Citation Nr: 22018977 Decision Date: 03/31/22 Archive Date: 03/31/22 DOCKET NO. 19-18 500 DATE: March 31, 2022 ORDER The severance of service connection for diabetes mellitus type II was improper; restoration of service connection for diabetes mellitus type II is granted. The severance of service connection for frequent urination and leakage was improper; restoration of service connection for frequent urination and leakage is granted. The severance of service connection for left lower extremity sciatic nerve neuropathy was improper; restoration of service connection for left lower extremity sciatic nerve neuropathy is granted. The severance of service connection for left upper extremity neuropathy was improper; restoration of service connection for left upper extremity neuropathy is granted. The severance of service connection for right upper extremity neuropathy was improper; restoration of service connection for right upper extremity neuropathy is granted. The severance of service connection for right lower extremity sciatic nerve neuropathy was improper; restoration of service connection for right lower extremity sciatic nerve neuropathy is granted. The severance of service connection for left lower extremity femoral nerve neuropathy was improper; restoration of service connection for left lower extremity femoral nerve neuropathy is granted. The severance of service connection for right lower extremity femoral nerve neuropathy was improper; restoration of service connection for right lower extremity femoral nerve neuropathy is granted. Entitlement to service connection for posttraumatic stress disorder (PTSD) for treatment purposes only under 38 U.S.C. chapter 17 is granted. FINDINGS OF FACT 1. Special Court Martial Order 217-68 (October 24, 1968) reflects that the Veteran was charged with violation of Uniform Code of Military Justice (UCMJ) Article 86 Absent Without Official Leave (AWOL from April 20, 1968, to April 24, 1968, and June 4, 1968, to July 29, 1968). The Veteran pled guilty to all charges and was found guilty of all charges. His sentence was to be confined at hard labor for 6 months, reduction in pay grade, and to be discharged with a bad conduct discharge. 2. The original Report of Separation from Active Duty (DD 214) reflects that the character of the Veteran's discharge was "Under Honorable Conditions" (i.e., an undesirable discharge). 3. In April 1977, the Department of the Navy, Navy Discharge Review Board concluded that the Veteran's case met the program criteria for the Presidential Clemency Program (i.e., Presidential Proclamation 4313 of September 16, 1974) and the Secretary of the Navy directed that the Veteran's original discharge be changed to General by reason of Convenience of the Government. 4. In May 1978, the Department of the Navy, Naval Discharge Review Board concluded that the Veteran did not qualify for an upgrading of the character of his discharge under the new, uniform standards for discharge review. 5. There is not clear and unmistakable evidence that when the Veteran went AWOL he was not insane (because of his TBI) or had the mental capacity to form the intent to absent himself without authorization (i.e., commit willful misconduct). 6. The Veteran suffers from PTSD related to fear of hostile military and terrorist activity. CONCLUSIONS OF LAW 1. The severance of service connection for diabetes mellitus type II was improper; the criteria for restoration of service connection for diabetes mellitus type II have been met. 38 U.S.C. §§ 5112, 5303; 38 C.F.R. §§ 3.12, 3.105. 2. The severance of service connection for frequent urination and leakage was improper; the criteria for restoration of service connection for frequent urination and leakage have been met. 38 U.S.C. §§ 5112, 5303; 38 C.F.R. §§ 3.12, 3.105. 3. The severance of service connection for left lower extremity sciatic nerve neuropathy was improper; the criteria for restoration of service connection for left lower extremity sciatic nerve neuropathy have been met. 38 U.S.C. §§ 5112, 5303; 38 C.F.R. §§ 3.12, 3.105. 4. The severance of service connection for left upper extremity neuropathy was improper; the criteria for restoration of service connection for left upper extremity neuropathy have been met. 38 U.S.C. §§ 5112, 5303; 38 C.F.R. §§ 3.12, 3.105. 5. The severance of service connection for right upper extremity neuropathy was improper; the criteria for restoration of service connection for right upper extremity neuropathy have been met. 38 U.S.C. §§ 5112, 5303; 38 C.F.R. §§ 3.12, 3.105. 6. The severance of service connection for right lower extremity sciatic nerve neuropathy was improper; the criteria for restoration of service connection for right lower extremity sciatic nerve neuropathy have been met. 38 U.S.C. §§ 5112, 5303; 38 C.F.R. §§ 3.12, 3.105. 