Citation Nr: 22014441 Decision Date: 03/12/22 Archive Date: 03/12/22 DOCKET NO. 19-04 372 DATE: March 12, 2022 ORDER Service connection for an acquired psychiatric disability, including posttraumatic stress disorder (PTSD), is denied. FINDING OF FACT The claimed in-service stressor events of accidentally hitting a civilian pedestrian and causing her serious bodily injury or death while driving a vehicle during service in Korea or having sustained a left knee injury during service have not been corroborated by credible, independent evidence. CONCLUSION OF LAW The criteria for service connection for an acquired psychiatric disability, including PTSD, are not met. 38 U.S.C. §§ 1131, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran, who is the appellant, had active service from July 1981 to December 1988. This matter is on appeal from a December 2017 rating decision. Service connection for an acquired psychiatric disability, including PTSD, is denied. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military, naval, or air service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303(a). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Service connection may be established on a direct basis when there is competent, credible evidence of: (1) a current disability; (2) a disease or injury in service, and; (3) a relationship or nexus between the current disability and any injury or disease during service. 38 C.F.R. § 3.303(a), (d). The Veteran has been diagnosed with PTSD (i.e., earlier psychiatric diagnoses were provisional). Service connection for PTSD may be established when there is: 1) a current medical diagnosis of PTSD in accordance with 38 C.F.R. § 4.125(a); (2) combat status or credible supporting evidence that the claimed in-service stressor occurred; and (3) medical evidence of a causal nexus between diagnosed PTSD and the claimed in- service stressor. 38 C.F.R. § 3.303. In this case, the Veteran did not have combat service and was not exposed to hostile military or terrorist activity; therefore, the presumptions afforded to combat veterans and veterans who allege fear of hostile military or terrorist activity are inapplicable in this case. Any alleged in-service stressors must be independently verified, i.e., corroborated by objective credible supporting evidence. The Veteran contends that the current PTSD is causally related to a reported in-service stressor event of accidentally hitting a civilian pedestrian and causing her serious bodily injury while driving a vehicle during service in Korea approximately in early 1988. He asserts that he began to manifest psychiatric symptoms during service due to the incident. He also asserts that he experienced an in-service event of having sustained injury to the left knee while maintaining a mine thrower weapon, which he asserts may have caused the current PTSD. After review of all the lay and medical evidence of record, the Board finds that the weight of the evidence is against finding that there was psychiatric injury or disease during service, and that the claimed stressor event of accidentally hitting a civilian pedestrian and causing serious bodily injury while driving a vehicle during the Veteran's second tour of duty in Korea has not been sufficiently corroborated by credible, independent supporting evidence. The service treatment records (STRs) are complete and show no report, complaint, symptoms, diagnosis, or treatment for mental health problems or reference to the Veteran having been involved in a vehicular accident with a pedestrian or of having injured the left knee. At the July 1988 service separation examination, the neurological and psychiatric systems and lower extremities were clinically normal. On the July 1988 service separation report of medical history, which was contemporaneous to service and to the time of the alleged in-service events, the Veteran checked "no" when asked if he then had or had ever had frequent trouble sleeping, nervous trouble of any sort, depression or excessive worry, and trick or locked knee. The service personnel records show that the Veteran had tours of duty in Korea from December 1984 to July 1985 as a unit supply specialist and from April 1987 to December 1988 as a general construction equipment operator. He was discharged for unsatisfactory performance in December 1988 after accumulating negative counseling statements for a variety of infractions, including writing bad checks, poor performance, failure to go, pass violations, failure to obey lawful orders, failing the physical fitness test, being late for work, and other infractions during the second tour of duty in Korea. On the post-service April 1989 application for the review of discharge or dismissal from the Armed Forces of the U.S. included in the service personnel records, the Veteran wrote that he had experienced mental problems during service due to hitting and almost killing a Korean national and a divorce, but had been denied mental health services at the time. He reiterated that he was having serious mental health problems and requested help during service, but the help was never provided. Thereafter, the Army Discharge Review Board determined that the assertions were not supported by the record and the reason for discharge was proper and equitable, so the review board voted to deny the Veteran's request for a change in the character and/or reason of discharge. Although the Veteran has asserted, pursuant to this claim for compensation, that psychiatric symptoms began during service, the account is of less probative value because it is inconsistent with, and outweighed by, the lay and medical evidence contemporaneous to service showing no psychiatric symptoms, diagnosis or treatment during service, a clinically normal psychiatric system in July 1988, and the Veteran's own contemporaneous denials of any such psychiatric symptoms in July 1988. Because the Veteran's assertion that psychiatric symptoms were manifested during service is inconsistent with the other lay and medical evidence, especially the evidence generated contemporaneous to service, the recent assertion of in-service events, psychological symptoms, and the alleged request for psychological treatment during service, and that the request was denied, is not credible, so lacks probative value. Although the Veteran now contends that the current psychiatric disability is related to the claimed in-service stressor events of hitting a pedestrian while driving a vehicle during service in Korea or having sustained a left knee injury in service, the claimed stressor events are not supported by independent, corroborative evidence. As explained above, the STRs and service personnel records include no independent corroborative evidence that the alleged incidents occurred. The Veteran, as a lay person, is competent to report any psychiatric symptoms he has experienced at any given time, as well as a contemporaneous diagnosis by a medical provider, and to report a physical injury; however, he is not competent to diagnose a psychiatric disability or render a competent medical opinion on the questions of causation because answers to such questions require medical expertise in the area of psychiatric disorders and falls outside the realm of common knowledge of a lay person. See Young v. McDonald, 766 F.3d 1348, 1353 (Fed. Cir. 2014) (holding that "PTSD is not the type of medical condition that lay evidence . . . is competent and sufficient to identify"). The DSM-5 cautions that it was "not sufficient to simply check off the symptoms in the diagnostic criteria to make a mental disorder diagnosis." Rather, clinical training is required "to recognize when the combination of predisposing, precipitating, perpetuating, and protective factors has resulted in a psychopathological condition in which physical signs and symptoms exceed normal ranges." The "purpose of DSM-5 is to assist trained clinicians in the diagnosis" of various mental disorders. Consequently, the Veteran's attribution of the current psychiatric disability to service is of no probative value. Although VA mental health care providers have diagnosed PTSD based on the inaccurate factual assumption of the claimed in-service stressor event of having hit a pedestrian while driving a vehicle during service in Korea, the occurrence this asserted in-service event has not been sufficiently supported by credible independent evidence. Consequently, the purported medical statements attempting to diagnose PTSD and link the diagnosis to service are of no probative value. See Reonal v. Brown, 5 Vet. App. 458, 461 (1993) (holding that an opinion based upon an inaccurate factual premise has no probative value). No mental health care providers have linked PTSD to the claimed in-service stressor event of the alleged left knee injury, which is also uncorroborated by independent, credible evidence. The credible and probative evidence shows no verified in-service stressor event, no psychiatric symptoms until many years after service, and that the current psychiatric disability is unrelated to service. For those reasons, service connection for a psychiatric disability is not warranted, and the appeal must be denied. J. PARKER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Palmer, 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.