Citation Nr: 21028805 Decision Date: 05/12/21 Archive Date: 05/12/21 DOCKET NO. 17-51 131 DATE: May 12, 2021 ORDER Entitlement to service connection for posttraumatic stress disorder (PTSD) is denied. FINDINGS OF FACT 1. Although the Veteran has a current diagnosis of PTSD, which at least one VA medical provider has related to claimed in-service stressors, the evidentiary record does not establish that he was engaged in combat with the enemy or that he was exposed to hostile military or terrorist activity while on active duty. 2. The occurrence of the Veteran's reported in-service stressful experiences have not been corroborated by service records, or other credible supporting evidence, and he has not provided sufficient information for VA to attempt to corroborate independently any such in-service stressor events. CONCLUSION OF LAW The criteria for service connection for an acquired psychiatric disorder including PTSD are not met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. §§ 3.303, 3.304(f). REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran seeks service connection for a psychiatric disorder, claimed as PTSD which he asserts is related to traumatic experiences during his military service. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). To establish a right to compensation for a present disability, a Veteran must show: (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 or aggravated during service - the so-called "nexus" requirement. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Service connection may be granted for any disease initially diagnosed after discharge when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). There are particular requirements for establishing service connection for PTSD in 38 C.F.R. § 3.304(f) that are separate from those for establishing service connection generally. Arzio v. Shinseki, 602 F.3d 1343, 1347 (Fed. Cir. 2010). Service connection for PTSD requires medical evidence diagnosing the condition in accordance with 38 C.F.R. § 4.125(a); a link, established by medical evidence, between current symptoms and an in-service stressor; and credible supporting evidence that the claimed in-service stressor occurred. If the evidence establishes that the veteran engaged in combat with the enemy and the claimed stressor is related to that combat, in the absence of clear and convincing evidence to the contrary, and provided that the claimed stressor is consistent with the circumstances, conditions, or hardships of the veteran's service, the veteran's lay testimony alone may establish the occurrence of the claimed in-service stressor. 38 C.F.R. § 3.304(f); see also Cohen v. Brown, 10 Vet. App. 128 (1997). In order to grant service connection for PTSD to a non-combat veteran, there must be credible evidence to support the veteran's assertion that the stressful event occurred. A stressor need not be corroborated in every detail. Suozzi v. Brown, 10 Vet. App. 307, 311 (1997). Moreover, a medical opinion diagnosing PTSD does not suffice to verify the occurrence of the claimed in-service stressors. Cohen, supra; Moreau v. Brown, 9 Vet. App. 389, 395-396 (1996). However, if a stressor claimed by a veteran is related to fear of hostile military or terrorist activity and a VA psychiatrist or psychologist, or a psychiatrist or psychologist with whom VA has contracted, confirms that the claimed stressor is adequate to support a diagnosis of PTSD and that the veteran's symptoms are related to the claimed stressor, in the absence of clear and convincing evidence to the contrary, and provided the claimed stressor is consistent with the places, types, and circumstances of the veteran's service, the veteran's lay testimony alone may establish the occurrence of the claimed in-service stressor. 38 C.F.R. § 3.304(f)(3). Cases involving allegations of personal assault fall within the category of situations in which it is not unusual for there to be an absence of service records documenting the events of which the veteran complains. If a PTSD claim is based on an in-service personal assault, evidence from sources other than the Veteran's service records may corroborate his or her account of the stressor incident. Examples of such evidence include, but are not limited to the following: records from law enforcement authorities, mental health counseling centers, hospitals, or physicians, and statements from family members, roommates, fellow service members, or clergy. Evidence of behavior changes following the claimed assault is one type of relevant evidence that may be found in these sources. Examples of behavior changes that may constitute credible evidence of the stressor include, but are not limited to the following: a request for a transfer to another military duty assignment; deterioration in work performance; substance abuse; episodes of depression, panic attacks, or anxiety without an identifiable cause; or unexplained economic or social behavior changes. 38 C.F.R. § 3.304(f)(5). A diagnosis of PTSD must conform to the American Psychiatric Association's Diagnostic and Statistical Manual for Mental Disorders (DSM). 