7. The severance of service connection for left lower extremity femoral nerve neuropathy was improper; the criteria for restoration of service connection for left lower extremity femoral nerve neuropathy have been met. 38 U.S.C. §§ 5112, 5303; 38 C.F.R. §§ 3.12, 3.105. 8. The severance of service connection for right lower extremity femoral nerve neuropathy was improper; the criteria for restoration of service connection for right lower extremity femoral nerve neuropathy have been met. 38 U.S.C. §§ 5112, 5303; 38 C.F.R. §§ 3.12, 3.105. 9. The criteria for entitlement to service connection for PTSD for treatment purposes only under 38 U.S.C. chapter 17 have been met. 38 U.S.C. §§ 1110, 1154, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.360. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from January 1964 to December 1968. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a January 2018 rating decision issued by the Regional Office (RO). In October 2021, the Veteran testified in a virtual hearing before the undersigned Veterans Law Judge. A Transcript of the hearing is of record. This appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.800(c). 38 U.S.C. § 7107(a)(2). Severance Of Service Connection 1. Whether the severance of service connection for diabetes mellitus type II was proper 2. Whether the severance of service connection for frequent urination and leakage was proper 3. Whether the severance of service connection for left lower extremity sciatic nerve neuropathy was proper 4. Whether the severance of service connection for left upper extremity neuropathy was proper 5. Whether the severance of service connection for right upper extremity neuropathy was proper 6. Whether the severance of service connection for right lower extremity sciatic nerve neuropathy was proper 7. Whether the severance of service connection for left lower extremity femoral nerve neuropathy was proper 8. Whether the severance of service connection for right lower extremity femoral nerve neuropathy was proper The RO initially granted service connection for diabetes mellitus, frequent urination and leakage, left lower extremity sciatic nerve neuropathy, right lower extremity sciatic nerve neuropathy, left upper extremity neuropathy, right upper extremity neuropathy, left lower extremity femoral nerve neuropathy, and right lower extremity femoral nerve neuropathy (all associated with diabetes mellitus) in a June 2017 rating decision. In November 2017, the RO issued a rating decision proposing to sever service connection for diabetes mellitus, frequent urination and leakage, left lower extremity sciatic nerve neuropathy, right lower extremity sciatic nerve neuropathy, left upper extremity neuropathy, right upper extremity neuropathy, left lower extremity femoral nerve neuropathy, and right lower extremity femoral nerve neuropathy. The RO stated that the character of the Veteran's discharge from service was a bar to benefits. Thus, the RO concluded that service connection for diabetes mellitus, frequent urination and leakage, left lower extremity sciatic nerve neuropathy, right lower extremity sciatic nerve neuropathy, left upper extremity neuropathy, right upper extremity neuropathy, left lower extremity femoral nerve neuropathy, and right lower extremity femoral nerve neuropathy was not warranted. The January 2018 rating decision (on appeal) severed service connection for diabetes mellitus, frequent urination and leakage, left lower extremity sciatic nerve neuropathy, right lower extremity sciatic nerve neuropathy, left upper extremity neuropathy, right upper extremity neuropathy, left lower extremity femoral nerve neuropathy, and right lower extremity femoral nerve neuropathy. The RO reiterated that the character of the Veteran's discharge from service was a bar to benefits. Thus, the RO concluded the decision to grant service connection for diabetes mellitus, frequent urination and leakage, left lower extremity sciatic nerve neuropathy, right lower extremity sciatic nerve neuropathy, left upper extremity neuropathy, right upper extremity neuropathy, left lower extremity femoral nerve neuropathy, and right lower extremity femoral nerve neuropathy was clear and unmistakable error. Service connection will be severed only where evidence establishes that the award of service connection was clearly and unmistakably erroneous (CUE) (the burden of proof being on the Government). 