Citation Nr: 21022890 Decision Date: 04/19/21 Archive Date: 04/19/21 DOCKET NO. 17-32 246 DATE: April 19, 2021 ORDER Entitlement to service connection for a psychiatric disorder, diagnosed as anxiety, is granted. FINDING OF FACT The evidence is at least in equipoise as to whether the Veteran’s anxiety is attributable to his active service. CONCLUSION OF LAW The criteria for service connection for an acquired psychiatric disorder, diagnosed as anxiety, have been met. 38 U.S.C. §§ 1110, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2020). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from December 1988 to December 1992. For his meritorious service, the Veteran was awarded (among other decorations) the Southwest Asia Service Medal and the Kuwait Liberation Medal. This matter is before the Board of Veterans’ Appeals (Board) on appeal from an April 2016 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). A Board hearing was held before the undersigned in March 2021. A transcript of the hearing is of record. The United States Court of Appeals for Veterans Claims (Court) has held that, although a Veteran claims service connection for a specified diagnosed disability, it cannot be a claim limited only to that diagnosis, but must rather be considered a claim for any disability that may reasonably be encompassed by several factors, including the Veteran’s description of the claim, the symptoms the Veteran describes, and the information the Veteran submits or that VA obtains in support of the claim. The Court reasoned that a Veteran does not file a claim to receive benefits only for a particular diagnosis, but for the affliction (symptoms) his condition, however described, causes him. Clemons v. Shinseki, 23 Vet. App. 1, 5-6 (2009). Here, although the Veteran filed a claim seeking service connection for PTSD specifically, the record also reflects diagnoses of major depressive disorder with anxious distress, unspecified trauma and stress related disorder, alcohol use disorder, and anxiety. The Board therefore finds that, pursuant to Clemons, the Veteran’s claim seeking service connection for PTSD is more accurately characterized as one for any acquired psychiatric disorder and has recharacterized the issue accordingly. 23 Vet. App. at 5-6. Entitlement to service connection for a psychiatric disorder, diagnosed as anxiety, is granted. The Veteran and his attorney contend that the Veteran’s psychiatric disorder is related to his active service. Service connection may be granted for disability resulting from disease or injury incurred or aggravated during active military service. 38 U.S.C. §§ 1131. Generally, service connection requires (1) the existence of a present disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). The Board concludes that the Veteran has a current diagnosis of a psychiatric disorder that is related to his service. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. § 3.303(a); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). In this case, the record reflects that the Veteran has a current diagnosis of anxiety, as noted in various VA treatment records. Thus, the first element of service connection has been established. Regarding an in-service incurrence, during the March 2021 Board hearing, the Veteran reported an incident where he responded as a medic to a missile attack that killed 27 soldiers. He reported that, on the scene, there were body parts and blood everywhere and that there was a stench of burning flesh and fuel. He also reported two other attacks, one on his bunkhouse and another that killed his friend. Lastly, the Veteran provided details of his treatment for a soldier who was split open after flipping his Humvee. He reported that he was tasked with completing a sew job on the soldier but could not complete the task because he was shaking badly. He reported that he botched the surgery and another doctor had to step in and finish the surgery. The Board finds the Veteran to be competent and credible to describe the circumstances of his service and his military duties. See Layno v. Brown, 6 Vet. App. 465, 470 (1994). In addition, his DD-214 reflects that his military occupational specialty was a medical specialist and his military personnel records reflect that he served as a medical service specialist in Southwest Asia during the Persian Gulf War. The Veteran’s descriptions of his service are consistent with the “places, types, and circumstances” of his service. 38 U.S.C. § 1154(a). Thus, the second element of service connection has also been established. Thus, the question becomes whether the Veteran’s current psychiatric disorder, diagnosed as anxiety, is related to his service. On this question, the Board notes that there are two medical opinions of record. In August 2015, the Veteran underwent a VA examination. A review of the examination report reflects that the examiner diagnosed the Veteran with major depressive disorder with anxious distress and alcohol use disorder. The examiner indicated that the Veteran’s major depressive disorder was not related to his service, noting that the condition was at least as likely as not related to a long history of alcohol abuse and recent sobriety and remorse/regret about decisions and conduct of his life. However, the examiner indicated that some of the Veteran’s anxiety symptoms, including his hypervigilance, nightmares, panic attacks linked to reminders about combat experiences, and difficulty sleeping, were at least as likely as not related to his active service. The Board finds the opinion regarding the Veteran’s anxiety persuasive and places great probative weight on the opinion as it reflects adequate consideration of the Veteran’s symptoms and reported history. Although the examiner did not specifically provide a diagnosis of anxiety during the examination, the examiner specifically addressed the etiology of the Veteran’s symptoms of anxiety and the Board finds that is sufficient to conclude the Veteran’s diagnosed anxiety is related to his active service. The other medical opinion was provided during an April 2016 VA examination. A review of the examination report reflects that the examiner diagnosed major depressive disorder and alcohol use disorder. The examiner then indicated that the Veteran’s diagnosed conditions were less likely than not related to his service, noting that the Veteran’s major depressive disorder appeared to be largely from past alcoholism, poor life choices, failure to maintain employment, and recent loss of his mother. The examiner added that there were probably some issues related to the Veteran’s deployment but, after over 20 years, that is no longer the case. The Board places little probative weight on this opinion as it does not discuss the Veteran’s treatment history or other diagnoses noted in medical records. In addition, the examiner did not provide an adequate rationale for concluding his conditions are not related to his combat experiences. Consequently, the Board finds the evidence is at least in equipoise as to whether the Veteran’s acquired psychiatric disorder, diagnosed as anxiety, is related to his active service. Accordingly, service connection for a psychiatric disorder, diagnosed as anxiety, is granted. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). At the Veteran’s hearing, the Veteran’s representative contended that the “anxiety symptomatology that [the Veteran] had is connected to his service.” For the reasons outlined above, the Board agrees. Given the representative’s contention and the fact that regardless of how the Veteran’s disability is characterized (or how many diagnoses are present) the Veteran may only be compensated for one psychiatric disorder, the Board finds that the instant decision applies to and resolves all pending claims of service connection for a psychiatric disability, however diagnosed. See Clemons v. Shinseki, 23 Vet. App. 1, 5-6 (2009). Evan M. Deichert Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Jiggetts 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.