38 C.F.R. § 4.125(a). The Board recognizes that the Veterans Benefits Administration is now required to apply concepts and principles set forth in the upon the to the recently updated Fifth Edition, (DSM-5). The Veteran's service personnel records confirm that he served in the Southwest Asia Theater during the Persian Gulf War (PGW). However, there is no indication he engaged in combat, as he did not receive any commendations or awards, such as the Combat Infantryman Badge, Purple Heart, or similar citation, typically awarded primarily or exclusively for circumstances relating to combat. Moreover, he has not reported in-service stressors that fall within the scope fear of hostile military or terrorist activity under 38 C.F.R. § 3.304 (f)(3). In various statements and testimony submitted with his claim, the Veteran has identified the primary events that he considers to be the precipitating causes of his PTSD. Specifically, he has described: (1) witnessing a chief's suicide of a chief and tasked with handling the body; (2) exposure to serious flight deck injuries and death while he was on the flight deck; (3) another hanging suicide while on his last Westpac tour; (4) the stress of constant sound/noise level of the flight deck, and the level of intensity associated with his job; (5) a personal assault by his crew. See VA Form 21-0781, Statement in Support of PTSD Claim, received in March 2015 and February 2021 Hearing Transcript. The record also contains evidence favorable to the claim in the form of a June 2015 VA medical opinion in which the psychologist concluded that the Veteran's symptoms were consistent with a diagnosis of PTSD according to DSM-5. This medical opinion also establishes a link between the Veteran's symptoms and his reported in-service stressors of the chief's suicide, the deaths of six other crewman who went overboard during his tours either by suicide or by being accident, and the personal assault by his crew members. However, the psychologist also noted there were no direct markers to prove the physical assault and that he did not report it. Therefore, the issue in this case is whether the evidence supports a finding that the Veteran's claimed in-service stressors occurred. Although the AOJ attempted to verify these stressors, the Veteran did not respond to an August 2015 VA letters, requesting more specific information as to the events experienced in-service that contributed to his PTSD. It was determined that information required to verify the events, as provided by the Veteran, was insufficient to send to the U.S. Army and Joint Services Records Research Center (JSRRC). See VA Form 21-0961 memorandum dated in November 2015. The Veteran also did not reply to a second VA letter in November 2016, requesting more specific information as to the personal assault during service. Additionally, the Veteran's service records do not contain evidence of markers to support the asserted in-service personal assault. There is no evidence of any treatment for physical injuries, unexplained behavioral changes, deterioration in work performance/disciplinary problems, requests for reassignment, or chronic mental health symptoms. In fact, the Veteran's 1995 separation examination report shows no psychiatric abnormality, and he specifically denied a history of depression, excessive worry, nervous trouble, or trouble sleeping. The Veteran also has not submitted any supporting statements from family members, roommates, or fellow service members to support his assertion of having been assaulted during service. Because the diagnosis of PTSD was based on a questionable history, it may not be relied upon by the Board. See West v. Brown, 7 Vet. App. 70 (1994). See also Moreau v. Brown, 9 Vet. App. 389 (1996); (medical opinion diagnosing PTSD does not suffice to verify the occurrence of the claimed in-service stressors). See, e.g., Reonal v. Brown, 5 Vet. App. 458 (1993) (a diagnosis and purported relationship to service is only as good and credible as the history on which it is predicated). In other words, just because a physician or other health professional has accepted a veteran's description of his experiences as credible and diagnosed PTSD does not mean the Board is required to grant service connection for that disorder. See Wilson v. Derwinski, 2 Vet. App. 614, 618 (1992); see also Menegassi v. Shinseki, 638 F.3d 1379, 1382 n.1 (Fed. Cir. 2011) (VA is not required to accept a doctor's diagnosis of PTSD due to personal assault as proof that the stressor occurred, as doctors typically rely on unverified stressor information provided by the patient). Also, the AOJ took appropriate actions to verify the Veteran's reported stressors but because he did not respond with the information requested, VA's attempts to verify his stressors were hindered. See Wood v. Derwinski, 1 Vet. App. 190, 193 (1991) (holding that the duty to assist is not a "one-way street," and that, if he desires help with his claim, he must cooperate with VA's efforts to assist him). The Veteran's failure to provide the requested information served only to deprive the Board of critical, clarifying medical evidence which might have helped support his claim. In short, the Board finds no credible supporting evidence that any of the reported in-service stressors occurred. Furthermore, as the medical evidence of record which diagnoses the presence of PTSD is based on unverified stressors, service connection for PTSD is not warranted. Accordingly, the preponderance of the evidence is against the claim, and there is no reasonable doubt to be resolved. 38 U.S.C. § 5107(b). Thomas H. O'Shay Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Bryant, Jeana R 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.