Citation Nr: 22018044 Decision Date: 03/28/22 Archive Date: 03/28/22 DOCKET NO. 15-42 548A DATE: March 28, 2022 ORDER Service connection for an acquired psychiatric disability is denied. FINDINGS OF FACT 1. There is no competent medical evidence of a psychiatric disorder, except for personality disorder; and there are no other psychiatric disabilities superimposed upon the personality disorder as a result of service. 2. A personality disorder may not be service-connected as a matter of law. CONCLUSIONS OF LAW 1. A personality disorder is not a disease or injury within the meaning of the law providing compensation. 38 C.F.R. §§ 3.303, 4.9. 2. An acquired psychiatric disorder was not incurred in or aggravated by active service. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had active service in the United States Navy from September 1986 through November 1987. This matter was before the Board of Veterans' Appeals (Board) in June 2019 when it was remanded for additional development. Service Connection Service connection may be granted for disability resulting from disease or injury incurred or aggravated during active service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. Service connection may also be granted for any injury or disease diagnosed after service, 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). Generally, service connection requires: (1) medical evidence of a current disability; (2) medical evidence, or in certain circumstances lay testimony, of in-service incurrence or aggravation of an injury or disease; and (3) medical evidence of a nexus between the current disability and the in-service disease or injury. See Hickson v. West, 12 Vet. App. 247 (1999). For the reasons expressed below, the Board finds that the service connection for an acquired psychiatric disability is not warranted. Service treatment records (STRs) show the Veteran was seen in October 1987 by Emergency Care and Treatment with complaints of marked depression and suicidal ideation. He was unhappy with military life and his duties aboard ship. He expressed a desire to be discharged and return to his mother. Impression included dependent personality traits, immature personality traits and goal-seeking behavior. A November 1987 separation Report of Medical Examination shows the Veteran's psychiatric clinical evaluation was abnormal with findings of dependent personality traits, immature personality traits and goal-seeking behavior. The Veteran's DD Form 214 shows his separation from service was due to personality disorder. The Veteran submitted the instant claim in May 2014. A June 2014 VA Mental Health Admission Note shows the Veteran was seen with complaints of increasing depressive symptoms and suicidal ideation. He reported recent cocaine abuse 2-3 days earlier. He was admitted for safety and stabilization. At discharge, diagnoses were stimulant (cocaine) use disorder and mild stimulant (cocaine) induced depressive disorder with onset during withdrawal. A September 2014 VA mental disorders disability benefits questionnaire (DBQ) notes the Veteran reported vague symptoms; he was unable to identify precipitants. He inconsistently reported documented mental health history, to include his history of substance abuse. He had "a history of performing acts that are grounds for arrest; deceitfulness and failure to sustain consistent work." The examiner opined the Veteran did not meet the criteria for an acquired psychiatric disability. Rather, he had an unspecified personality disorder (antisocial traits) that was not incurred in or caused by his military service. A March 2020 addendum/clarification DBQ notes the examiner reviewed the claims file and stated the Veteran was diagnosed with an unspecified personality disorder, antisocial traits, that was not incurred in or caused by an in-service injury, event or illness. Regarding the Veteran's complaints of depression and suicidal ideation, and whether the Veteran had any other psychiatric disorder, the examiner stated: Mood fluctuations are typical manifestations of personality disorders. There is no evidence in the (medical record) that the Veteran was experiencing a mental disorder or mood fluctuations that are not typical of or associated with a personality disorder. Regarding the October 1987 emergency care treatment in service, the VA examiner noted the Veteran's reports of depression and inability to cope. "He was dealing with family stressors, as his mother wanted him to return home and he was having difficulty adjusting to military life. The Veteran denied suicidal and homicidal ideation and stated that he just wanted to get out of the Navy. His insight and judgment were noted to be 'highly influenced by his goal-seeking intent.'" It was noted that, given the Veteran's "maladaptive behaviors, he may consider or attempt self-harm or harm to others in the future - particularly in a manipulative fashion to achieve a desired response from the Command." Regarding the psychiatric history of dependent personality disorder, immature personality traits, and goal-seeking behavior noted on separation examination, the examiner noted the Veteran attempted suicide due to problems at home and inability to adjust to Navy life. It is noted that he was nervous about his family being alright. Regarding the June 2014 inpatient treatment, the examiner stated, "There is no evidence . . . the Veteran was experiencing a mental disorder or mood fluctuations that are not typical of or associated with a personality disorder or substance use. Personality disorders and/or mood fluctuations do not cause substance use." The examiner also noted the Veteran's current episode of depression and suicidal ideation began when he snorted 2-3 lines of cocaine just days earlier. After reviewing the foregoing, the Board notes that, while the Veteran was evaluated for possible emotional difficulties while he was on active duty, a psychiatric evaluation at that time found personality disorder (dependent personality traits, immature personality traits and goal seeking behavior) and no acquired psychiatric disability. Post-service clinical records dated during the period of the appeal show various diagnoses were made; these included a personality disorder and depressive disorder. However, no basis for the depressive disorder diagnosis was provided. After VA examination, it has been determined that the Veteran may only be diagnosed with a personality disorder, with no superimposed acquired psychiatric disorder diagnosed. See March 2020 DBQ. (A superimposed acquired psychiatric disorder resulting from such personality disorder or representing an aggravation of the disorder may, however, be service connected. See 38 C.F.R. § 4.127 ; VAOPGCPREC 82-90 (1990) (cited at 55 Fed. Reg. 45,711 ) (Oct. 30, 1990); Carpenter v. Brown, 8 Vet. App. 240, 245 (1995). This is not shown here.) It is further noted that a personality disorder is not a disability for which service connection may be granted; rather, it is considered a congenital or developmental abnormality. See 38 C.F.R. § 3.303(c). As VA regulations specifically prohibit service connection for congenital or developmental defects, the Veteran's diagnosed other specified personality disorder is, therefore, not a disability for which VA compensation benefits may be awarded. The Board assigns the greatest probative value to the VA medical opinions to support the finding that the there is no competent medical evidence of a psychiatric disorder, except for personality disorder. The 2020 VA examiner, in particular, provided well-grounded conclusions supported by thorough rationale and the medical evidence of record. There is no medical or other competent evidence to the contrary. Finally, regarding any diagnosis of substance abuse, a substance abuse disorder cannot be service connected as a direct result of service, and while it may be service connected on a secondary basis, service connection for a psychiatric disorder that may have caused or aggravated the substance abuse is denied herein. Therefore, service connection for any substance abuse disorder is not warranted. See 38 U.S.C. §§ 105, 1131; 38 C.F.R. § 3.301(a). In the absence of any other psychiatric disability superimposed upon the personality disorder, the Board finds that service connection for the Veteran's personality disorder is precluded by law, and therefore not warranted. Sabonis v. Brown, 6 Vet. App. 426, 430 (1994). Accordingly, the claim must be denied. A. ISHIZAWAR Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Fletcher, Kathleen 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.