Citation Nr: 21021241 Decision Date: 04/12/21 Archive Date: 04/12/21 DOCKET NO. 16-04 184 DATE: April 12, 2021 ORDER Entitlement to an acquired psychiatric condition, to include as due to service-connected pseudofolliculitis barbae, is denied. FINDING OF FACT The most competent, probative evidence of record indicates that the Veteran’s psychiatric condition, which first manifested years after separation from active duty service, was not related to his active service or caused or aggravated by a service-connected condition. CONCLUSION OF LAW The criteria for service connection for an acquired psychiatric condition have not been met. 38 U.S.C. §§ 1101, 1131, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served in the Army from February 1971 until January 1972. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a November 2015 rating decision rendered by the Department of Veterans Affairs (VA) Regional Office (RO) in Milwaukee, Wisconsin. In November 2018, the Veteran presented testimonial evidence at a video conference hearing held at his local RO before the undersigned Veterans Law Judge. A transcript is of record. Addressing the relevant procedural history, this claim was previously before the Board in April of 2019 at which time it was remanded for additional development. It has now been returned to the Board for adjudication. Entitlement to an acquired psychiatric condition, to include as due to service-connected pseudofolliculitis barbae, is denied. The Veteran contends that he is entitled to service connection for a psychiatric condition. Specifically, the Veteran contends that his “mental health condition should be service connected because my pseudofolliculitis for which I received no military or VA benefits for over 40 years has caused me significant depression”. See VA Form 9 Received January 2016. Generally, service connection may be established for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. To establish service connection for a disability, the Veteran must show: (1) the existence of a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the disease or injury incurred in or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may also be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d). In addition, secondary service connection may be granted for a disease or injury which resulted from a service-connected disability or was aggravated thereby. 38 C.F.R. §3.310. When service connection is thus established for a secondary condition, the secondary condition shall be considered a part of the original condition. Further, any increase in severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice-connected disease, will also be service connected. Turning to the evidence of record, the medical evidence of record in this case, including examinations conducted by VA examiners, clearly demonstrates that the Veteran has a currently diagnosed psychiatric condition. At the outset, the Board has considered whether the evidence indicates that the Veteran’s condition onset during active duty service or is otherwise directly related to service. It is not contended here, nor does the evidence independently indicate an association on a direct basis between the Veteran’s psychiatric condition and his active duty service. The Veteran’s service treatment records are silent for complaints of or treatment for symptoms consistent with a psychiatric condition. Even the Veteran clarified at his November 2018 hearing before the Board, via his representative, that “there was no psychiatric treatment in service”. Instead, it was also alleged at the November 2018 Board hearing that “the effects of his pseudofolliculitis and scarring did cause him some mental health impairment, and that admittedly became greatly -- that greatly escalated in 2010 and since then has caused him a great deal of problems in his functioning”. As such, the relevant question before the Board is whether the Veteran’s psychiatric condition was caused or aggravated by his service-connected pseudofolliculitis. In this case, the most probative and competent evidence of record is not supportive of a link between these two conditions such that would be sufficient to warrant service connection. Specifically, the Veteran was afforded a Compensation and Pension Examination in November of 2015. That examiner determined that it was “less likely as not” that the Veteran’s mental health issues were “proximately due to or the result of the Veteran’s service-connected pseudofolliculitis barbae”. However, this opinion addressed only the causation prong of secondary service connection and thus, the Board previously remanded this claim after determining that this opinion provides an insufficient basis upon which to decide the claim. In that regard, in January of 2020, a VA examiner authored an addendum opinion after a review of the Veteran’s claims file in order to comply with the Board’s remand. The VA examiner determined that, “[p]er clinical interview, testing results, and available data in C-file/VBMS, it is in the opinion of this examiner that Mr. [REDACTED] meets criteria for Other Specified Depressive Disorder. It is in this examiner’s opinion that Veteran’s Other Specified Depressive Disorder is less likely as not proximately due to or the result of the Veteran’s service-connected pseudofolliculitis barbae. Per Veteran’s self-report today and previous mental health assessments in May 2010 and February 2015, depressive symptoms seemed to have emerged in 2010 in the midst of psychosocial stressors including financial, work, and disability issues not related to the Veteran’s service-connected pseudofolliculitis barbae.” The examiner specified that “There is no evidence of causality or aggravation of the Veteran's depressive disorder by the pseudofolliculitis barbae.” The examiner offered clear conclusions with reliance on the supporting data. