Citation Nr: 21021315 Decision Date: 04/12/21 Archive Date: 04/12/21 DOCKET NO. 14-43 173 DATE: April 12, 2021 ISSUE Entitlement to service connection for an acquired psychiatric disorder ORDER Entitlement to service connection for an acquired psychiatric disorder is denied. FINDING OF FACT An acquired psychiatric disorder was not manifest during active service, or until many years after service, and is not shown to be causally or etiologically related to an in-service event, injury, or disease. CONCLUSION OF LAW The criteria for entitlement to service connection for an acquired psychiatric disorder have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a), 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Navy from June 1973 to September 1975. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2009 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Pittsburg, Pennsylvania. By way of history, the Veteran initially filed a claim for service connection for a psychiatric condition in March 1992, which was denied in an August 1992 rating decision. The Veteran did not file a timely appeal and that decision became final. In August 1997 the Veteran filed a claim for service connection for a mental condition and post-traumatic stress disorder (PTSD) which was denied in a May 1998 rating decision. The Veteran did not file a timely appeal and that decision became final. In February 2001 the Veteran filed a claim for service connection for chronic alcoholism, passive aggressive disorder and depression which was denied in a September 2001 rating decision. The Veteran did not file a timely appeal and that decision became final. More recently, in October 2008 the Veteran filed a claim for service connection for depression, alcoholism and PTSD, which was denied by the RO in the September 2009 rating decision. In December 2014 the Veteran filed her substantive appeal (VA Form 9) and requested a hearing before the Board. The Veteran testified before the undersigned Veterans Law Judge (VLJ) at a September 2015 Board video conference hearing. A transcript of that hearing has been associated with the claims file. A May 2018 Board decision recharacterized the issue from the September 2009 rating decision as entitlement to service connection for an acquired psychiatric disorder, under Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009). At that time the Board determined that the receipt of new and material evidence warranted the reopening of the Veteran’s claim for entitlement to service connection for an acquired psychiatric disorder, and remanded the issue for further development and for the Veteran to receive an adequate VA examination. This matter was remanded again in September 2020 for an addendum VA opinion to be issued. Upon review of the Veteran’s claim file, the Board finds that there has been substantial compliance with the Board's remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998); Barr v. Nicholson, 21 Vet. App. 303, 307 (2007). Therefore, the Board will proceed to the merits of the issue on appeal. Duties to Notify and Assist The Veterans Claims Assistance Act of 2000 (VCAA) and implementing regulations impose obligations on VA to provide claimants with notice and assistance. 38 U.S.C. §§ 5102, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326(a) (2018). Unfortunately, the Veteran's VA treatment records are incomplete. A formal finding was issued in December 2013 indicating that records from February 1, 1994 to June 23, 1994 and from March 20, 1999 to October 31, 1999 were unavailable and any further attempt to locate the records would be futile. VA's duty to assist under the VCAA includes helping the claimant obtain service treatment records (STRs) and other pertinent records, as well as performing an examination or obtaining a medical opinion when one is necessary to make a decision on the claim. See 38 U.S.C. § 5103A ; 38 C.F.R. § 3.159(c). In cases such as this in which VA treatment records are incomplete or unavailable, the Board's obligation to explain its findings and conclusions, and to consider carefully the benefit-of-the-doubt rule, is heightened. See O'Hare v. Derwinski, 1 Vet. App. 365, 367 (1991); Pruitt v. Derwinski, 2 Vet. App. 83, 85 (1992) However, case law does not establish a heightened "benefit of the doubt," only a heightened duty of the Board to consider the applicability of the benefit of the doubt, to assist the claimant in developing the claim, and to explain its decision when a Veteran's medical records have been destroyed. See Ussery v. Brown, 8 Vet. App. 64 (1995). Similarly, the case law does not lower the legal standard for proving a claim, but rather increases the Board's obligation to evaluate and discuss in its decision all of the evidence that may be favorable to the appellant. Russo v. Brown, 9 Vet. App. 46 (1996). Here, the Veteran's VA treatment records are not available because they were lost. Because of missing records, the analysis below has been undertaken with this heightened duty in mind. The Veteran in this case has not referred to any deficiencies in either the duties to notify or assist; therefore, the Board may proceed to the merits of the claim. