Citation Nr: 22017292
Decision Date: 03/24/22	Archive Date: 03/24/22

DOCKET NO. 19-30 561
DATE: March 24, 2022

ORDER

Entitlement to service connection for an acquired psychiatric disorder, claimed as bipolar and personality disorder, is denied.

FINDING OF FACT

The evidence of record is persuasively against a finding that the Veteran has a diagnosis of an acquired psychiatric disorder. 

CONCLUSION OF LAW

The criteria for entitlement to service connection for an acquired psychiatric disorder are not met. 38 U.S.C. §§ 1131, 5107 (b); 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served in the Marine Corps, on active duty from July 1982 to April 1984. 

This claim comes before the Board of Veterans' Appeals (Board) on appeal from an April 2018 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). 

In July 2021, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A transcript of that hearing is of record. 

Service Connection

Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.303, 3.304. 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).

Generally, establishing service connection requires medical or, in certain circumstances, lay evidence of (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. See Shedden v. Shinseki, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

Also, congenital and developmental defects, including personality disorders, are not considered diseases for VA compensation purposes. 38 C.F.R. § 3.303 (c). A defect of congenital, familial or hereditary origin, such as a personality disorder, by its very nature preexists military service. Carpenter v. Brown, 8 Vet. App. 240, 245 (1995); Monroe v. Brown, 4 Vet. App. 513, 514-15 (1993). Therefore, the presumption of sound condition at service entrance does not attach in the case of a personality disorder. See Quirin v. Shinseki, 22 Vet. App. 390, 397 (2002); Terry v. Principi, 340 F.3d 1378, 1385-86 (Fed. Cir. 2003) (presumption of soundness does not apply to congenital defects); Morris v. Shinseki, 676 F.3d 1346, 1354-56 (Fed. Cir. 2012) (presumption of soundness is not relevant to personality disorders because these are not diseases or injuries and thus not compensable). However, disability resulting from a mental disorder that is superimposed upon a personality disorder may be service connected. 38 C.F.R. § 4.127.

Entitlement to service connection for an acquired psychiatric disorder

The Veteran asserts that he has a psychiatric disorder related to active service. Specifically, he claims his behavior changed while stationed at Guantanamo Bay, and that his DD-214 states he was discharged due to a personality disorder caused by military service. 

The Board notes the Veteran's initial argument in his July 2017 claim, was that he developed a psychiatric disorder due to his exposure to contaminated water while stationed at Camp Lejeune. However, at his July 2021 hearing the Veteran, through his representative, stated he was specifically seeking direct service connection instead. As such, the Board will not discuss possible exposure to contaminated water at Camp Lejeune as a theory of entitlement in this decision. 

For the reasons outlined below, the Board finds that the evidence of record is persuasively against the Veteran's claim for service connection. 

First, while the Veteran's service treatment records reflect that he exhibited some mental health symptoms in service, it does not appear that these were chronic in nature. While stationed at Guantanamo Bay in August 1983, a treatment note indicates he complained of depression and presented with suicidal ideation and/or intent. He was given an initial diagnosis of depression, schizoid and immature personality trait disorders. However, the medical treatment team in Guantanamo Bay reported they did not have the ability to treat the Veteran, and he was transferred to Bethesda Naval Hospital that same month. While admitted to Bethesda for treatment, he was diagnosed with Immature Personality Disorder, only, under the DSM-III. 

In March 1984, the Veteran's command team determined that he should be separated from service at the convenience of the government due to character and behavioral concerns. His Immature Personality Disorder was noted as sufficiently severe to warrant an administrative separation on this basis. While the Veteran reported previous symptoms of attempted suicide, depression and sleepwalking at his April 1984 separation examination, the examiner concluded his psychiatric condition was "normal". Indeed, the Veteran reports that he first attended outpatient mental health treatment in 2003, 19 years after active service. 

As such, the medical evidence shows that the Veteran did not have symptoms, complaints or a diagnosis related to a psychiatric disorder until approximately 2003. Therefore, continuity of symptoms is not shown based on the medical evidence. 

As part of this claim, the Board recognizes the statements made by the Veteran regarding his history of symptoms. In this regard, while the Veteran is not competent to diagnose a psychiatric disorder, as it may not be diagnosed by its unique and readily identifiable features, and thus require a determination that is "medical in nature," he is nonetheless competent to testify about the presence of observable symptomatology, which may provide sufficient support for a claim of service connection, if credible, regardless of the lack of contemporaneous medical evidence. Jandreau v. Nicholson, 492 F.3d 1372, 1376 (Fed. Cir. 2007). See Barr v. Nicholson, 21 Vet. App. 303, 307 (2007); Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006).

