet. App. 1 (2009). In addition, the December 2020 examiner noted that the Veteran’s symptoms claimed under acquired psychiatric disorder were evaluated in his 100 percent rating for his service-connected schizoaffective disorder. Finally, the Veteran does not have mental health training and credentials and is not competent to provide a diagnosis of a specific mental health disorder. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). His lay evidence is thus not probative in support of this claim. As such, service connection is not warranted for a psychiatric disorder, other than a schizoaffective disorder, bipolar type/schizophrenia. See 38 U.S.C. § 1110; Rabideau v. Derwinski, 2 Vet. App. 141 (1992); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). A. C. MACKENZIE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Glaeser, Associate 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.