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015, cert denied, U.S.C. Oct. 3, 2016) (holding that "the Board's obligation to read filings in a liberal manner does not require the Board....to search the record and address procedural arguments when the [appellant] fails to raise them before the Board"); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to an appellant's failure to raise a duty to assist argument before the Board). Service Connection Generally, service connection for a disability requires evidence of: (1) the existence of a current disability; (2) the existence of the disease or injury in service, and; (3) a relationship or nexus between the current disability and any injury or disease during service. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). Service connection may also be granted for any injury or disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease or injury was incurred in service. 38 C.F.R. § 3.303 (d). Certain diseases shall be presumed to have been incurred in or aggravated in service, even though there is no evidence of such disease during the period of service, if they manifest within a specified time period following service. See 38 U.S.C. §§ 1101, 1112; 38 C.F.R. §§ 3.307, 3.309. 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, as opposed to merely isolated findings or a diagnosis including the word "chronic." When the fact of chronicity in service (or during any applicable presumptive period) is not adequately supported, then a showing of continuity after discharge is required to support the claim. 38 C.F.R. § 3.303 (b). The term "chronic disease" refers to those diseases listed under section 1101(3) of the statute and section 3.309(a) of VA regulations. 38 U.S.C. § 1101 (3); 38 C.F.R. § 3.309 (a); Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). For VA purposes, the term psychosis includes schizoaffective disorder. See 38 C.F.R. § 3.384. Where a chronic disease under 3.309(a) is "shown as such in service" ("meaning clearly diagnosed beyond legitimate question," Walker, 708 F.3d at 1339 ), or in the presumptive period so as to permit a finding of service connection, subsequent manifestations of the same chronic disease at any later date, however remote, are service connected, unless clearly attributable to intercurrent causes. 38 C.F.R. § 3.303 (b). Generally, personality disorders are not diseases or injuries within the meaning of the applicable legislation for VA compensation purposes. 38C.F.R.§§3.303(c), 4.9, 4.127; see also Winn v. Brown, 8 Vet. App. 510, 516 (1996). Although a personality disorder may be capable of progression, it is excluded from service connection as non-compensable. See O'Bryan v. McDonald, 771 F.3d 1376, 1380-81 (Fed. Cir. 2014). In any such case, the presumption of soundness would not apply. See Morris v. Shinseki, 678 F.3d 1346, 1354-56 (Fed. Cir. 2012). VA regulations also specifically prohibit service connection for a congenital or developmental defect, such as a personality disorder, unless such defect was subjected to a superimposed disease or injury which created additional disability. See VAOPGCPREC 82-90 (cited at55 Fed. Reg. 45,711) (Oct. 30, 1990) (service connection may not be granted for defects of congenital, developmental or familial origin, unless the defect was subject to a superimposed disease or injury); Carpenter v. Brown, 8 Vet. App. 240, 245 (1995) (same). VA is required to give due consideration to all pertinent medical and lay evidence in evaluating a claim for disability benefits. 38 U.S.C. § 1154(a). Lay evidence can be competent and sufficient to establish a diagnosis of a condition when (1) a layperson is competent to identify the medical condition, (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, 1377 (Fed. Cir. 2007). Lay evidence cannot be determined to be not credible merely because it is unaccompanied by contemporaneous medical evidence. Buchanan v. Nicholson, 451 F.3d 1331, 1336-37 (Fed. Cir. 2006). However, the lack of contemporaneous medical evidence can be considered and weighed against a Veteran’s lay statements. Id. Further, a negative inference may be drawn from the absence of complaints or treatment for an extended period. Maxson v. West, 12 Vet. App. 453, 459 (1999), aff’d sub nom. Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000). Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits under laws administered by the Secretary. The Secretary shall consider all information and lay and medical evidence of record in a case before the Secretary with respect to benefits under laws administered by the Secretary. