Citation Nr: 21030602 Decision Date: 05/19/21 Archive Date: 05/19/21 DOCKET NO. 16-59 239 DATE: May 19, 2021 ORDER Service connection for posttraumatic stress disorder (PTSD) is denied. Service connection for an acquired psychiatric disorder other than PTSD is denied. FINDINGS OF FACT 1. The Veteran had active duty from August 1987 to August 1991. 2. A diagnosis of PTSD has not been shown. 3. An acquired psychiatric disorder, diagnosed as alcohol use disorder, unspecified depressive disorder, and probable personality pathology, was not shown in service and is not causally or etiologically related to service. CONCLUSIONS OF LAW 1. PTSD was not incurred in service. 38 U.S.C. §§ 1110, 1131, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.159, 3.303, 3.304(f) (2020). 2. An acquired psychiatric disorder other than PTSD was not incurred in service. 38 U.S.C. §§ 1110, 1131, 5103(a), 5103A, 5107 (2012); 38 C.F.R. §§ 3.159, 3.303 (2020). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS In August 2019, the Board denied the appeal. The Veteran appealed to the Veterans Claims Court. In August 2020, the Court Clerk granted a Joint Motion for Partial Remand (JMPR). Specifically, the issues were remanded to obtain outstanding VA treatment records and Social Security Disability (SSDI) records. However, during the April 2021 Board hearing, the Veteran stated that he never received treatment from the specified VA healthcare centers and was not receiving SSDI benefits. Accordingly, remand is not necessary as there are no records to obtain. Turning to the relevant laws and regulations, 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). PTSD With specific regard to PTSD, three elements must be present: (1) a current medical diagnosis of PTSD in accordance with 38 C.F.R. § 4.125(a); (2) medical evidence of a causal nexus between current symptomatology and a claimed in-service stressor; and (3) credible supporting evidence that the claimed in-service stressor actually occurred. 38 C.F.R. § 3.304(f); Cohen v. Brown, 10 Vet. App. 128 (1997). Turning to the medical evidence, the record does not show a current diagnosis of PTSD, nor was he diagnosed with PTSD at any time during the pendency of the appeal. Clinical treatment records throughout the relevant period reflect complaints of PTSD and PTSD related symptoms by the Veteran; however, he is not competent to diagnosis PTSD and as such, these complaints are not sufficient to reflect a diagnosis. In January 2012, clinical treatment records show the Veteran presented for an assessment to explore the possibility of a PTSD diagnosis. Upon testing, the examiner found that the Veteran's responses indicated an exaggeration of symptoms and a possible deliberate attempt to cast himself as more disturbed than he really was. The examiner concluded that the Veteran did not meet the criteria for a diagnosis of PTSD. He sought a second opinion in 2012, but again no finding of PTSD was made. In March 2014, a nurse found that given the Veteran's symptoms and the duration of the symptoms, there was a likelihood that he may have had PTSD related to service; however, no diagnosis was actually made. Further, an August 2014 treatment note indicated that PTSD was not found. Also weighing against the claim, a September 2016 VA examiner reported that the Veteran had a diagnosis of alcohol use disorder, unspecified depressive disorder, and probable personality pathology; however, he found that the Veteran did not have a diagnosis of PTSD at the time of the examination. The examiner further explained that psychological assessments and biophysical assessments made since 2002, when the Veteran first complained of PTSD, have not found evidence of symptoms to support a diagnosis of PTSD. Instead, the records reflected consistent and chronic difficulties with depression. As such, the medical evidence does not show a current diagnosis of PTSD. No psychologist or psychiatrist has ever diagnosed the Veteran with PTSD and he has been consistently diagnosed with alcohol use dependence, depression, and personality disorder traits. Accordingly, without a current diagnosis, service connection for PTSD is not warranted. An Acquired Psychiatric Disorder Other Than PTSD Turning to the medical evidence, a September 2016 VA examiner indicated diagnoses of alcohol use disorder, unspecified depressive disorder, and probable personality pathology. As such, a current psychiatric disorder has been shown and the first element of service connection has been met. As to in-service incurrence, the service treatment records (STRs) do not reflect complaints of or treatment for a psychiatric disorder during service. Specifically, the August 1991 separation examination reflected a normal clinical psychiatric evaluation and no defects were noted. In addition, the Veteran denied frequent trouble sleeping and depression or excessive worry. The first complaints of a psychiatric disorder came while the Veteran was serving in the National Guard. Specifically, an April 1996 Report of Medical History noted frequent trouble sleeping that began in January 1996 and depression and excessive worry that began in December 1995. However, the evidence shows that this came during the Veteran's time in the National Guard and not during active service. There is no indication that any psychiatric symptoms occurred during a period of active duty for training (ACDUTRA) or inactive duty for training (INACDUTRA). Further, the Veteran has not contended that psychiatric symptoms began during a period of ACDUTRA or INACDUTRA. As such, the medical evidence does not support the in-service incurrence of a psychiatric disorder. Further weighing against the claim, the medical evidence does not support a nexus between a current psychiatric disorder and service. In January 2013, a VA psychologist stated that while the Veteran experienced some traumas during service, he did not appear to be suffering from effects directly from those incidents. However, the psychologist noted that those experiences significantly impacted the Veteran and complicated his efforts at functioning in civilian society. He concluded that most of the Veteran's stress was related to family issues. Accordingly, no medical nexus was established. The September 2016 VA examiner noted that symptoms of depression had been documented and treated since 1995. He opined that while the nexus of this diagnosis was unclear, it was more likely than not that depression and sleep problems began while serving in the National Guard. Given that symptoms of depression began several years after active service, the examiner concluded it would be mere speculation to opine if depression was the result of an in-service stressor related event. In addition, the examiner reflected that psychological testing was invalid due to probable over-reporting of symptoms and the Veteran was vague, evasive, and guarded during the interview, which made it difficult to obtain the necessary information to make a confident opinion regarding the etiology of the psychiatric disorder. There are no other medical opinions of record. Accordingly, the medical evidence does not support service connection for an acquired psychiatric disorder as the record does not reflect an in-service incurrence or a causal nexus. The Board has considered the lay statements of the Veteran and his family members and his testimony at a hearing before the Board that an acquired psychiatric disorder was caused by service. He and his family members are competent to report symptoms because this requires only personal knowledge as it comes to them through their senses. However, they are 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 service records, clinical evidence, and examination obtained and associated with the claims file. Here, the Board attaches greater probative weight to the clinical findings than to the lay statements. In light of the above, the preponderance of the evidence is against the claims for service connection and there is no doubt to be otherwise resolved. As such, the appeals are 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 T. Kokolas, 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.