38 C.F.R. § 3.105(d). When severance of service connection is considered warranted, a rating proposing severance will be prepared setting forth all material facts and reasons. The claimant will be notified at his or her latest address of record of the contemplated action and furnished detailed reasons therefor and will be given 60 days for the presentation of additional evidence to show that service connection should be maintained. Unless otherwise provided in paragraph (i) of this section, if additional evidence is not received within that period, final rating action will be taken, and the award will be reduced or discontinued, if in order, effective the last day of the month in which a 60-day period from the date of notice to the beneficiary of the final rating action expires. 38 C.F.R. § 3.105(d). A change in diagnosis may be accepted as a basis for severance action if the examining physician or physicians or other proper medical authority certifies that, in the light of all accumulated evidence, the diagnosis on which service connection was predicated is clearly erroneous. This certification must be accompanied by a summary of the facts, findings, and reasons supporting the conclusion. 38 C.F.R. § 3.105(d). To establish that a grant of service connection was the product of CUE, VA must show that (1) either the correct facts as they were known at the time were not before the adjudicator, the adjudicator made an erroneous factual finding, or the statutory or regulatory provisions were incorrectly applied; (2) the alleged error was undebatable, not merely a disagreement as to how the facts were weighed or evaluated; and (3) the error manifestly changed the outcome of the prior decision. See Allen v. Nicholson, 21 Vet. App. 54, 58-59 (2007); Stallworth v. Nicholson, 20 Vet. App. 482, 487-88 (2006); cf. Bustos v. West, 179 F.3d 1378, 1380-81 (Fed. Cir. 1999); Damrel v. Brown, 6 Vet. App. 242, 245 (1994); Russell v. Principi, 3 Vet. App. 310, 313-14, 319 (1992) (en banc). A clear and unmistakable error is one about which reasonable minds could not differ. See, e.g., 38 C.F.R. § 20.1403(a). In most respects, the CUE standard for severing service connection under § 3.105(d) is equivalent to the CUE standard for reversing or revising a prior final decision under 38 C.F.R. § 3.105(a). See Baughman v. Derwinski, 1 Vet. App. 563, 566 (1991). Section 3.105(d) places at least as high a burden of proof on the VA when it seeks to sever service connection as § 3.105(a) places upon an appellant seeking to have an unfavorable previous determination overturned. See id. However, the determination is not limited to the law and the record that existed at the time of the original decision. VA may consider medical evidence and diagnoses that postdate the original award of service connection to demonstrate that the diagnosis on which service connection was predicated is clearly erroneous. Stallworth, 20 Vet. App. at 488. The Secretary's burden is not to prove clear and unmistakable error in the original decision in the same manner a claimant would show CUE under sections 5109A or 7111. Id. A decision that is reversed or amended based on CUE is revised to conform to the true state of the facts or the law that existed at the time of the original adjudication. Allen, 21 Vet. App. at 62 (internal quotations omitted). The initial question for the Board is whether the RO followed the due process requirements of 38 C.F.R. § 3.105(d) for severing service connection. The Board finds that it did. The RO issued the proposed ratings in November 2017. The Veteran was notified in November 2017 at his latest address of record of this contemplated action and furnished detailed reasons therefor and was given 60 days for the presentation of additional evidence to show that service connection should be maintained. The May 2018 notice letter also informed the Veteran that he had the opportunity for a predetermination hearing if such a request for a hearing was received by VA within 30 days from the date of the notice. See 38 C.F.R. § 3.105(i). Thereafter, the RO issued the January 2018 rating decision, which severed service connection for diabetes mellitus, frequent urination and leakage, left lower extremity sciatic nerve neuropathy, right lower extremity sciatic nerve neuropathy, left upper extremity neuropathy, right upper extremity neuropathy, left lower extremity femoral nerve neuropathy, and right lower extremity femoral nerve neuropathy prospectively, effective May 1, 2018. Notification of this rating decision, plus his appeal rights, was sent to the Veteran in a February 2018 letter. The May 1, 2018, severance date was greater than the last day of the month in which a 60-day period from the date of the February 2018 notice expired. Thus, all due process requirements were met in severing service connection for diabetes mellitus, frequent urination and leakage, left lower extremity sciatic nerve neuropathy, right lower extremity sciatic nerve neuropathy, left upper