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; see also 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), citing Gilbert, 1 Vet. App. at 54. In this case, the Board has reviewed all of the evidence of record, with an emphasis on the evidence relevant to this appeal. Although the Board has an obligation to provide reasons and bases supporting its decision, there is no need to discuss, in detail, every piece of evidence of record. Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) (holding that VA must review the entire record but does not have to discuss each piece of evidence). Hence, the Board will summarize the relevant evidence where appropriate and the Board's analysis below will focus specifically on what the evidence shows, or fails to show, with regard to the Veteran's claims. 1. Entitlement to service connection for an acquired psychiatric disorder The Veteran contends that her acquired psychiatric disorder is related to her active service and is related to sexual and racial harassment that she experienced during service. Regarding the first criteria for entitlement to service connection, we turn to the medical evidence. In April 2011 the Veteran was afforded a VA examination at which time alcohol dependence and schizoaffective disorder were diagnosed. In a November 2020 medical opinion, the examiner diagnosed schizoaffective disorder and alcohol use disorder. As such, the Veteran has been shown to have a current disability and has met the first criteria for service connection. See Shedden, 381 F.3d at 1163. Regarding the second element for service connection, which is an inservice event, the Veteran has made several statements that while in service she endured racial and sexual harassment. Specifically in an August 2009 statement in support of the claim the Veteran stated that she “put up with a lot of sexism, racism, sexual discrimination and sexual harassment while in the Navy” and she said this “took a toll on [her] sanity”. Additionally, in a June 2019 statement the Veteran reported that while in service a fellow serviceman touched her breast while he was driving her home. She stated that she did not report the incident because she was friends with his wife. The Veteran is competent to report as to that which she experienced directly, and in this case as it relates to the incidents of harassment which she alleges to have experienced. See Jandreau v. Nicholson, 492 F. 3d 1372, 1376-77 (Fed. Cir. 2007). As such, the Board finds the Veteran’s statements of an in-service event are sufficient to meet the second criteria for service connection. See Shedden, 381 F.3d at 1163. Turning to the final criteria, there must be a causal relationship between the present disability and the disease or injury incurred or aggravated during service. 38 C.F.R. § 3.303(a). First the Board notes that the Veteran’s service treatment records contain an August 1974 treatment note which reflects a diagnosis of “passive- aggressive personality”. The Veteran’s September 1975 separation examination is silent for mention or diagnosis of an acquired psychiatric disorder. Private treatment records from May 1993 reflect that the Veteran underwent a psychiatric evaluation due to depression, alcohol abuse and paranoid thinking. An April 1998 VA treatment note reflects a diagnosis of paranoid schizophrenia. VA treatment notes show that the Veteran has a history of diagnoses of Bipolar disorder, schizophrenia, alcohol dependence and schizoaffective disorder. VA treatment records reflect that the Veteran has been engaged in mental health treatment in the VA system since the 1990’s. The Veteran was first afforded a VA examination for an acquired psychiatric disorder in April 2011. At that time alcohol dependence and schizoaffective disorder were diagnosed. The examiner noted that the Veteran has a long history of substance abuse that began as a teenager. Furthermore, the examiner explained that in the past the Veteran has been diagnosed with bipolar disorder, depressive disorder and paranoid schizophrenia. The examiner stated that those diagnoses were all made following periods where the Veteran was drinking heavily and, which likely complicated her symptoms presentation as alcohol exacerbated irritability, sleep difficulties and mood symptoms. As it related to the Veteran’s diagnosis of Passive Aggressive Personality disorder while in the military, the examiner explained that as the Veteran did not endorse any symptoms congruent with a current diagnosis, it was likely that the previous diagnosis was linked to her excessive alcohol use. The examiner determined that the Veteran’s current diagnoses of alcohol dependence and schizoaffective disorder were not related to the Veteran’s active service because, according to the Veteran’s report, her depressive symptoms began following a sexual assault when she was fourteen years old and delusions began six years after discharge from active service. In May 2018 the Board, however, determined that it was unclear whether the examiner relied on other data to determine if the Veteran’s depressive symptoms began prior to service. 