Citation Nr: 22008032 Decision Date: 02/11/22 Archive Date: 02/11/22 DOCKET NO. 17-29 410 DATE: February 11, 2022 ORDER Entitlement to service connection for an acquired psychiatric condition, to include major depressive disorder and PTSD. FINDING OF FACT The most probative evidence of record indicates that the Veteran's psychiatric conditions, which include PTSD and major depressive disorder, are related to his military service. CONCLUSION OF LAW The criteria for service connection for an acquired psychiatric disorder, to include PTSD and major depressive disorder, are met. 38 U.S.C. §§ 1110, 1111, 1131, 1132; 38 C.F.R. § 38 C.F.R. §§ 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from May 1968 to December 1969. This matter is on appeal from a September 2013 rating decision. The Veteran testified before the undersigned Veterans Law Judge at a January 2022 Board hearing. Service connection will be granted if the evidence demonstrates that current disability resulted from an injury suffered or disease contracted in active military, naval, or air service. 38 U.S.C. § § 1110, 1131; 38 C.F.R. § 3.303 (a). Establishing service connection generally requires competent evidence of three things: (1) current disability; (2) in-service injury or disease; and (3) a relationship between the two. Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018). Consistent with this framework, service connection is warranted for a disease first diagnosed after service when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d). It is the Veteran's contention that he developed psychiatric disorders, which include PTSD and depressive disorder, as a result of his service. He testified that during his active duty, he engaged in combat in the Republic of Vietnam and received a Combat Action Ribbon. In doing so, he has had to fire his weapon and machine gun on different occasions. Service connection for PTSD requires medical evidence diagnosing the condition; 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. 38 C.F.R. § 3.304 (f). The applicable regulation requires that if the in-service stressor is related to the veteran's fear of hostile military or terrorist activity means the veteran experienced, witnessed, or was confronted with an event or circumstance that involved actual or threatened death, serious injury, or a threat to the physical integrity of self or others and the person's response involved a psychological or psycho-physiological state of fear, helplessness, or horror. The Veteran's service treatment records were silent for any psychiatric diagnosis. However, his DD214 show that in addition to the Vietnam Service Medal and Vietnam Campaign Medal, the Veteran is also in receipt of the Combat Action Ribbon as well as the Vietnam Cross of Gallantry. In the Statement of the Case, the AOJ conceded that as the recipient of the Combat Action Ribbon, the Veteran experienced a stressful event in service or fear of hostile military or terrorist activity. Post service treatment records offered conflicting psychiatric diagnoses. For example, VA treatment notes dating August 2012 noted a diagnosis of PTSD, which was then refuted by an August 2013 VA examiner. Instead, the examiner found that the Veteran exhibited symptoms of a mild major depressive disorder. Then, in May 2014, the Veteran's private psychologist offered a diagnosis of PTSD. VA obtained a medical opinion in March 2017, in which the examiner did not find a diagnosis of PTSD. However, the August 2019 Board remand found the March 2017 examination report inadequate as it failed to address the Veteran's previous diagnosis of PTSD. A new medical opinion was then obtained in April 2020 from Dr. K.D. The private physician diagnosed the Veteran with PTSD and unspecified depressive disorder, which result in occupational and social impairment with occasional decrease in work efficiency and intermittent periods of inability to perform occupational task. He demonstrated hypervigilance, mistrust, and anger issues secondary to PTSD. In her report, Dr. K.D. noted that the Veteran was deployed to the Republic of Vietnam. Since then, he has had consistent metal health problems such as depression, anxiety, restlessness, hyperarousal, defensive avoidance, poor anger control, social withdrawal, and alcohol use. During his service, he was required to escort prisoners to and from interrogation, provide bridge security, and arrest fellow soldiers who disobeyed orders. He witnessed disturbing interrogation techniques, causing internal anguish as he felt helpless and conflicted. He recalled being under attack by rockets and mortar fire, fearing for his life on a daily basis. He witnessed the deaths of many service members and had even fired weapons against the enemy. Since separating from service, the Veteran continued to experience significant anxiety. He has exhibited problems with sleep due to nightmares about his service. He dislikes crowds, has poor anger control, and has reacted violently towards others. His wife has noticed the Veteran's change in behavior, indicating that his demeanor deteriorated after service. Therefore, given the Veteran's verified stressor evidence by his Combat Action Badge and his current symptoms, which were confirmed by various psychological tests, the Veteran has PTSD and unspecified major depressive disorder that directly resulted from his military service. In considering the totality of the evidence, the Board finds the April 2020 private medical opinion from Dr. K.D., highly probative as to whether the Veteran's psychiatric conditions is related to or had onset in service. In finding so, the private physician based her conclusions on an accurate characterization of the evidence, which includes an in-depth exploration of the Veteran's history, his credible and consistent statements, as well as his various treatment records. The April 2020 medical opinion established clinical diagnoses and linked them to his conceded in-service stressors. While the record also contains a negative medical opinion, such as the March 2017 VA examination report, its findings were inadequate as it failed to consider relevant and vital treatment records. In summation, the Board finds that the Veteran's clinical psychiatric diagnoses, his combat experience, along with a thorough positive medical opinion by Dr. K.D., all support the Veteran's service connection claim. Accordingly, service connection for an acquired psychiatric disorder, to include PTSD and major depressive disorder, is granted. Tiffany Dawson Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Yeh, Nicole 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.