extremity neuropathy, right upper extremity neuropathy, left lower extremity femoral nerve neuropathy, and right lower extremity femoral nerve neuropathy. See 38 C.F.R. § 3.105(d). The remaining question before the Board is whether the grant of service connection for diabetes mellitus, frequent urination and leakage, left lower extremity sciatic nerve neuropathy, right lower extremity sciatic nerve neuropathy, left upper extremity neuropathy, right upper extremity neuropathy, left lower extremity femoral nerve neuropathy, and right lower extremity femoral nerve neuropathy was clearly and unmistakably erroneous. The Board concludes that the severance of service connection for diabetes mellitus, frequent urination and leakage, left lower extremity sciatic nerve neuropathy, right lower extremity sciatic nerve neuropathy, left upper extremity neuropathy, right upper extremity neuropathy, left lower extremity femoral nerve neuropathy, and right lower extremity femoral nerve neuropathy was improper because there is probative evidence indicating that at the time the Veteran went AWOL, he was insane or at the very least, did not have the mental capacity to form the intent to absent himself without authorization (i.e., go AWOL). A discharge or release from active service under conditions other than dishonorable is generally a prerequisite to entitlement to VA pension or compensation benefits. See 38 U.S.C. § 101 (18); 38 C.F.R. § 3.12 (a). In pertinent part, benefits are not payable where the former service member was discharged or released by reason of the sentence of a general court-martial. 38 C.F.R. § 3.12 (c)(2). If a person was discharged or released by reason of the sentence of a general court martial, only a finding of insanity or a decision of a board of correction of records established under 10 U.S.C 1552 can establish basic eligibility to receive VA benefits. 38 C.F.R. § 3.12 (c)(6). Unless a discharge review board established under 10 U.S.C. 1553 determines on an individual case basis that the discharge would be upgraded under uniform standards, an honorable or general discharge awarded under, in pertinent part, The President's directive of January 19, 1977, implementing Presidential Proclamation 4313 of September 16, 1974, does not remove any bar to benefits imposed under this section. 38 C.F.R. § 3.12 (g), (h). Special Court Martial Order 217-68 (October 24, 1968) reflects that the Veteran was charged with violation of Uniform Code of Military Justice (UCMJ) Article 86 (AWOL from April 20, 1968, to April 24, 1968, and June 4, 1968, to July 29, 1968). The Veteran pled guilty to all charges and was found guilty of all charges. His sentence was to be confined at hard labor for 6 months, reduction in pay grade, and to be discharged with a bad conduct discharge. It was documented that the two previous convictions were considered. In April 1977, the Department of the Navy, Navy Discharge Review Board concluded that the Veteran's case met the program criteria for the Presidential Clemency Program (i.e., Presidential Proclamation 4313 of September 16, 1974) and the Secretary of the Navy directed that the Veteran's original discharge be changed to General by reason of Convenience of the Government. In May 1977, the Department of the Navy notified the Veteran that his records had been corrected and new separation documents (reflecting the upgrade in discharge) were issued. In May 1978, the Department of the Navy, Naval Discharge Review Board concluded that the Veteran did not qualify for an upgrading of the character of his discharge under the new, uniform standards for discharge review. Service treatment records reflect that the Veteran sustained a concussion in May 1966 from an unknown explosive device while in defensive position in Phu Bai, Republic of Vietnam. A November 1968 neuropsychiatric evaluation report reflects that the Veteran's problems were mounting because he could not get along with his unit and platoon commander since returning from confinement because he felt he was receiving unfair treatment. Psychological testing showed problems with authority and nervous tensions and getting along with others in general. The Veteran reported that he was moody and depressed and had feelings of inadequacy. He was regarded as a candidate for restoration because of his fairly good military record until recently, which included 14 months in-country in the Republic of Vietnam. There were no signs of psychosis or neurosis and the Veteran's intelligence was estimated to be in the low dull normal range. The diagnosis was moderate immature personality with dependency and inadequacy. The December 2018 VA residuals of traumatic brain injury (TBI) examination report documents diagnosis of TBI