38C.F.R.§3.304(b)(3). The matter was therefore remanded for the Veteran to receive a new examination to clarify the nature and etiology of any diagnosed psychiatric disorder. At the September 2015 Board hearing the Veteran testified that she did not have problems with drinking or depression until she joined the military. She testified that approximately six months into service she began to have issues because of the “all male environment” that she was in where she dealt with sexual and racial discrimination. She testified to incidents of where fellow servicemen would make sexual and racial jokes and comments in her presence. Additionally, she testified that she never made complaints or vented her anger, instead she held it all in. The Veteran attended the Board-directed VA examination in April 2019 and a Mental Health Disorders Disability Benefits Questionnaire (DBQ) was completed. During the April 2019 examination the Veteran reported that she was raped at the age of 14 and although she did not receive mental health care prior to joining the military she began to experience anxiety and depressive symptoms at that time. She reported that she used alcohol and promiscuity as a way to cope. The Veteran reported that after joining the military she was caught off guard by the harassment and discrimination that she was exposed to as a woman of color at her duty assigment. She stated that this increased her psychological symptoms and alcohol use and she began to get into trouble for behavioral issues. The examiner noted that upon review of the Veteran’s records she was ordered to complete alcohol rehabilitation while in service and when she did not fully engage in treatment she was discharged for her lack of participation with a diagnosis of “passive aggressive personality”. At the time of the examination the examiner noted that the Veteran was taking Citalopram for her psychiatric symptoms and reported relative stability in her symptoms with no hospitalizations since 2012. The Veteran did report that she was having issues with hypersomnia and depressed mood at times but reported that she was relatively stable on her current medications. On her report, under the heading labeled ‘Diagnosis’, the April 2019 examiner was asked, “[i]f the Veteran currently has one or more mental disorder that conform to the DSM-5 criteria, provide all diagnosis”. The examiner found that the Veteran had a diagnosis of (1) major depressive disorder as well as (2) alcohol dependence, in sustained full remission. However further down in the DBQ under the heading labeled ‘Differentiation of symptoms’, the examiner was asked to list all symptoms attributable to each diagnosis and to discuss if there is any association between the Veteran’s diagnoses. In response, the examiner stated that “[a]ll current symptoms are due to the Veteran’s diagnosis of Schizoaffective Disorder. Alcohol Use Disorder has been in sustained remission since 2009”. The remainder of the examiner’s report only discusses schizoaffective disorder and alcohol use disorder as the Veteran’s current psychiatric diagnoses. The examiner explained that upon review of the Veteran’s medical records since 2008, her previous diagnoses of substance abuse disorder, paranoid schizophrenia and Bipolar I Disorder have been removed from her active problem list. The examiner did however throughout her report describe the Veteran as having “depressive symptoms”. In response to the question of whether the Veteran had an acquired psychiatric disorder which pre-existed service, the examiner opined that she could not state that this disorder clearly and unmistakably pre-existed service. In providing a rationale the examiner stated that she relied on the Veteran’s inconsistent statements in her VA examinations and at her Board hearing testimony as to the onset of her symptoms, as well as the lack of mental health records, and a negative entrance examination at the time of her enlistment into service. Next, the examiner opined that it was less likely than not that the Veteran’s current diagnosis of schizoaffective disorder began in or was related to her active duty service. In providing a rationale the examiner relied on the fact that the Veteran did not receive any treatment for the condition while in service, her negative entrance examination and the fact that her first depressive and psychotic symptoms associated with her current diagnosis were not diagnosed or treated until several years after discharge from service. Finally, the examiner opined that