Citation Nr: 21014745 Decision Date: 03/15/21 Archive Date: 03/15/21 DOCKET NO. 14-41 378A DATE: March 15, 2021 ORDER Entitlement to service connection for an acquired psychiatric disorder is denied. FINDING OF FACT The preponderance of the evidence is against finding that an acquired psychiatric disorder began during active service or is otherwise related to an in-service injury or disease. CONCLUSION OF LAW The criteria for service connection for an acquired psychiatric disorder are not met. 38 U.S.C. §§ 1110, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303 (2019). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from August 1962 to May 1964. He died in August 2018 and his surviving spouse has been substituted as the appellant. This case comes before the Board of Veterans’ Appeals (Board) on appeal from a November 2012 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). This case has been before the Board five times previously. Most recently in November 2020 this issue was remanded to the agency of original jurisdiction (AOJ) for additional development specifically an addendum to the June 2020 VA examination. This case has now been returned to the Board for further appellate action. Service Connection - Acquired Psychiatric Disorder Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303 (a). Establishing service connection generally requires (1) evidence of a current disability; (2) evidence of in-service incurrence or aggravation of a disease or injury; and (3) evidence of a nexus between the claimed in-service disease or injury and the present disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004); see also Caluza v. Brown, 7 Vet. App. 498, 506 (1995), aff’d per curiam, 78 F.3d 604 (Fed. Cir. 1996) (table); 38 C.F.R. § 3.303. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107 (b). The appellant asserts that the Veteran’s service treatment records include notes of nervousness and depression as well as headaches, dizziness, and episodes of passing out that she believes indicate depression which is related to his time in service. The most recent Board remand sent this matter back for further development to specifically include an addendum opinion. The Veteran’s medical record and file were sent to the same VA examiner who completed the June 2020 VA opinion. This new opinion was ordered to determine if the Veteran had an acquired psychiatric disorder prior to service, if so if it was aggravated by service, and if no acquired psychiatric disorder existed prior to service to determine if the Veteran’s current disability was manifested, caused by, or related to service. Additionally, the examiner was to determine if the Veteran’s diagnosed personality disorder and acquired psychiatric disorder were superimposed upon one another. The ordered addendum opinion was completed in December 2020. The VA psychologist found that the Veteran’s diagnosis of schizoaffective disorder bipolar type was not caused or incurred by military service and was not related to an in-service injury, event, or disease. The psychologist reviewed the Veteran’s service treatment records and concluded that no schizoaffective disorder existed prior to his military service. The psychologist acknowledged that the Veteran did complain of nervousness and depression while in service, but the psychologist explained these as normal variations in mood. The psychologist also stated that in the same interview the Veteran noted considerable satisfaction with the Navy. Accordingly, the 1964 mental health evaluation did not diagnose the Veteran with a psychotic or mood disorder. The psychologist found the Veteran’s mental health issues, including a possible personality disorder, were not caused or incurred by military service and were not related to an in-service injury, event, or disease. The psychologist explained that the Veteran’s mental health treatment records do not show a diagnosis until 2003 which is far beyond his exit from service in 1964. The Veteran’s records contain a long-standing history of psychosis dating back to 1995. According to the psychologist, given that this was over 20 years post military service the only way to connect this diagnosis to the Veteran’s time in service would be pure speculation. This also would be beyond the manifestation of one year for a presumptive service-connection claim. Finally, the psychologist noted that in the June 2020 medical opinion there was no diagnosis of a personality disorder. The psychologist explains this by noting some discrepancies in the Veteran’s past statements. These include his PTSD stressor from his combat in Vietnam that was never confirmed. Therefore, the psychologist believed that the PTSD diagnosis is not accurate. The psychologist again noted that to diagnose the Veteran with borderline personality disorder would be based upon pure speculation due to the lack of evidence in the Veteran’s record. As such, the psychologist found the Veteran’s diagnoses of schizoaffective disorder, bipolar type, was not caused by or incurred in military service and is less likely than not related to an in-service injury, event, or disease. The appellant is not competent to link the Veteran’s psychiatric disorder to a period of service. Competent lay evidence means any evidence not requiring that the proponent have specialized education, training, or experience. Lay evidence is competent if it is provided by a person who has knowledge of facts or circumstances and conveys matters that can be observed and described by a lay person. 38 C.F.R. § 3.159. Lay evidence may be competent and sufficient to establish a diagnosis of a condition when: (1) a layperson is competent to identify the medical condition (i.e., when the layperson will be competent to identify the condition where the condition is simple, for example a broken leg, and sometimes not, for example, a form of cancer); (2) the layperson is reporting a contemporaneous medical diagnosis, or; (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. Jandreau v. Nicholson, 492 F. 3d 1372 (Fed. Cir. 2007); see also Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009) (where widow seeking service connection for cause of death of her husband, the Veteran, the Court holding that medical opinion not required to prove nexus between service connected mental disorder and drowning which caused Veteran’s death). The appellant is a lay person and is not competent to establish that the Veteran’s psychiatric disorder onset because of an event or incident during a period of service. The question regarding the etiology of such disability is a complex medical issue that cannot be addressed by a layperson. Accordingly, the Board finds that the preponderance of the evidence is against the claim and entitlement to service connection for an acquired psychiatric disorder is not warranted. 38 U.S.C. § 5107 (2018); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). G. Jackson Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Andrew Ledman II 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.