Citation Nr: 22016142 Decision Date: 03/21/22 Archive Date: 03/21/22 DOCKET NO. 20-02 661 DATE: March 21, 2022 ORDER Service connection for posttraumatic stress disorder (PTSD) is granted. Service connection for an acquired psychiatric disorder other than PTSD, diagnosed as major depressive disorder, is granted. FINDINGS OF FACT 1. Resolving reasonable doubt in the Veteran's favor, the Veteran has a current diagnosis of PTSD in accordance with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) that is at least as likely as not the result of an in-service stressor event confirmed by credible supporting evidence. 2. Resolving reasonable doubt in the Veteran's favor, his acquired psychiatric disorder, diagnosed as major depressive disorder, is at least as likely as not related to an in-service event. CONCLUSIONS OF LAW 1. The criteria for service connection for PTSD are met. 38 U.S.C. §§ 1110, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2021). 2. The criteria for service connection for an acquired psychiatric disorder other than PTSD, diagnosed as major depressive disorder, are met. 38 U.S.C. §§ 1110, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303. (2021). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from June 1966 to June 1968. These matters are before the Board of Veterans' Appeals (Board) on appeal from a May 2018 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In February 2021, the Veteran testified at a virtual hearing before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the claims file. At the hearing, the Veteran was granted a 90-day abeyance period for the submission of additional evidence to support his claim. During that time period, the Veteran submitted additional evidence which has been included in the record for consideration. A. Duties to Notify and Assist VA has duties to notify and assist claimants in substantiating a claim for VA benefits. 38 U.S.C. § 5103, 5103A, 5106, 5107, 5126; 38 C.F.R. § 3.159. In this case, any error in notice or assistance regarding the claims is harmless given the favorable determination. B. Service Connection Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Service connection may also be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Entitlement to direct service connection requires evidence of three elements: (1) the existence of a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship or nexus between the current disability and the disease or injury incurred or aggravated during active service. Walker v. Shinseki, 708 F.3d 1331, 1333 (Fed. Cir. 2013). Service connection for PTSD specifically requires medical evidence diagnosing this disorder based on examination findings and in accordance with the DSM-5, 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), 4.125(a). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Lynch v. McDonough, 2021 U.S. App. LEXIS 37307, No. 2020-2067 (Fed. Cir. Dec. 17, 2021). The Veteran has been diagnosed with PTSD (under the DSM-5) and major depressive disorder; thus, the Veteran has PTSD and an acquired psychiatric disorder other than PTSD. Regarding the in-service stressor, the Veteran indicated in his May 2018 stressor statement that during service he worked in finance which was in the quality assurance division. The Veteran stated he experienced the stressor while part of Center Troop Command from 1966 to 1968. He stated that his responsibilities included interviewing soldiers returning from the Vietnam war about their financial status and the soldiers relayed stories about their combat experiences. The Veteran's representative indicated in an August 2020 informal hearing presentation that the stressor occurred while the Veteran was stationed at Fort Benning. Similarly, the Veteran testified at the Board hearing that prior to service he did not have any psychiatric issues. The Veteran stated his military occupational specialty during service was in finance and that as part of his duties he interviewed soldiers coming back from Vietnam. The Veteran added that a lot of the soldiers were depressed and spoke at length about their experiences in Vietnam. Specifically, the soldiers related their combat experiences, including seeing dead people. The Veteran stated he conducted these interviews for a "good part of the year." The Veteran reported that this experience negatively affected his mental health. The Veteran's DD-214 documents that his military occupational specialty was pay specialist. Additionally, the Veteran's service personnel records show that he was part of the 1st Battalion, U.S. Army Infantry Center Troop Command at Fort Benning in 1968. In April 2021 one of the Veteran's VA treating psychiatrists, Dr. J.M., provided a letter in support of the Veteran's claims. Dr. J.M. stated that the Veteran's repeated and extreme exposure to aversive details of combat while interviewing Vietnam soldiers was an in-service stressor as it was over exposure to these traumatic events. She noted that the Veteran did not have any other risk factors that could have precipitated the Veteran's mental health disorders. Based on the above, the Board concludes that there is credible supporting evidence that the claimed in-service stressor event occurred. Namely, the Veteran's service personnel records show that he was part of Center Troop Command at Fort Benning in 1968, just as the Veteran indicated in his May 2018 stressor statement. Additionally, Dr. J.M.'s conclusion that the Veteran was exposed to repeated and extreme details of combat further supports the Veteran's contentions that he interviewed soldiers who spoke at length about their combat experiences in Vietnam. For these reasons, the Board concludes that there is credible supporting evidence that the claimed in-service stressor event occurred. Concerning the nexus element, in April 2021 Dr. J.M. opined that it was at least as likely as not that the Veteran's PTSD and major depressive disorder were the result of the in-service stressor. Dr. J.M. noted that she had reviewed the Veteran's medical history, including VA medical records. Dr. J.M. added that she was familiar with the Veteran's history because the Veteran had been her patient and that she had examined the Veteran several times while the Veteran had been under her care. Dr. J.M. stated that the Veteran's job during service required him to interview soldiers returning from Vietnam, who told the Veteran about aversive details of combat. Dr. J.M. explained that repeatedly hearing these accounts resulted in the Veteran's mental health disorders because the Veteran continued to experience recurrent memories of interviewing the soldiers and continued to worry about them. Dr. J.M. indicated that it was common for patients to delay their care and treatment for mental health disorders. The Board concludes that the evidence is in at least approximate balance as to whether the Veteran's in-service stressor event caused his PTSD and his major depressive disorder. In reaching this conclusion, the Board assigns substantial weight of probative value to Dr. J.M.'s April 2021 opinion. The Board affords Dr. J.M.'s conclusion that it was at least as likely as not that the Veteran's PTSD and major depressive disorder were the result of the in-service stressor great weight of probative value because her opinion is based on a thorough review of the medical evidence, is well-reasoned, and supported by medical evidence. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). For example, Dr. J.M. explained that the Veteran's in-service stressor of interviewing soldiers returning from Vietnam resulted in the Veteran's mental health disorders because the Veteran continued to experience recurrent memories of interviewing the soldiers and continued to worry about them. Dr. J.M. also noted that the Veteran did not have any other risk factors that could have resulted in his current mental disorders. Additionally, Dr. J.M. has an increased insight into the etiology of the Veteran's PTSD and major depressive disorder because Dr. J.M. has been the Veteran's treating physician and examined the Veteran several times. For these reasons, the Board assigns substantial weight of probative value to Dr. J.M.'s April 2021 opinion. Lastly, the Board recognizes that it is granting service connection for PTSD and a separate acquired psychiatric disorder other than PTSD. It is possible to separately grant service connection for both PTSD and another psychiatric disorder. See Amberman v. Shinseki, 570 F.3d 1377, 1381 (Fed. Cir. 2009) ("We recognize that bipolar disorder and PTSD could have different symptoms and it could therefore be improper in some circumstances for VA to treat these separately diagnosed conditions as producing only the same disability"). In sum, the Board finds that the evidence is in approximate balance as to whether the Veteran has PTSD and an acquired psychiatric disorder other than PTSD (diagnosed as major depressive disorder) that are related to his service. In such cases the doubt is resolved in the Veteran's favor and therefore service connection is granted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Lynch v. McDonough, 2021 U.S. App. LEXIS 37307, No. 2020-2067 (Fed. Cir. Dec. 17, 2021). M. SORISIO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Patel, 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.