Citation Nr: 21030337 Decision Date: 05/18/21 Archive Date: 05/18/21 DOCKET NO. 15-05 889 DATE: May 18, 2021 ORDER Entitlement to service connection for an acquired psychiatric condition, to include major depressive disorder and substance abuse disorder, is denied. FINDING OF FACT The preponderance of the evidence is against finding that the Veteran's acquired psychiatric condition began during active service, or is otherwise related to an in-service injury or disease. CONCLUSION OF LAW The criteria for entitlement to service connection for an acquired psychiatric condition, to include major depressive disorder and substance abuse disorder, are not met. 38 U.S.C. §§ 1110, 1154, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303, 3.304, 4.125 (2020). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Navy from September 1974 to April 1975. Unfortunately, during the pendency of the appeal the Board was notified of the Veteran's death in January 2016. The appellant is the Veteran's spouse who has been recognized as a substitute claimant. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida denying the Veteran's claim for depression. In October 2020, the Board remanded the claim for additional development including obtaining a medical opinion. It has since been returned to the Board for further appellate consideration. The scope of a claim for service connection for disability includes any disability that reasonably may be encompassed by the claimant's description of the claim, reported symptoms, and the other information of record. See Clemons v. Shinseki, 23 Vet. App. 1, 5-6 (2009). In accordance with Clemons, the Board has expanded the issue on appeal to service connection for an acquired psychiatric disability, to include major depressive disorder, substance abuse disorder and alcohol abuse disorder. 1. Entitlement to service connection for an acquired psychiatric condition The appellant contends that the Veteran's acquired psychiatric condition was related to his military service. Alternatively, she contends that the Veteran's substance abuse disorder, alcohol abuse disorder and major depressive disorder were secondary to his chronic back and neck condition. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004). Pursuant to 38 U.S.C. §§ 105, 1110, and 1131, "no compensation shall be paid if the disability is the result of the person's own willful misconduct or abuse of alcohol or drugs." However, service connection is warranted for an alcohol or drug abuse disability acquired as secondary to, or as a symptom of, a veteran's service-connected disability. See Allen v. Brown, 237 F. 3d 1368 (Fed. Cir. 2001). A claimant may be compensated for a substance abuse disability only "where there is clear medical evidence establishing that the alcohol or drug abuse disability is indeed caused by a primary service-connected disability, and where the alcohol or drug abuse disability is not due to willful wrongdoing." The question for the Board is whether the Veteran had a current acquired psychiatric disability, that began during service or is at least as likely as not related to an in-service injury, event, or disease. The Board finds that the preponderance of the evidence is against finding that the Veteran had an acquired psychiatric condition that began during active service, or is otherwise related to an in-service injury, event, or disease. The Veteran's service treatment records (STRs) are silent for complaints, symptoms, treatment or diagnosis of depression or any other mental health disorder. See October 1975 STRs. In June 1976, the Veteran entered a hospital detoxification program due to his heroin dependency, however his mental status was normal and there's no indication he was treated for a mental health disorder. See July 1976 Hospital Summary. After separating from service, the Veteran was treated through the years for substance and alcohol abuse. During a March 1999 addiction severity evaluation, the examiner indicated the Veteran had been abusing alcohol for 29 years, and abusing drugs, including heroin and cocaine, for over 15 years. See May 2005 VA Medical Treatment Records. The Veteran reported treatment for substance abuse on 4 different occasions. The Veteran stated that he had never been treated or diagnosed with psychological or emotional problems, and there was no history of suicidal ideation. Id. The Veteran had multiple negative depression screens including in August 1998, December 1999, September 2001, April 2005, July 2006, August 2008, and February 2010. See May 2005 and April 2014 VA Medical Treatment Records. During a June 2010 mental status examination, the Veteran reported that he had depression and his symptoms started 10 years prior after witnessing the death of a friend. See October 2020 Medical Treatment Records from SSA. The Veteran reported being treated for a mental health disorder in 1989 but could not remember any medications and stated he did not have counseling. He reported being hospitalized in 2000 for depression. Id. The