Citation Nr: 21041670 Decision Date: 07/09/21 Archive Date: 07/09/21 DOCKET NO. 11-29 658 DATE: July 9, 2021 ORDER Entitlement to service connection for an acquired psychiatric disability is granted. FINDING OF FACT Resolving all doubt in favor of the Veteran, his acquired psychiatric disability is etiologically related to service. CONCLUSION OF LAW The criteria for entitlement to service connection for an acquired psychiatric disability have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from September 1972 to September 1974, and from January 1991 to March 1991. He also had periods of active duty for training (ACDUTRA) and inactive duty for training (INACDUTRA) in the Army Reserve. This case initially came before the Board of Veterans' Appeals (Board) on appeal from a February 2011 rating decision issued by a Regional Office (RO) of the Department of Veterans Affairs (VA). This claim has been before the Board and the United States Court of Appeals for Veterans Claims (Court) on multiple occasions. In an April 2017 decision, the Board denied entitlement to service connection for a psychiatric disability and the Veteran appealed to the Court. In May 2018, pursuant to a Joint Motion for Remand, the Court vacated the Board's decision. In September 2018, October 2019, and January 2021, the Board remanded the claim for additional development. The case has since been returned to the Board for further appellate review. Service Connection Under the relevant laws and regulations, 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. Generally, the evidence 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. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Under 38 C.F.R. § 3.303(b), an alternative method of establishing the second and third Shedden element is through a demonstration of continuity of symptomatology if the disability claimed qualifies as a chronic disease listed in 38 C.F.R. § 3.309(a). Regulations also provide that service connection may be granted for a disability diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disability is due to disease or injury which was incurred in or aggravated by service. 38 C.F.R. § 3.303(d). Finally, 38 U.S.C. § 1154(a) requires that VA give "due consideration" to "all pertinent medical and lay evidence" in evaluating a claim for disability or death benefits. Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). Specifically, "[l]ay evidence can be competent and sufficient to establish a diagnosis of a condition when (1) a layperson is competent to identify the medical condition, (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, 1377 (Fed. Cir. 2007); see also Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006). Entitlement to service connection for an acquired psychiatric disability Service connection for PTSD specifically requires medical evidence establishing a diagnosis of the disability, credible supporting evidence that the claimed in-service stressor actually occurred, and a link, established by medical evidence, between the current symptomatology and the claimed in-service stressor. See 38 C.F.R. § 3.304(f). The Veteran asserts that he suffers from an acquired psychiatric disability as a result of his time in service. The Veteran has been diagnosed with numerous psychiatric disabilities to include PTSD, depressive disorder, personality disorder, and dysthymic disorder as noted by a February 2020 VA examiner and March 2020 CAPRI records. The first Shedden element, that of a current disability, has thus been met. With regard to an in-service occurrence, the Veteran reported throughout the entirety of this appeal period that he witnessed a troop carrier roll over and crush two fellow soldiers, killing them. The Board finds the Veteran credible, especially considering that he has been consistent and specific in his report of that traumatic event throughout the appeal. Therefore, the Board finds that the second Shedden elements has also been met. Accordingly, the Board will turn to the question of whether his acquired psychiatric disability is related to military service. In support of the claim is a February 2020 VA examination. Therein, the VA examiner diagnosed the Veteran with PTSD with depressive disorder and dysthymic disorder subsumed by it. The Veteran informed the examiner of the same traumatic event from service (the troop carrier rollover) which he alleges is his stressor. The examiner concluded that the Veteran's PTSD is at least as likely as not related to this traumatic event from service because the "Veteran has no mental health issues prior to military service" and "stated that he saw the bodies and brains laying in pieces of skull BEFORE they were put in body bags." The examiner based his opinion on the in-person examination and consideration of the Veteran's claims file. Upon careful review of the record, the Board finds that entitlement to service connection for an acquired psychiatric disability is warranted. In so finding, the Board assigns great probative value to the February 2020 opinion. The probative value of a medical opinion comes from the factually accurate, fully articulated, and sound reasoning for the conclusion. Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). The February 2020 opinion is based upon a thorough review of the record and an examination of the Veteran, and the VA examiner concluded that the Veteran's symptomatology is attributable to his experiences in service. The Board notes that the Veteran was diagnosed with PTSD, and regulations require credible supporting evidence that the stressor occurred in order for service connection for PTSD, in particular, to be granted. 38 C.F.R. § 3.304(f). For this reason, the January 2021 Board decision remanded for further development. However, such development was not performed as the May 2021 record research response states that the "request closed without research." Stegall v. West, 11 Vet. App. 268 (1998). Nevertheless, the Board finds that the Veteran has additionally been diagnosed with other mental disabilities other than PTSD during the course of the appeal period, to include depressive disorder and dysthymic disorder, and although those diagnoses are "subsumed" by PTSD (according to the February 2020 VA examiner), they are nonetheless eligible for service connection on their own merit. Given this, the Board thus finds that the evidence is at least in equipoise that the Veteran's psychiatric disorderhowever diagnosedis etiologically related to the in-service incident. The third Shedden element, the existence of a causal relationship or nexus between the Veteran's psychiatric symptoms and service, is thus satisfied. Therefore, resolving all doubt in favor to the Veteran, the Board finds that the evidence supports a nexus between the Veteran's current acquired psychiatric disability and his service. As all elements of service connection have been satisfied, service connection for an acquired psychiatric disability is granted. See 38 U.S.C. § 5107(b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990); 38 C.F.R. § 3.303(d). The nature and extent of the disorder is not before the Board at this time. Caroline B. Fleming Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Finelli, 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.