Citation Nr: 21028549 Decision Date: 05/11/21 Archive Date: 05/11/21 DOCKET NO. 15-34 520 DATE: May 11, 2021 ORDER Service connection for an acquired psychiatric disorder, to include a depressive disorder, is granted. FINDING OF FACT It is at least as likely as not that the Veteran's current acquired psychiatric disorder, to include a depressive disorder, had onset in or is otherwise related to service. CONCLUSION OF LAW The criteria for entitlement to service connection for an acquired psychiatric disorder, to include a depressive disorder, have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from September 1972 to December 1973. In August 2018, the Board remanded the Veteran's claim for entitlement to service connection for an acquired psychiatric disorder for additional development. The agency of originally jurisdiction (AOJ) has substantially complied with the remand directives, and the Board finds the evidence of record is sufficient to proceed with a decision on the merits of the Veteran's claim. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). In August 2012 correspondence, the Veteran submitted an informal claim for entitlement to service connection for depression. In connection with his claim, the Veteran submitted a letter from his sister, M.W., a licensed professional counselor. M.W. reported that the Veteran demonstrated changes in his behavior following military service. See also undated correspondence from K.S. received by VA in December 2013. M.W. reported that she had observed that the Veteran appeared withdrawn, agitated, and irritable after his separation from service. M.W. reported that the Veteran demonstrated obvious changes in his interpersonal skills, that he was moody, did not relate well to others, and oftentimes appeared to be depressed. M.W. reported the Veteran has continued to exhibit through the present day destructive behaviors, poor coping skills, paranoia, and limited interaction with family. In December 2012 correspondence, the Veteran indicated he had a long history of depression. The Veteran indicated that he self-medicated his depression by using illegal drugs. In reviewing service records, the Veteran received nonjudicial punishment in July 1973 for having illegal drugs in his possession. See July 1973 Record of Proceedings Under Article 15. The Veteran reported he possessed the illegal drugs with the intent to use them to ease his worries. In response to personnel counseling records, the Veteran reported he had experienced nothing but problems since entering active duty service, and that he had been subjected to harassment. In a November 1973 request for mental health consultation, the Veteran's commander reported the Veteran had a lengthy record of personal problems. Service treatment records document that the Veteran reported frequent trouble sleeping, depression or excessive worry, and nervous trouble. See November 1973 Report of Medical History. The provider noted that the Veteran's reported symptoms of nervousness, trouble sleeping, and depression had onset in service. The Veteran was afforded a VA mental disorders examination in February 2013. The Veteran reported he had a depressed mood most of the time, and occasional anxiety. The examiner indicated that if the Veteran had experienced periods of depression since his separation from service, it is reasonable to suspect that this history had something to do with mood changes. In December 2013, Dr. H.H. reported the Veteran had a current diagnosis of depressive disorder, not otherwise specified. The Veteran reported chronic sleep impairment, and frequent crying. The Veteran reported he self-medicated with drugs. The Veteran reported that his near-continuous depression and anxiety symptomatology were not present prior to his military service. Based on interview with the Veteran, and review of the claims file and letters from the Veteran's sisters, Dr. H.H. opined that the working conditions the Veteran was exposed to during his military service caused his current depressive disorder. Dr. H.H. reported there was a clear correlation between the Veteran's return home from service and psychological complaints leaving him unable to develop and maintain social relationships, which contributed even more to his depressive disorder. In February 2016 correspondence, M.W. reported the Veteran was "happy-go-lucky, very outgoing, and well groomed" before joining the military. M.W. reported the Veteran was completely different upon his separation from service. See also February 2016 correspondence from K.S. M.W. opined the Veteran would abuse drugs and alcohol to help cope with his mental condition, improve his mood, make him feel better, and alleviate how he was thinking and feeling. M.W. reported the Veteran's mental condition had gotten worse over the years, and that he continues to have a mental problem to this day. The Veteran was afforded another VA mental disorder examination in May 2019. The examiner reported the Veteran had a current diagnosis of unspecified depressive disorder. The examiner reported there was no evidence that the reported symptoms of depression in service had been continuous. See also October 2019 VA examination. The examiner opined the Veteran's current symptoms did not appear to be related to the symptoms of depression and trouble sleeping in service. In a July 2020 private assessment, Dr. K.B. reviewed the Veteran's service records, post-service treatment records, mental health evaluations, statements from the Veteran's family members, and conducted an interview with the Veteran. Dr. K.B. indicated the Veteran began having symptoms of depression due to stressors he encountered while serving in the Army. Dr. K.B. reported the Veteran began abusing substances to cope with these symptoms, avoiding formal treatment for some time. Dr. K.B. reported the Veteran's reduced coping skills placed him at a greater risk of self-medication, a behavior that had played out in his clinical history. Dr. K.B. opined the Veteran's mental health disorder more likely than not had onset during service. In consideration of the entire evidence of record, the Board finds that entitlement to service connection for an acquired psychiatric disorder, to include unspecified depressive disorder, is warranted. In this regard, the Board assigns probative weight to the December 2013 mental health evaluation by Dr. H.H., and the July 2020 mental health evaluation by Dr. K.B. The positive medical opinions from Dr. H.H. and Dr. K.B. are fully articulated, based on a thorough review of the claims file and supporting evidence in the Veteran's service records, the observations of family members concerning the Veteran's behavioral and mental health symptoms before and after the Veteran's discharge from service (to include M.W.'s competent medical statements), and interview of the Veteran. See also 38 C.F.R. § 3.159. With respect to the negative VA medical opinions of record, the examiners appear to rely primarily on a lack of mental health treatment records following the Veteran's separation from service. Buchanan v. Nicholson, 451 F.3d 1331, 1336 (Fed. Cir. 2006) (While the lack of contemporaneous medical records may be considered and weighed against a veteran's lay evidence, the lack of such records does not, in and of itself, render lay evidence not credible). The negative VA medical opinions do not appear to consider the Veteran's report of continued mental health symptoms following service, which is supported by the observations of family members (to include M.W.'s competent medical statements). Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008) (the probative value of a medical opinion comes from when it is factually accurate, fully articulated, and sound reasoning for the conclusion). In light of the above, the Board finds entitlement to service connection for an acquired psychiatric disorder, to include unspecified depressive disorder, is warranted, and the claim is granted. V. Chiappetta Veterans Law Judge Board of Veterans' Appeals Attorney for the Board B. Mask, 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.