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). Significantly, there are no conflicting opinions of record. In addition, the Board notes that even the 2015 opinion authored by a VA examiner, while insufficient for the reasons outlined above, contained a very similar rationale to that provided by the 2020 examiner. Further, while the treatment records of record are acknowledged and have been reviewed, these records also do not offer any evidence indicative of a psychiatric condition that was caused or aggravated by the Veteran’s service-connected pseudofolliculitis barbae nor that this condition is otherwise related to his military service. The Board acknowledges the Veteran’s belief that his psychiatric condition is secondary to his service-connected pseudofolliculitis barbae or is otherwise related to his active duty service. However, the Veteran is not considered competent to provide a nexus opinion regarding this issue. The issue is medically complex as it requires knowledge of the diagnostic criteria for psychiatric conditions, the signs and symptoms of such, and the possible interaction between pseudofolliculitis barbae and psychiatric symptomology. Therefore, the issue is outside the competence of the Veteran, as he has not been shown to have the medical training or credentials to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). Consequently, the Veteran’s statements are not probative and do not weigh against the evidentiary value of the January 2020 VA examiner’s opinion. Further, the Board notes that the record contains several inconsistencies regarding the supposed onset and nature of the Veteran’s psychiatric condition. For example, at his Board hearing, the Veteran agreed with his representative that he had, “psychological difficulties from 1971 up until 2010”. However, he stated at the same hearing that “[w]ell, it didn’t really bother me until after I was awarded my [pseudofolliculitis barbae] disability, and that caused me to have depression and anxiety for several other reasons because I lost all that time that I didn’t know about.” Further, he stated at this hearing that “You know, it was a mental thing that, you know, all those years went past and what I could have done with my life with forty years of extra income, you know. That’s what really, you know, took a toll, you know. Time loss.”. He additionally asserted that “I would just like if possible compensation for some of the 40 years or the last seven, six years of depression and going through treatment. Maybe an increase in my percentage.” The Board acknowledges that the Veteran may not have been aware of his ability to file for VA benefits for several decades following his departure from active duty. However, the Veteran’s arguments, in essence, are an appeal to equity, and the principles of equity cannot be applied to award benefits that are not authorized by statute. See e.g. Harvey v. Brown, 6 Vet. App. 416, 425 (1994); McTighe v. Brown, 7 Vet. App. 29 (1994). The Board is bound by the law and has no authority to grant benefits on an equitable basis; instead it must apply the laws and regulations as drafted. Id. Further, while the Board recognizes that the Veteran now alleges that his psychiatric condition was present during the almost four decades between his active duty service and when he admittedly sought mental health treatment in 2010, the Board also notes that he previously told the 2015 VA examiner and other VA treatment providers that his condition onset after he experienced a series of psychosocial stressors including financial, work, and disability issues not related to the Veteran’s service-connected pseudofolliculitis barbae. Of note, statements made for the purpose of medical diagnosis or treatment are exceptionally trustworthy because the declarant has a strong motive to tell the truth in order to receive a proper diagnosis or treatment. See White v. Illinois, 502 U.S. 346, 356 (1992). Given the inconsistencies in the Veteran’s statements, the Board finds that they lack credibility. See Caluza v. Brown, 7 Vet. App. 498 (1995) (in determining whether evidence submitted by a Veteran is credible, the Board may consider internal consistency, facial plausibility, and consistency with other information submitted on behalf of the claimant). The Board also observes that at least one treatment examiner has noted that the Veteran has “some credibility issues” and has made several conflicting statements. See SSA Records Received January 2016. Even if the Veteran’s statements were wholly credible, which they are unfortunately not in this case, the Board also recognizes that the law distinguishes between credibility and competence, and again emphasizes that there is no evidence in this case that the Veteran is otherwise competent to provide a nexus opinion in regard to psychiatric conditions. An opinion as to the cause or aggravation of this disability due to a service-connected condition would involve an analysis of the medical records on file and a knowledge of highly complex medical matters. See Jandreau, 492 F.3d 1372, 1377. The Board does not doubt that the Veteran has a psychiatric condition. However, as the preponderance of the evidence is against the claim for service connection, the benefit-of-the-doubt rule is not for application and the claim must be denied. See 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). MICHAEL MARTIN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Smith, 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.