with residual headaches. The Veteran reported that he sustained the TBI in service in 1966 in Vietnam. The physiatrist opined that the TBI was at least as likely as not incurred during service because the evidence was suggestive of TBI. The physiatrist explained the Veteran experienced residual symptoms of TBI including poor memory, impaired judgment, inappropriate social interaction, impaired visual spatial orientation, headaches, and neurobehavioral effects. A December 2018 private neuropsychological evaluation report reflects, in pertinent part, that the Veteran felt dazed and confused since suffering a concussion during his period of service. He reported that he never returned to normal functioning and after his concussion developed depression, anxiety, social withdrawal, and increased alcohol consumption. He also manifested symptoms of posttraumatic stress disorder (PTSD) around the time that he suffered the concussion, including nightmares, lapses of time, diminished motivation, and discomfort around others. The neuropsychologist concluded that it appeared likely that the Veteran sustained a concussion that impacted his functioning for a time. The neuropsychologist explained that it would be difficult to determine how long the Veteran experienced the prolonged deviation from his typical pattern of behavior, but changes in behavior, cognition, and emotional functioning were common following concussions and TBIs with normal recovery lasting approximately 18 months post injury. The neuropsychologist noted that some individuals experience problems over the long term. A June 2019 VA medical opinion reflects that at the time of the incident that led to the Veteran military punishment, he reported several problematic symptoms suggestive of PTSD. However, the psychologist concluded that the Veteran appeared to be able to understand right from wrong, understood the roles of others in his chain of command, and expressed understanding of cause and effect. The Veteran understood that his punishment was the consequence of his unauthorized absence and his behavior was not impulsive or uncontrolled. The psychologist noted that the Veteran reported his symptoms to his commanding officer that dismissed the symptoms. The psychologist concluded that despite his symptoms, the Veteran was able to understand right from wrong and appreciate the consequences of his behavior. Additionally, he denied loss of consciousness prior to or during the incident and was able to clearly recall all the details. The psychologist noted that the events leading to punishment did not occur in close temporal activity to his TBI and concluded that it was unlikely that the Veteran was insane (due to his TBI) at the time of the actions that led to his bad conduct discharge. Here, as documented, the Veteran was charged with violation of UCMJ Article 86. He pled guilty to all charges and was found guilty of all charges. His sentence (by Special Court Martial Order) was confinement at hard labor for 6 months, reduction in pay grade, and to be discharged with a bad conduct discharge. His original DD 214 reflects that the character of his discharge was "Under Conditions other than Honorable (i.e., an undesirable discharge). Thus, his discharge was a bar to VA benefits. 38 C.F.R. § 3.12 (c)(2). The upgraded General/Convenience of the Government (Under Honorable Conditions) discharge awarded in April 1977 by satisfaction of program criteria for the Presidential Clemency Program, implementing Presidential Proclamation 4313 of September 16, 1974, did not remove his bar to VA benefits. 38 C.F.R. § 3.12 (h). Only a finding of insanity or a decision of a board of correction of records established under 10 U.S.C 1552 can establish basic eligibility to receive VA benefits. On this record, there is not clear and unmistakable evidence that the Veteran was not insane at the time of commission of his offense that led to his dishonorable discharge from service. The December 2018 private neuropsychological reflects that the Veteran sustained a concussion during his period of service in May 1966 that impacted his functioning. The neuropsychologist could not determine how long the Veteran had experienced the prolonged deviation from his typical pattern of behavior but explained changes in behavior, cognition, and emotional functioning were common following concussions and TBIs with normal recovery lasting approximately 18 months post injury though some individuals experience problems over a prolonged time. The psychologist's opinion that that it was unlikely that the Veteran was insane (due to his TBI) at the time of the actions that led to his bad conduct discharge because the events leading to punishment did not occur in close temporal activity