However, the Board is unable to grant service connection based on the Veteran's own statements alone. Specifically, while he reported prior mental health issues during his service, at separation his examiner concluded there were no mental health symptoms or a psychiatric diagnosis. Moreover, the Veteran testified that he did not seek treatment for several decades following service.  The Board also cannot ignore that the Veteran's own commanding officer did not believed him to not be truthful in his statements. 

Next, service connection may nonetheless be established if a relationship may be otherwise established by competent evidence, including medical evidence and opinions. In this case, the Board finds that the evidence is persuasive in finding that the Veteran does not have a current psychiatric disorder. 

With respect to Shedden element (1), a current disability, the most probative evidence of record reflects that the Veteran does not have a current psychiatric disorder. In this regard, private treatment records from 2015 through 2017 indicate he was diagnosed, at various times, with alcohol dependence, unspecified psychosis and unspecified episodic mood disorder. 

However, the Veteran underwent a VA examination in March 2018, during which the VA examiner concluded that those private diagnoses were "in error" as objective signs from his private treatment records "do not support the diagnoses." Further, the VA examiner wrote that the objective medical evidence from his private treatment records do not meet the criteria for a psychiatric disorder under DSM-V. The examiner wrote that during his VA examination testing, the Veteran's responses resulted in an invalid profile, with exaggeration of his psychological problems and impaired functions. Finally, the examiner concluded due to the Veteran's own statements, his reported issues while on active duty, were "alcohol-related, and that that was willful behavior" and thus "very little weight can be assigned to those symptoms, treatment, and diagnoses". 

In sum, the April 2018 VA examiner concluded that the Veteran has not had a psychiatric disorder during the entire claim period. The VA examiner determined that his private treatment records indicating psychiatric diagnoses were based on the Veteran's self-reports as opposed to objective medical criteria needed to meet DSM-V. Moreover, the Veteran's mental status, reported symptoms and psychological testing during his VA examination did not support a psychiatric diagnosis. 

For the reasons detailed above, the 2015-2017 private treatment notes indicating psychiatric diagnoses carry minimal probative weight. Moreover, the April 2018 VA examiner, in pertinent part, found the Veteran did not have a current mental disorder that conformed with the DSM-V criteria. Indeed, the opinion of the VA examiner was predicated on a full overview of the entire relevant record and was presented by an examiner who was specifically tasked to provide psychiatric diagnoses after review of the evidence. The April 2018 VA examiner explained and documented the Veteran's report of symptoms and stated their reasons for not endorsing a psychiatric diagnosis. The Board finds that the April 2018 VA examination is adequate, as it was based upon sufficient facts and data, upon reliable principles and methods in the field of psychiatry, and the facts have been applied reliably to the claim. Thus, the April 2018 VA examiner's opinion is entitled to substantial probative weight. 

The Board recognizes the Veteran's statements that he experiences psychiatric symptoms. While the Veteran is competent to report what comes to him through his sense, he does not have the requisite knowledge or training to be deemed competent to provide a psychiatric diagnosis. See Layno, 6 Vet. App. at 469; Jandreau, 492 F.3d at 1377 n.4. Such competent evidence concerning a diagnosis related to the Veteran's mental condition has been provided by the April 2018 VA examiner who objectively examined the Veteran. The Board finds the April 2018 VA examiner's findings to be the most competent, objective and probative evidence of record, and is therefore afforded greater weight than the Veteran's subjective complaints of psychiatric symptomatology. 

Thus, in weighing the evidence, the Board finds the April 2018 VA examiner's opinion that the Veteran has no psychiatric disorder, is more probative than the private treatment records indicating diagnoses of psychiatric disorders. In this regard, the private treatment records lack probative value due to a lack of review of the entire claims file and the lack of objective symptoms that meet the diagnostic criteria of a psychiatric disorder. See Nieves-Rodriguez, 22 Vet. App. at 304.

Therefore, element (1), a current disability, of service connection for an acquired psychiatric disorder has not been met. The existence of a current disability is the cornerstone of a claim for VA disability compensation, and without a current disability, service connection is not warranted. 38 U.S.C. § 1110.   

In sum, the most probative evidence of record is persuasive in establishing that there is no current diagnosis of an acquired psychiatric disorder. Accordingly, entitlement to service connection for an acquired psychiatric disorder is denied.  

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. 

 

B.T. KNOPE

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	T. McDonald