Citation Nr: 21015344 Decision Date: 03/17/21 Archive Date: 03/17/21 DOCKET NO. 17-13 848 DATE: March 17, 2021 ORDER Service connection for posttraumatic stress disorder (PTSD) is granted. FINDING OF FACT The Veteran’s PTSD clearly and unmistakably pre-existed her service and was aggravated by her military service. CONCLUSION OF LAW The Veteran’s PTSD, which existed prior to service, was aggravated by her active service. 38 U.S.C. §§ 1101, 1131, 1132, 1153, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from March 1976 to April 1976. This case comes before the Board of Veterans’ Appeals (Board) on appeal from an October 2014 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Detroit, Michigan. The Veteran testified before the undersigned Veterans Law Judge at a Board virtual hearing in June 2020. A transcript of this proceeding has been associated with the claims file. Service connection for PTSD is granted. 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. § 1131; 38 C.F.R. § 3.303(a). Establishing service connection generally requires competent evidence of three things: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship, i.e., a nexus, between the claimed in-service disease or injury and the current disability. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009). Service connection may also be granted for a disease first diagnosed after discharge when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Every veteran shall be taken to have been in sound condition when examined, accepted, and enrolled for service, except as to defects, infirmities, or disorders noted at the time of the examination, acceptance, and enrollment, or where clear and unmistakable evidence demonstrates that the injury or disease existed before acceptance and enrollment and was not aggravated by such service. See 38 U.S.C. §§ 1132; 38 C.F.R. § 3.304(b). Only such conditions as are recorded in examination reports are to be considered as noted. 38 C.F.R. § 3.304(b). If a disorder was not “noted” on entering service, the government must show clear and unmistakable evidence of both a preexisting condition and a lack of in-service aggravation to overcome the presumption of soundness. A lack of aggravation may be shown by establishing that there was no increase in disability during service or that the “increase in disability [was] due to the natural progress of the preexisting condition.” 38 C.F.R. § 3.306 (2016); Wagner v. Principi, 370 F.3d 1089, 1096 (Fed. Cir. 2004). If the government fails to rebut the presumption of soundness, the claim is one for service connection, not aggravation. Wagner, 370 F.3d at 1097. The Veteran contends that service connection is warranted for PTSD. Specifically, she contends that she was raped immediately prior to enlistment, began feeling pregnancy symptoms in service, was treated for these symptoms on several occasions during service (to include radiation and immunizations), was upset after finding out she was pregnant because of potential harm to the fetus caused by the in-service medical testing, had an abortion immediately after his discharge from service, and has suffered psychological problems since her military service. A January 1976 pre-enlistment examination shows a normal psychiatric system and in a January 1976 report of medical history, the Veteran denied “depression or excessive worry” and “nervous trouble of any sort.” Service treatment records (STRs) confirm that the Veteran was treated for several pregnancy symptoms, to include anxiety, immediately after her enlistment. It was later determined that the Veteran was pregnant. An April 1976 memorandum shows that the Veteran was discharged due to the pregnancy and that the pregnancy existed prior to her entry on active duty. It appears that the Veteran underwent an abortion in May 1976, shortly after her discharge from service. Post-service treatment records show diagnoses of both PTSD and major depressive disorder as early as June 1993 related to domestic violence by an old boyfriend. The Veteran submitted an initial claim for service connection for PTSD in October 2013. In connection with this claim, she submitted a May 2018 private psychosocial assessment from Dr. E.M.T. Significantly, Dr. E.M.T. continued the Veteran’s diagnosis of PTSD and opined that the Veteran’s PTSD was incurred during her pre-service rape and, thus, pre-existed the Veteran’s military service. In a July 2020 addendum opinion, Dr. E.M.T. opined that the Veteran’s PTSD, which she suffered just before active duty, was aggravated by her military experience. Dr. E.M.T. noted that the Veteran’s STRs show that she was very anxious and, once it was determined that she was pregnant, she was given no choice but to be discharged. She had an abortion after the military discharge, and her symptoms continued to increase. Since her discharge in 1976, she has sought mental health treatment for this unfortunate situation. To clarify, Dr. E.M.T. opined that the Veteran’s PTSD, which occurred just prior to her going into the military as a result of being raped, was aggravated by her military experience. There is no contrary medical opinion of record. The Board finds that the evidence supports granting the Veteran’s claim of service connection for PTSD. As an initial matter, the Board notes that while the Veteran was not diagnosed with PTSD until after her military service, the medical evidence shows that the Veteran’s PTSD clearly and unmistakably pre-existed her military service. Furthermore, the Veteran, understandably, exhibited anxiety during her military service due to her unplanned pregnancy. Thus, the Veteran’s preexisting PTSD will be considered to have been aggravated by her service unless there is a specific finding that the increase in disability is due to the natural progress of the disease. In this case, there is only one medical opinion to consider and the Board finds the opinion of Dr. E.M.T. to be highly probative. Dr. E.M.T. correctly noted that the Veteran was not diagnosed with PTSD prior to her military service, but also noted that the Veteran’s rape occurred prior to her military service and, because the Veteran’s PTSD stems from her pre-service rape, her PTSD also pre-existed her military service. Dr. E.M.T. also noted that the Veteran was found to be anxious during her service and opined that the Veteran’s PTSD was, understandably, aggravated by her unplanned pregnancy during her military service. This opinion was based on the pertinent records, and provided the underlying reasons for the medical conclusions reached. Therefore, the Board relies on it to grant service connection. In summary, the Board finds that the Veteran’s PTSD clearly and unmistakably pre-existed her service and was aggravated beyond the normal progression during her service. Accordingly, service connection for PTSD is warranted. 38 U.S.C. §§ 1110, 1131, 1153; 38 C.F.R. § 3.306. Bethany L. Buck Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board April Maddox, 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.