the Veteran did not have PTSD as she had not been diagnosed or treated for the condition and did not report any symptoms which met the criteria for PTSD. Upon review of the April 2019 examination the Board determined that due to the inconsistency in the examiner’s report between the Veteran’s listed diagnoses and the description of symptoms an addendum opinion would be needed to clarify the diagnosis of any psychiatric disorders of the Veteran. In November 2020 an addendum medical opinion and Disability Benefits Questionnaire (DBQ) was completed. Upon review of the claims file the examiner stated that although there was no way to completely reconcile the conflicting statements of the April 2019 VA examiner it did appear as though the diagnosis section was written in error. The examiner determined that it was more likely than not that the intended diagnoses of the April 2019 examiner were schizoaffective disorder and alcohol use disorder. In explaining this conclusion, the November 2020 examiner explains that schizoaffective disorder is a psychotic disorder which includes “a major mood episode (major depression or manic)”. Therefore, the discussion of depressive symptoms by the April 2019 examiner was not contradictory to the diagnosis of schizoaffective disorder but instead a necessary diagnostic criterion. Furthermore, the examiner explained that there was major overlap between the diagnoses of record (alcohol use disorder and schizoaffective disorder) and the diagnosis listed by the April 2019 examiner (alcohol dependence and major depressive disorder). In addition to providing a clarifying opinion, the November 2020 VA examiner opined that it was less likely than not that the Veteran’s acquired psychiatric disorder was incurred in or caused by her active duty service. The examiner stated that the Veteran’s medical records reflect that her earliest diagnosis for any kind of schizophrenia did not appear until around 1998, which was over 20 years since her discharge from service. The examiner also points out that the Veteran denied depressive symptoms on self- reports numerous times, including in 1998 and in more recent mental health notes. Therefore, the examiner concluded that the Veteran’s current acquired psychiatric disorder did not appear to be related to service. The Board finds the November 2020 VA opinion to be of great probative value. The examiner’s opinion considered the Veteran's specific contentions of her in- service events, the claims file, and clinical medical evidence, before providing a negative opinion. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008) (the probative value of a medical opinion is derived from a factually accurate, fully articulated, and soundly reasoned opinion). The examiner's negative etiological opinion was supported by a sufficiently clear and well-reasoned rationale and was consistent with the verifiable facts regarding the Veteran's contentions. See Bloom v. West, 12 Vet. App. 185, 187 (1999); Hernandez-Toyens v. West, 11 Vet. App. 379, 382 (1998); see also Claiborne v. Nicholson, 19 Vet. App. 181, 186 (2005). For example, the examiner relied on the lack of a diagnosis of schizophrenia until over 20 years after the Veteran’s discharge from service as well as her mental health notes which show multiple denials of depressive symptoms on self-reports. There is no evidence that the November 2020 VA examiner was not competent or credible, and as the report was based on accurate facts and objective examinations, the Board finds that it is entitled to significant probative weight as to the etiology of the Veteran's acquired psychiatric disorder. See Nieves-Rodriguez, Id. The Board acknowledges that the Veteran is competent to provide statements as to her beliefs that her acquired psychiatric disorder is related to service. Barr v. Nicholson, 21 Vet. App. 303, 307-08 (2007). In order for lay evidence to be competent, the individual must have personal knowledge, derived from his/her own senses, of what is being attested; "[c]ompetent testimony is thus limited to that which the witness has actually observed, and is within the realm of his personal knowledge." Layno v. Brown, 6 Vet. App. 465, 471 (1994). Here, the Veteran is competent to provide statements about her symptoms relating to her claimed acquired psychiatric disorder. However, there is nothing in the record to suggest that the Veteran has the appropriate training, experience, or expertise to render a medical opinion regarding etiology of such a condition of any kind. See 38 C.F.R. § 3.159 (a)(1) (setting forth that competent medical evidence means evidence provided by a person who is qualified through education, training, or experience to offer medical diagnoses, statements, or opinions). While the Veteran is competent to report what she has experienced, she is not competent to ascertain the etiology