Citation Nr: 21027974 Decision Date: 05/10/21 Archive Date: 05/10/21 DOCKET NO. 17-05 837 DATE: May 10, 2021 ORDER Service connection for an acquired psychiatric disorder is denied. FINDINGS OF FACT 1. The Veteran had active duty from October 1977 to August 1992. 2. A current diagnosis of posttraumatic stress disorder (PTSD) is not shown for VA purposes; an acquired psychiatric disorder, diagnosed as major depressive disorder, was not shown in service, is not causally or etiologically related to service, and has not been medically associated with a service connected disability. CONCLUSION OF LAW An acquired psychiatric disorder was not incurred in service and is not secondary to a service connected disability. 38 U.S.C. §§ 1110, 1131, 5103, 5103A, 5107 (2012); 38 C.F.R. § 3.303, 3.310 (2020). REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran testified before the undersigned Veterans Law Judge in May 2019. A copy of the transcript has been associated with the claims file. Service connection may be granted on a direct basis as a result of disease or injury incurred in service based on nexus using a three-element test: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred in or aggravated by service. See 38 C.F.R. §§ 3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). Service connection may be granted on a secondary basis for a disability which is aggravated by, proximately due to, or the result of a service-connected disease or injury under 38 C.F.R. § 3.310. Allen v. Brown, 7 Vet. App. 439 (1995). In order to establish service connection on a secondary basis, there must be (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) medical evidence establishing a link between the service-connected disability and the current disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998). As an initial matter, in 2019, the Veteran was diagnosed with PTSD by a social worker; however, under the relevant laws and regulations, only a VA psychiatrist or psychologist, or a psychiatrist or psychologist with whom VA has contracted may confirm that the claimed stressor is related to a diagnosis of PTSD. Further, in a February 2021 VA examination, the examiner did not diagnose the Veteran with PTSD. Therefore, service connection will only be addressed for an acquired psychiatric disorder other than PTSD. The Veteran contends that an acquired psychiatric disorder was incurred in service and/or caused or aggravated by service connected hemorrhoids/fecal incontinence. Therefore, both direct and secondary service connection will be addressed. Turning first to direct service connection, the Veteran was diagnosed with depression in 2013. Therefore, a current disorder is shown, and the first element of direct service connection is met. As to an in-service incurrence, in an August 2019 clinical record, the Veteran reported depressive episodes due to inspecting cars for bombs in service and seeing a police chief die while trying to diffuse a bomb. However, service treatment records (STRs) are absent of complaints, diagnoses, or treatment for an acquired psychiatric disorder. Specifically, he sought treatment for hemorrhoids, gastrointestinal symptoms, and an arm injury, among others, but did not report symptoms of an acquired psychiatric disorder. To the extent that the Veteran asserts that an acquired psychiatric disorder began in service, in a January 2020 VA examination, the examiner opined that an acquired psychiatric disorder was less likely than not due to service. The examiner reasoned that the Veteran reported that he did not struggle with depression until his son's death in 2004. Therefore, the examiner concluded that the predominant driver for the Veteran's emotional distress appeared to be his substance abuse. This evidence weighs against the claim. Further, in a February 2021 VA examination, the Veteran stated that while he had been depressed in service, his symptoms did not become consistent until his son's death. Upon examination, the examiner opined that an acquired psychiatric disorder was less likely than not incurred in service. He reasoned that the Veteran's psychiatric symptoms did not begin until 2000, eight years after separation from service. This evidence weighs against the claim. There is no medical opinion inconsistent with the medical opinions discussed above. Therefore, the medical evidence weighs against a finding that an acquired psychiatric disorder was incurred in service. Therefore, the medical evidence does not support the claim of direct service connection. As to secondary service connection, the Veteran has been diagnosed with major depressive disorder and is service connected for hemorrhoids and fecal incontinence. Therefore, the first two element of secondary service connection, a current disorder and a service connected disability, are met. As to nexus, in a December 2014 VA examination, the examiner opined that an acquired psychiatric disorder was not caused or aggravated by a service connected disability. He reasoned that there was no evidence that depression was due to hemorrhoids. Rather, when the Veteran was first seen for depression, issues related to the death of his son, his separation from his wife, and house fire were paramount. This evidence weighs against the claim. Further, in a January 2020 VA examination, the examiner opined that an acquired psychiatric disorder was not caused or aggravated by a service connected disability. While the examiner wrote that the "presence of a gastrointestinal illness is more than 50% related to and complicating emotional problems," the examiner also stated that the Veteran's depression began in 2004 and that the predominant driver for the Veteran's emotional distress appeared to be substance abuse. Therefore, as the examiner concluded that the predominant driver for the Veteran's emotional distress was not a service connected disability, this evidence weighs against the claim. Based on the above, the medical evidence does not support the claim of secondary service connection. In sum, the medical evidence does not support that an acquired psychiatric disorder was incurred in service and/or was caused or aggravated by a service connected disability. The Board has considered the Veteran's lay statements and testimony that this disorder began in service and/or is related to a service connected disability. He is competent to report symptoms because this requires only personal knowledge, as it comes to him through his senses; however, he is not competent to offer an opinion as to the etiology of his current disorder due to the medical complexity of the matters involved. Such competent evidence has been provided by the medical personnel who have examined the Veteran during his current appeal and by service records obtained and associated with the claims file. Here, the Board attaches greater probative weight to the clinical findings than to the lay statements that have been submitted. Therefore, the appeal is denied. Finally, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board's consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). L. HOWELL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Ragofsky, Danielle 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.