Citation Nr: 21029980 Decision Date: 05/17/21 Archive Date: 05/17/21 DOCKET NO. 19-33 632 DATE: May 17, 2021 ORDER Service connection for bipolar disorder is denied. FINDING OF FACT The Veteran's bipolar disorder did not onset due to an event or incident of his period of service. CONCLUSION OF LAW The criteria for entitlement to service connection for bipolar disorder have not been met. 38 U.S.C. §§ 1110, 1154 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from December 1964 to December 1966. This matter came before the Board of Veterans' Appeals (Board) on appeal from an October 2018 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). In the February 2021 decision, the Board denied claims of service connection for posttraumatic stress disorder (PTSD), claustrophobia, alcohol use disorder, major depressive disorder (MDD), and social anxiety disorder. The Board remanded the claim for service connection for bipolar disorder for the RO to schedule the Veteran for VA examination to determine the etiology of the bipolar disorder. The Veteran underwent VA mental disorders examination in March 2021 and the psychologist provided an opinion as to the etiology of the bipolar disorder. The development has been completed and the case has been returned to the Board for appellate consideration. As the other psychiatric disorders were decided in the previous, February 2021 Board decision, the claim for service connection for bipolar disorder will be the only psychiatric disorder addressed in this Board decision. The Veteran contends that his bipolar disorder onset because of the performance of his duties in an enclosed munitions handling room and was involved in the firing of ammunition while stationed in Vietnam. He reported that he felt helpless and feared not having any escape route which caused panic and anxiety attacks. Because there is no competent evidence of a connection between the bipolar disorder and his service, the appeal will be denied. This appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c). 38 U.S.C. § 7107(a)(2). 1. Entitlement to service connection for bipolar disorder Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Establishing service connection generally requires (1) evidence of a current disability; (2) evidence of in-service incurrence or aggravation of a disease or injury; and (3) evidence of a nexus between the claimed in-service disease or injury and the present disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004); see also Caluza v. Brown, 7 Vet. App. 498, 506 (1995), aff'd per curiam, 78 F.3d 604 (Fed. Cir. 1996) (table); 38 C.F.R. § 3.303. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107(b). The December 1966 separation examination and a February 1967 annual examination documents that psychiatric clinical evaluation resulted in normal findings. Service treatment records contain no documentation of complaints of or treatment for an acquired psychiatric disorder. In February 1967, the Veteran underwent a service department medical examination. In his medical history questionnaire, he denied having a history of depression or excessive worry; loss of memory or amnesia; or, nervous trouble of any sort. Post service treatment records reflect continuing treatment for various psychiatric disorders. October 2017 and March 2018 treatment records reflect that the Veteran in therapy for treatment of anxiety associated with his time in service. The Veteran reported that he was stationed in a small room next to two five-inch guns aboard his assigned ship. He explained that 175 rounds were fired from the guns and that he felt a lot of stress because of this experience. The Veteran also alleged seeing eight to 15 body bags being unloaded of service members being unloaded for transport home. He also alleged that he witnessed the beating of a prisoner of war. The therapist noted that the Veteran recently had a history of cyclic mood challenges congruent to a bipolar spectrum disorder. In pertinent part, the DSM 5 diagnosis was bipolar II disorder. The March 2021 Report of VA mental disorders examination documents diagnosis of bipolar disorder. The psychologist commented that the Veteran had manic episodes which could last up to seven days. The Veteran's mania was usually defined by persistent elevated mood. During elevated mood episodes, the Veteran displayed grandiosity, decreased need for sleep, being more talkative than usual, having racing thoughts, and increased goal-driven behavior. The Veteran reported that he had two tours of service in Vietnam. He alleged that he worked with the Black Berets and his ship patrolled the Tra Khuc River in North Vietnam. He reported that he helped load guns that made contact with the North Vietnamese. After service he worked for the California Department of Transportation for 10 years and then was self-employed as a landscaper before retiring to care for his ailing parents. He had been married three times and lived with his current wife on a rural piece of property. On mental status examination, the psychologist opined that the Veteran's bipolar disorder was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The psychologist explained that the Veteran had a familial history of bipolar disorder and concluded the likely cause of his challenges with bipolar disorder was 50 percent or greater attributable to familial genetic pathway. Specifically, the psychologist concluded that the Veteran's bipolar disorder was not caused in any manner by experiences in his workspace during his period of service. Noting the Veteran's complaint of painting in an enclosed space during service and losing consciousness, the psychologist concluded that there was no causal connection between the painting incident and the Veteran's bipolar disorder. In expressing this opinion, the psychologist documented review of the evidence of record. Though the Veteran has current bipolar disorder, the preponderance of the evidence is against a finding of a linkage between the onset of the current bipolar disorder and a period of service. Rather, the evidence shows that the Veteran's current bipolar disorder had no relationship to service and was more likely attributable to familial genetic pathway (i.e., the familial history/genetic predisposition to bipolar disorder was the more likely cause of the Veteran's bipolar disorder) (See March 2021 VA examination report). In addition, the psychologist explained that the Veteran's bipolar disorder had no causal connection to any workspace problems or painting incidents during his period of service. These conclusions are probative as they are based on facts presented by both the service treatment records and the assertions made by the Veteran at the time of the VA examination. No examiner has determined an etiological relationship exists between the Veteran's bipolar disorder and event or incident of his period of service. The Veteran is not competent to link his bipolar disorder to service. Competent lay evidence means any evidence not requiring that the proponent have specialized education, training, or experience. Lay evidence is competent if it is provided by a person who has knowledge of facts or circumstances and conveys matters that can be observed and described by a lay person. 38 C.F.R. § 3.159. Lay evidence may be competent and sufficient to establish a diagnosis of a condition when: (1) a layperson is competent to identify the medical condition (i.e., when the layperson will be competent to identify the condition where the condition is simple, for example a broken leg, and sometimes not, for example, a form of cancer); (2) the layperson is reporting a contemporaneous medical diagnosis; or, (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. Jandreau v. Nicholson, 492 F. 3d 1372 (Fed. Cir. 2007); see also Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009) (where widow seeking service connection for cause of death of her husband, the Veteran, the Court holding that medical opinion not required to prove nexus between service connected mental disorder and drowning which caused Veteran's death). The Veteran is competent to report events he experienced during his period of service. However, he is a lay person and is not competent to establish that his current bipolar disorder onset as a result thereof. The Veteran is not competent to offer opinion as to etiology of any current bipolar disorder. The question regarding the etiology of such disabilities is a complex medical issue that cannot to be addressed by a layperson. For these reasons, his allegations are non-specific and are no more than conjecture and do not rise to the type of evidence addressed by Jandreau. On this record, the claim of service connection for bipolar disorder must be denied. The preponderance of the evidence is against the claim and the benefit-of-the-doubt doctrine is not applicable. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990). Vito A. Clementi Veterans Law Judge Board of Veterans' Appeals Attorney for the Board G. Jackson 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.