Citation Nr: 22016299 Decision Date: 03/21/22 Archive Date: 03/21/22 DOCKET NO. 17-04 930A DATE: March 21, 2022 ORDER Entitlement to service connection for nightmare disorder is granted. FINDING OF FACT Resolving reasonable doubt in the Veteran's acquired psychiatric disorder, diagnosed as nightmare disorder, had its onset during his active or is otherwise etiologically related thereto. CONCLUSION OF LAW The criteria for service connection for nightmare disorder are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had continuous active military service from May 1973 to August 1994. This appeal comes to the Board of Veterans' Appeals (the Board) following a July 2016 rating decision in which the Agency of Original Jurisdiction (AOJ) denied the Veteran's claim for entitlement to service connection for posttraumatic stress disorder (PTSD). Consistent with the Veteran's statements/intent and the evidence of record, the Board finds that the instant appeal reasonably encompasses a claim for service connection for an acquired psychiatric disorder, to include nightmare disorder, and not just PTSD. See Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009). Accordingly, the Board has reframed the issue on appeal in order to characterize the Veteran's claim more accurately. In August 2019, the Board remanded this matter in order to attempt to corroborate the Veteran's claimed stressors and to obtain a new Department of Veterans Affairs (VA) examination and etiological opinion. The record shows that the AOJ attempted to corroborate the Veteran's claimed stressors, and that the Veteran received a new VA examination in December 201. The matter has now returned to the Board for adjudication. 1. Entitlement to Service Connection for an Acquired Psychiatric Disorder The Veteran asserts that he is entitled to service connection for an acquired psychiatric disorder, including PTSD, major depressive disorder, and/or nightmare disorder. He maintains that the symptoms of his psychiatric disorder arose during his active service or are other due to events that he experienced while in service. Service connection may be granted for disabilities resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. Entitlement to service connection requires evidence of (1) a current disability, (2) in-service incurrence or aggravation of a disease or injury, and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Service connection may also be granted for an injury or disease diagnosed after discharge when all the evidence, including that pertinent to service, establishes that the disease or injury was incurred in service. 38 C.F.R. § 3.303(d). The evidence of record contains various diagnoses for the Veteran's current psychiatric condition. VA treatment records indicate that his past diagnoses have included PTSD. However, the June 2016 VA examiner explained that the Veteran did not meet the DSM-V criteria for PTSD because he did not have any clinically significant functional impairment, a necessary criterion for a diagnosis of PTSD. There was also no PTSD diagnosis made under the DSM-V when the Veteran was examined in 2019. A diagnosis of PTSD under the DSM is required for the purposes of granting service connection for the same. See 38 C.F.R. § 3.304 (f), 4.125. The record also shows that the June 2016 VA examiner diagnosed the Veteran with major depressive disorder. The Veteran's most recent VA examination in December 2019 diagnosed nightmare disorder. Thus, as the evidence shows that the Veteran has a current diagnosis of an acquired psychiatric disordernightmare disorderthe first Shedden element has been met. 381 F.3d at 1166-67. As for the second element of service connection, the Veteran reports that some of his psychiatric problems began in service. He relates that he started to experience repeated nightmares following two in-service events. The Veteran first described a stressful incident that occurred when he was in a foxhole while stationed in Seoul, Korea in October 1979. Later, the Veteran also reported that he witnessed a tornado that injured his fellow soldiers and caused him to seek shelter while stationed in Alabama in 1974. The Board finds no reason to question the credibility of the Veteran's description of these events, as they are consistent throughout the evidence of record, as well as his report of experiencing in-service nightmares . The second Shedden element has been met as well. 381 F.3d at 1166-67. Thus, the question for the Board becomes whether the Veteran's current diagnosis of an acquired psychiatric disorder, to include nightmare disorder, is etiologically related to his active military service. When he was examined in 2019, the Veteran reported nightmares and symptoms of depression since he served in Korea. Such symptoms are not noted in his service treatment records or separation examination, and he did not seek mental health treatment from VA until 2015, decades after his separation from service. However, the Veteran explained that he hid his symptoms for many years in order to avoid the stigma that can be associated with mental health problems. The Veteran's reports of symptoms are credible, and the Board finds no reason to question these statements. Indeed, the December 2019 examiner ultimately concluded that it is at least as likely as not that the Veteran's nightmare disorder was incurred in or caused by his military service. His rationale was that the Veteran meets the DSM-V criteria for nightmare disorder and that the symptoms of this condition "can be linked to his service in Korea." The examiner added that his opinion was based on clinical interview, review of records, and training as a psychologist. The Board concludes that this opinion is probative, especially because it is based upon full consideration of the Veteran's prior medical history. See Stefl v. Nicholson, 21 Vet. App. 120, 123. The Board recognizes that the June 2016 examination provided a negative nexus opinion. That opinion is no more or less probative that the positive 2019 VA opinion. To the contrary, the Board's remand appeared to question the overall adequacy of the examination report. The Board finds the evidence to at least be in equipoise as to whether the Veteran's nightmare disorder had its onset in or is related to his active military service. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for nightmare disorder is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. MICHAEL A. HERMAN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R.M. Sachs, 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.