examiner diagnosed the Veteran with major depressive disorder and alcohol and cannabis abuse. Id. During a July 2010 psychiatric review, the Veteran was diagnosed with major depressive disorder, affective disorder and substance addiction disorders. Id. In January 2013, the Veteran was hospitalized due to reported suicidal ideations, anxiety and shakiness. See April 2014 VA Medical Treatment Records. He reported recent alcohol and cocaine use but denied any prior history of withdrawal. Id. The Veteran was diagnosed with cocaine dependency and cocaine induced depression, however the physician noted the depression was resolved prior to discharge. Id. After approximately 24 hours in the hospital, the Veteran requested a discharge; the treating physician noted the Veteran did not have depression, psychosis or thoughts of harming himself or others and he was discharged the following day. Id. In a March 2021 VA medical opinion, the examiner opined that it was less likely than not that the Veteran's acquired psychiatric condition was incurred in or caused by service. The examiner provided a thorough analysis of the Veteran's medical history and although there were numerous reports of alcohol and substance abuse treatment, the examiner opined that the Veteran's medical records did not support a mental health disorder beyond substance abuse. Id. The record is silent for any complaints, symptoms, treatment or diagnosis of an acquired psychiatric condition until a June 2010 mental status examination that indicates a diagnosis of major depressive disorder, 35 years after service. In addition, the Veteran reported during the June 2010 examination that the onset of his depression was 10 years prior, in approximately 2000, after he witnessed the death of a friend. Medical records dated from 1998 to 2010 indicate the Veteran had multiple negative depression screens. The March 2021 VA examiner opined that the Veteran's acquired psychiatric condition was not related to service and provided a detailed analysis in support of his conclusion. While the appellant believes the Veteran's acquired psychiatric disability, including his depression, was related to his active service, the evidence of record does not support those contentions. Although lay people are competent to report on matters observed or within their own personal knowledge, a lay person is not competent to interpret clinical findings pertaining to the etiology of a psychiatric disorder as this requires specialized knowledge and training. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). The Board finds that the March 2021 VA examiner's opinion, in addition to the Veteran's May 2005, April 2014 and October 2020 medical treatment records, are entitled to more probative value. While the record indicates the Veteran was treated for alcohol and substance abuse in June 1976, service connection is only warranted for an alcohol or drug abuse disability acquired as secondary to, or as a symptom of, another service-connected disability. See Allen, 237 F. 3d 1368. The Board finds that the preponderance of the evidence is against a finding that the Veteran's acquired psychiatric condition was caused or aggravated by an event, injury, or illness during active service, or etiologically related to service. The rationale of the March 2021 VA examiner, supported by the service and medical treatment records, simply outweighs the appellant's contentions that the Veteran's mental health disorder began or was aggravated by service. The Board has considered the benefit-of-the-doubt doctrine; however, the Board does not perceive an approximate balance of positive and negative evidence. The preponderance of the evidence is against an in-service incurrence or aggravation of the disease or injury, and therefore, the claim. The doctrine is not applicable, and the claim for entitlement to service connection for an acquired psychiatric condition, to include major depressive disorder and substance abuse disorder, must be denied. See 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. a) Secondary Service Connection Service connection may be granted for a disability that is proximately due to, or aggravated by, service-connected disease or injury. 38 C.F.R. § 3.310. The appellant contends the Veteran's major depressive disorder, substance abuse disorder and alcohol abuse disorder were the result of his chronic neck and back condition. As the Veteran was not service connected for any disability, secondary service connection is not an available theory of entitlement. Therefore, the Board finds that entitlement to service connection for and acquired psychiatric condition, to include major depressive disorder and substance abuse disorder, as secondary to a neck and back condition, is not warranted. The benefit of the doubt doctrine is therefore not for application. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. K. MARENNA Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Aubee, 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.