to his TBI, the Veteran was able to understand right from wrong, and he was able appreciate the consequences of his behavior (June 2019) falls short of establishing by clear and unmistakable evidence that the Veteran was not insane due to the effects of a TBI at the time of his commission of the actions that led to his bad conduct discharge. The ultimate determination on these questions is an adjudicatory and not a medical one. 38 C.F.R. § 3.100(a) (delegating the Secretary's authority "to make findings and decisions... as to the entitlement of claimants to benefits" to, inter alia, VA "adjudicative personnel"); 38 C.F.R. § 4.2 ("It is the responsibility of the rating specialist to interpret reports of examination... so that the current rating may accurately reflect the elements of disability present"). Cf. Geib v. Shinseki, 733 F.3d 1350, 1354 (Fed. Cir. 2013) (the "applicable regulations place responsibility for the ultimate TDIU determination on the VA, not a medical examiner"). Given the above evidence suggesting the Veteran was insane (due to TBI) at the time of his unauthorized absences that led to his bad conduct discharge from service and evidence indicating the Veteran was not insane (due to TBI) at the time of his unauthorized absences that led to his bad conduct discharge from service, reasonable minds could disagree as to the ultimate determination. Because the evidence does not establish by clear and unmistakable evidence that the Veteran was not insane because of a TBI at the time of his unauthorized absences, the character of his discharge is not a bar to receipt of VA compensation benefits and the severance of service connection was improper. Even if the Veteran was not insane, this evidence certainly calls into question the willfulness of the Veteran's unauthorized absences during his period of service. Regardless of the ultimate weight assigned to this evidence, it is obvious that the evidence bears directly on the issue of whether the Veteran's unauthorized absences were the result of willful misconduct and raises a reasonable possibility of establishing that the Veteran's unauthorized absences were not the result of willful misconduct. Cf. Volz v. Shinseki, No. 07-0917, 2009 U.S. App. Vet. Claims LEXIS 1557 (Aug. 31, 2009) (mem dec) (Schoelen, J.) (evidence establishing that the Veteran was experiencing PTSD symptoms at the time of an in-service incident later found to be the result of his willful misconduct and that his PTSD had an impact on his alcohol abuse bore directly on the issue of whether the in-service incident was the result of willful misconduct and raised a reasonable possibility of establishing that the Veteran's injuries were not the result of willful misconduct); Bethea v. Derwinski, 2 Vet. App. 252, 254 (1992) (single judge decisions may be relied upon for any persuasiveness or reasoning they contain). For these reasons, the Board finds that the severance of service connection was improper and restoration of service connection for diabetes mellitus, frequent urination and leakage, left lower extremity sciatic nerve neuropathy, right lower extremity sciatic nerve neuropathy, left upper extremity neuropathy, right upper extremity neuropathy, left lower extremity femoral nerve neuropathy, and right lower extremity femoral nerve neuropathy is warranted. Service Connection 9. Entitlement to service connection for posttraumatic stress disorder (PTSD) for treatment purposes only under 38 U.S.C. chapter 17 The current claim on appeal is for service connection for treatment purposes only under 38 U.S.C. Chapter 17. In making determinations of health-care eligibility, the same criteria will be used as is now applicable to determinations of service incurrence and in line of duty when there is no character of discharge bar. 38 C.F.R. § 3.360 (c). Service connection may be granted for disability 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. The three-element test for 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). The appellant asserts that he suffers from PTSD from in-service stressors relating to combat and fear of hostile military and terrorist activity he experienced during his service in Vietnam. In a stressor statement received in October 2016, the Veteran described being wounded in action when his unit was hit my incoming mortar fire. In addition, he reported he sustained a TBI during this incident. He reported that he had suffered from chronic PTSD related to that experience. The December 2017 PTSD disability benefits questionnaire (DBQ) documents diagnoses of PTSD and severe major depressive disorder (MDD). The Veteran's reported stressor, seeing comrades severely injured during mortar attacks while stationed in Vietnam, was