Citation Nr: 21022590 Decision Date: 04/16/21 Archive Date: 04/16/21 DOCKET NO. 15-45 993 DATE: April 16, 2021 ORDER Entitlement to service connection for an acquired psychiatric disorder to include an anxiety disorder is granted. FINDING OF FACT The Veteran's current anxiety disorder is related to service. CONCLUSION OF LAW The criteria for service connection for an acquired psychiatric disorder to include an anxiety disorder are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service with the U.S. Army from June 1977 to June 1980, and with the U.S. Army National Guard from January 1991 to September 1991. During this time, he was awarded the Southwest Asia Service Medal and the National Defense Service Medal. In December 2018, the Veteran and his spouse testified before the undersigned Veterans’ Law Judge at a videoconference Board hearing. A transcript of that hearing is of record. The Board previously remanded this matter in March 2020, for additional development to include, providing the Veteran a VA examination. In that decision, the Board broadened the Veteran’s appeal from the original claim to include entitlement to service connection for an acquired psychiatric disorder. See Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009) (holding that a Veteran's claim for PTSD must be considered a claim for any mental disability that may reasonably be encompassed by several factors including the claimant's description of the claim; the symptoms the claimant describes; and the information the claimant submits in support of the claim). The matter has returned to the Board for an appellate review. 1. Entitlement to service connection for an acquired psychiatric disorder Generally, service connection may be established for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Establishing service connection generally requires competent evidence of: (1) a current disability; (2) an in-service precipitating disease, injury, or event; and (3) a causal relationship, such as, a nexus between the current disability and the in-service event. Fagan v. Shinseki, 573 F.3d 1282, 1287 (Fed. Cir. 2009); 38 C.F.R. § 3.303 (a). Determinations as to service connection will be based on review of the entire evidence of record, to include all pertinent medical evidence. VA must also consider all favorable lay evidence of record. See 38 U.S.C. § 5107 (b); see also Layno v. Brown, 6 Vet. App. at 470 (a Veteran is competent to report on that of which he or she has observed and is within the realm of his or her personal knowledge). The Veteran contends that he is entitled to service connection for an acquired psychiatric disorder related to an in-service exposure to multiple missile attacks and dead bodies during service in Saudi Arabia. The Veteran's service treatment records are devoid of reference to complaint of, or treatment for, any psychiatric or mental health problems. See STRs. Pursuant to the Board’s March 2020 remand directives, the Veteran was afforded a VA PTSD examination in July 2020. The examination was conducted via approved video telehealth. The diagnoses were unspecified depressive disorder and specified anxiety disorder. The examiner remarked that the Veteran, technically, does not meet the diagnostic criteria for PTSD. However, it is plausible to conclude that he has some trauma sequelae (i.e., intrusive thoughts/images, vigilance in public, and occasional startle) that can be said to be associated with his military history; albeit the severity of said symptoms is mild. The examiner continued that, the Veteran’s reports of mild depressive symptoms (i.e., loss of interest and motivation) do not have an exact etiology but tenable sources are health and financial problems by self-report. The examiner opined that the claimed condition was at least as likely as not (50 percent or greater probability) incurred in or caused by the claimed in-service injury, event, or illness. The examiner’s rationale was that even though the claimed condition is PTSD is not affirmed, a different, anxiety disorder was established that is linked to the Veteran's military service; but that the depressive disorder is not related to his service. See July 2020 C&P Examination. The first requirement of service connection claim is met because a current diagnosis of anxiety disorder is confirmed in the medical records and specifically by the July 2020 examiner. Therefore, the outcome turns on whether the Veteran's anxiety disorder is related to service. Regarding the second requirement of a service connection claim, the Veteran has consistently stated that during his service in Saudi Arabia, he was military police; and that he traveled the road as a highway patrol officer and saw lots of fatal accidents and dismembered bodies. At Board hearing, the Veteran testified that he was between King Khalid Military City and a town called Hafar Al-Baton when the “scud attacks” were happening, and that he saw at least one scud at night, but it was “a whole bunch more” than that. See December 2018 Hearing Transcript. The Board finds the Veteran’s report of in-service incidents consistent with the time, place, and circumstances of his service and thus meets the second requirement for service connection. Regarding the third element of service connection, the Board acknowledges the positive nexus opinion proffered by the July 2020 examiner. In an August 2020 addendum opinion (by the same examiner) he further elaborated that the etiology of the Veteran’s anxiety disorder is inferred based on the consistency between trauma stressors and symptoms as identified in the literature and in the evaluator’s experience. See July and August 2020 C&P Examinations. The Board finds the July 2020 and August 2020 medical opinions to be highly probative in relation to the Veteran’s anxiety disorder. The opinions were based on a review of the claims file and relevant facts, and the examiner provided a detailed rationale. Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). There are no opinions on record to the contrary. In sum, the Board finds that the most probative evidence shows that the Veteran has anxiety disorder related to service; thus, service connection for an acquired psychiatric disorder to include an anxiety disorder is granted. DAVID L. WIGHT Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board N. M. Rogers, 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.