Citation Nr: 21022121 Decision Date: 04/14/21 Archive Date: 04/14/21 DOCKET NO. 14-41 945 DATE: April 14, 2021 ORDER Entitlement to service connection for posttraumatic stress disorder (PTSD) is denied. FINDING OF FACT There is no current credible diagnosis of PTSD. CONCLUSION OF LAW The criteria for entitlement to service connection for PTSD have not been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from August 2006 to September 2010. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2011 rating decision. The Veteran was afforded a hearing before the undersigned Veterans Law Judge in December 2017. In June 2018 and September 2020, the Board remanded the issue for further development. That development was completed, and the case has since been returned to the Board for appellate review. 1. Entitlement to service connection for PTSD The Veteran contends that she has PTSD due to military sexual trauma and assault. See March 2011 VA examination. The Veteran is currently service connected for anxiety disorder not otherwise specified and therefore this analysis will focus solely on entitlement to service connection for PTSD. Under applicable law, service connection is warranted where the evidence of record establishes that a particular injury or disease resulting in disability was incurred in the line of duty in active military service or, if pre-existing such service, was aggravated thereby. 38 U.S.C. § 1110; 38 C.F.R. § 3.303 (a). Establishing service connection generally requires competent evidence of (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) 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 Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Pond v. West, 12 Vet. App. 341 (1999). Regulations also provide that service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disability was incurred in service. 38 C.F.R. § 3.303 (d). There are particular requirements for establishing PTSD in 38 C.F.R. § 3.304 (f), which take precedence over the general requirements for establishing service connection in 38 C.F.R. § 3.303. See Arzio v. Shinseki, 602 F.3d 1343, 1347 (Fed. Cir. 2010). Establishment of service connection for PTSD requires: (1) medical evidence diagnosing PTSD; (2) credible supporting evidence that the claimed in-service stressor actually occurred; and (3) medical evidence of a link between current symptomatology and the claimed in-service stressor. 38 C.F.R. § 3.304 (f). In determining whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). A lay witness is competent to testify as to the occurrence of an in-service injury or incident where such issue is factual in nature. Grottveit v. Brown, 5 Vet. App. 91, 93 (1993). In some cases, lay evidence will also be competent and credible on the issues of diagnosis and etiology. Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). Specifically, lay evidence may be competent and sufficient to establish a diagnosis where (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 at 1377; see also Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). A layperson is competent to identify a medical condition where the condition may be diagnosed by its unique and readily identifiable features. Barr v. Nicholson, 21 Vet. App. 303, 307 (2007). Additionally, where symptoms are capable of lay observation, a lay witness is competent to testify to a lack of symptoms prior to service, continuity of symptoms after in-service injury or disease, and receipt of medical treatment for such symptoms. Charles v. Principi, 16 Vet. App. 370, 374 (2002). Additionally, where a veteran served ninety days or more of active service, and certain chronic diseases become manifest to a degree of 10 percent or more within one year after the date of separation from such service, such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service.  38 U.S.C. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309(a). While the disease need not be diagnosed within the presumption period, it must be shown, by acceptable lay or medical evidence, that there were characteristic manifestations of the disease to the required degree during that time.  Id.  The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. The Board concludes that the Veteran does not have a current credible diagnosis of PTSD and has not had one at any time during the pendency of the claim or recent to the filing of the claim. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). The Veteran was afforded a VA PTSD examination in March 2011. The examiner noted the Veteran did not meet the DSM-IV criteria for a diagnosis of PTSD and instead has a diagnosis of anxiety disorder NOS. At the December 2017 Board hearing, the Veteran stated that she has been treated for PTSD. See Transcript of December 2017 Board Hearing at 9. She stated that she was not sure if her medical records formally listed PTSD, but that her PTSD was treated as anxiety. Id. The Veteran’s VA clinical psychologist, Dr. J.M., wrote that the Veteran was initially evaluated and treated for symptoms of anxiety and PTSD. See December 2017 Correspondence. Dr. J.M. stated that his evaluation of the Veteran revealed symptoms of PTSD marked by significant severity in the hyperarousal domain and ultimately led to the diagnosis of anxiety disorder NOS. Id. VA treatment records from September 2011 to July 2018 note ongoing treatment for PTSD. A September 2011 VA treatment note shows the Veteran screened positive for PTSD. The Veteran was afforded a VA PTSD examination in November 2020. The examiner found the Veteran’s symptoms do not meet the diagnostic criteria for PTSD under DSM-5 criteria. The examiner stated the Veteran did not endorse prototypical symptoms of PTSD, including flashbacks, hypervigilance, and exaggerated startle response. The Board notes that the Veteran has asserted she suffers from PTSD. Complaints, however, are not enough to establish service connection. There must be competent evidence of a current disability. The Board has considered the Veteran’s arguments. The Board notes that the Veteran is competent to give evidence about what she experiences; for example, she is competent to discuss current pain and other experienced symptoms. See Layno v. Brown, 6 Vet. App. 465 (1994). Additionally, while the Veteran is competent to report a contemporaneous medical diagnosis and is competent in describing symptoms that support a later diagnosis by a medical professional, the most probative evidence of record does not show that she has a post-service credible diagnosis of PTSD. The Board finds that the most probative evidence consists of the VA medical opinions, including that of VA clinical psychologist, Dr. J.M. The Board assigns greater probative value to the various VA medical opinions as they were prepared by skilled, neutral medical professionals after examining the Veteran and considering her symptoms. Indeed, the Veteran is not competent to provide a diagnosis in this case or determine that her symptoms are manifestations of PTSD related to service. See Clemons v. Shinseki, 23 Vet. App. 1, 6 (2009) (“It is generally the province of medical professionals to diagnose or label a mental condition, not the claimant.”). The Board finds that the claim must be denied. In the absence of a disability, the other elements of service connection for this claim need not be addressed. In sum, because post-service records do not indicate that the Veteran has a disability of PTSD, the Board finds that the evidence is against a grant of service connection for this disorder. Accordingly, the claim is denied. There is no doubt to resolve.  38 U.S.C. § 5107 (b). (continued on next page) TANYA SMITH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Alexia E. Palacios-Peters, 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.