of any current condition, as the causative factors for such are not readily subject to lay observation. See Layno v. Brown, 6 Vet. App. 465 (1994); Woehlaert v. Nicholson, 21 Vet. App. 456, 462 (2007) (concerning rheumatic fever); see also Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Accordingly, her assertions to that effect are of no probative value. In addition, the Board finds that the gap in time between the Veteran's last date of active service, in September 1975, to her initial evaluation by any medical provider regarding an acquired psychiatric disorder in May 1993 to be probative of a lack of nexus between the diagnosed current disability and active service. A negative inference may be drawn from the absence of complaints or treatment for an extended period. See Maxson v. West, 12 Vet. App. 453, 459 (1999), aff'd sub nom. Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000). With regard to presumptive service connection for the acquired psychiatric disorder, the weight of evidence shows no chronic symptoms of this condition during active service, no continuous symptoms of the condition since service, and that the condition did not manifest to a compensable degree within one year of service. The Board notes that the Veteran has provided inconsistent statements with regard to the onset of her symptoms. Based on the evidence of record, the Board notes that the continuity of symptomatology is not shown by the most probative evidence of record. Thus, characteristic manifestations sufficient to identify the disease entity in service or within one year following discharge have not been shown. The Board finds that the Veteran’s acquired psychiatric disorder was first manifest years post-service and that there is no nexus to service. 38 C.F.R. §§ 3.303, 3.307, 3.309. The Board recognizes that the Veteran’s service treatment records contain an August 1974 diagnosis of “passive aggressive personality”. In looking to whether service connection is warranted, first, the Board concludes that the Veteran’s Passive Aggressive Personality disorder is not eligible for service connection as a matter of express VA regulation. See 38 C.F.R. §§ 3.303 (c), 4.9, 4.127. As stated earlier, personality disorders are not diseases or injuries within the meaning of the applicable legislation for VA compensation purposes. C.F.R.§§3.303(c), 4.9, 4.127; see also Winn v. Brown, 8 Vet. App. 510, 516 (1996). Therefore, to the extent the evidence of record requires the Board to consider whether service connection may be warranted for the Veteran's personality disorder or personality traits, the Board must deny that aspect of the Veteran's psychiatric disability claim as a matter of law. Notably, service connection may be granted, in limited circumstances, for disability due to aggravation of a constitutional or developmental abnormality (to include personality disorder), by superimposed disease or injury. See VAOPGCPREC 82-90, 55 Fed. Reg. 45,711. Here, however, the Board finds no evidence of additional disability due to in-service aggravation of any personality disorder by superimposed disease or injury during service. Notably, the Veteran’s medical records are silent for any mention of a personality disorder following the August 1974 note. Upon review of the record, the Board concludes that entitlement to service connection for an acquired psychiatric disorder is not warranted. The Board notes a current diagnosis of schizoaffective disorder, and thus the requirement for a current disability is shown. The Board acknowledges the Veteran's contentions, and the Veteran's post-service statements are noted. However, the record documents normal examination findings upon separation in 1975 and is silent for any mention of an acquired psychiatric disorder until May 1993 when the Veteran underwent a psychiatric evaluation for depressive symptoms. There is no competent evidence to tie the current assertion to any in-service disease or injury. The Board thus finds the Veteran fails the third prong of the test for entitlement to service connection. See Davidson v. Shinseki, 581 F.3d 1313, 1315-16 (Fed. Cir. 2009); Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004); 38 C.F.R. § 3.303. In summary, the medical evidence in this case outweighs the Veteran's assertions that her current schizoaffective disorder is of service origin. For these reasons, the preponderance of the evidence is against the claim and service connection for an acquired psychiatric disorder is not warranted. As the preponderance of the evidence weighs against the claim, the benefit of the doubt rule is not for application. 38 U.S.C. § 5107(b), 38 C.F.R. § 4.3; see Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990). Michael A. Pappas Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Nettey, 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.