adequate to support a diagnosis of PTSD and was related to the Veteran's fear of hostile military or terrorist activity. The DBQ provided a detailed report of how the Veteran satisfied the diagnostic criteria for a diagnosis of PTSD and reflected the Veteran's stressor contributed to his PTSD diagnosis. Reported symptoms of his PTSD included depressed mood, anxiety, suspiciousness, chronic sleep impairment, mild memory loss, flattened affect, disturbances of motivation and mood, difficulty in establishing and maintaining effective work and social relationships, and difficulty adapting to stressful circumstances. The January 2019 VA PTSD examination report documents diagnosis of PTSD. The Veteran's reported stressor, receiving incoming machine gun fire and mortars, witnessing comrades being severely injured and killed during mortar attacks, sustaining a TBI, while stationed in Vietnam, was adequate to support a diagnosis of PTSD and was related to the Veteran's fear of hostile military or terrorist activity. The PTSD examination provided detail report of how the Veteran satisfied the diagnostic criteria for a diagnosis of PTSD and reflected the Veteran's stressor contributed to his PTSD diagnosis. Reported symptoms of his PTSD included depressed mood; anxiety; panic attacks more than once per week; near continuous panic or depression affecting the ability to function independently, appropriately and effectively; chronic sleep impairment; impairment of short and long term memory; flattened affect; circumstantial, circulatory or stereotyped speech; impaired abstract thinking, disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships; and difficulty adapting to stressful circumstances. The psychologist concluded that the Veteran met the diagnostic criteria for PTSD that was at least as likely as not incurred in or caused by the Veteran's fear during service. The Board recognizes that there is also medical evidence weighing against finding a current diagnosis of PTSD. Specifically, the March 2017 VA PTSD examination report reflects that the Veteran's symptoms do not meet the diagnostic criteria for PTSD and the Veteran does not have a mental disorder that conforms to the DSM-5 criteria. The psychologist documented that the Veteran did not report any maladaptive behaviors or conditions that would suggest deficits in functioning. In addition, he did not report experiencing any of the most salient features of PTSD. The psychologist concluded the Veteran's adaptive functioning and mental health appeared intact. The evidence is therefore approximately evenly balanced as to whether the Veteran has a current diagnosis of PTSD (and MDD). As the reasonable doubt created by this relative equipoise in the evidence must be resolved in favor of the Veteran, the Board finds that the current disability element of the claim has been met. 38 C.F.R. § 3.102 (the benefit of the doubt doctrine applies to all points within a claim as well as its ultimate disposition); Martinez-Bodon v. Wilkie, 32 Vet. App. 393, 404 (2020), aff'd sub nom. Martinez-Bodon v. McDonough, __ F.3d __, No. 2021-1328, 2022 U.S. App. LEXIS 6559 (Fed. Cir. Mar. 15, 2022) (a valid DSM-5 diagnosis is required to warrant compensation for a psychiatric disability). The evidence required to establish a claimed in-service stressor depends on the nature of both the stressor and the veteran's service. If the evidence establishes that the claimed stressor is related to the veteran's fear of hostile military or terrorist activity and a VA psychiatrist or psychologist confirms that the claimed stressor is adequate to support a diagnosis of PTSD and the veteran's symptoms are related to that claimed stressor, a veteran's lay statements alone may establish occurrence of the claimed in-service stressor, in the absence of clear and convincing evidence to the contrary, as long as the claimed stressor is consistent with the circumstances, conditions, or hardships of the veteran's service. 38 U.S.C. § 1154 (b); 38 C.F.R. § 3.304 (f)(3). Here, in the January 2019 VA PTSD examination report, the VA psychologist indicated that the Veteran's reported stressor was adequate to support a diagnosis of PTSD, was related to the Veteran's fear of hostile military or terrorist activity and contributed to his PTSD diagnosis. Thus, the Veteran's lay testimony establishes occurrence of the claimed in-service stressor. 38 C.F.R. § 3.304 (f)(3). Affording him the benefit of the doubt, service connection for treatment purposes only under Chapter 17 for PTSD is warranted. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. Jonathan Hager Veterans Law Judge Board of Veterans' Appeals Attorney for the Board G. Jackson, 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.