Citation Nr: 22019741 Decision Date: 04/02/22 Archive Date: 04/02/22 DOCKET NO. 14-28 717 DATE: April 2, 2022 ORDER Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD) and depression, is denied. FINDING OF FACT The Veteran's acquired psychiatric disorders are not related to his military service. CONCLUSION OF LAW The criteria for service connection for an acquired psychiatric disorder are not 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 active military service from April 1968 to March 1970. This matter comes before the Board of Veterans' Appeals (Board) from the August 2012 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). This matter was previously before the Board in March 2018 and was remanded for further development. The Board finds that there was substantial compliance with the prior remand order, as is discussed more fully below, and the Board may continue with its determination. Stegall v. West, 11 Vet. App. 268 (1998). The Veteran appeared at a December 2017 hearing before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the record. Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD) and depression The Veteran contends that his acquired psychiatric disorders are related to his military service. The Veteran's original claim was characterized as entitlement to service connection for posttraumatic stress disorder (PTSD). However, pursuant to Clemons v. Shinseki, the Board has consolidated and expanded the issue on appeal to encompass all diagnosed psychiatric disorders. See Clemons v. Shinseki, 23 Vet. App. 1 (2009) (holding that the scope of a mental health disability claim includes any mental disability that may reasonably be encompassed by the claimant's description of the claim, reported symptoms, and the other information of record.) At the Veteran's December 2017 Board hearing, and throughout the record, the Veteran testified about two alleged in-service stressors that he experienced. The Veteran stated that while stationed in Panama, beginning in September 1968, his unit wrongfully fired upon and killed numerous civilians. Specifically, the Veteran testified that the first night he was in Panama, he was told to report to the arms room and was told his unit had to go to Panama City. The Veteran stated that there was fighting and shooting occurring and his unit ended up going to the city of Rio Hato. In this town, one of the medics in the Veteran's unit was killed and thrown into the water. The Veteran testified that he later found the body of the medic in the water. After this event, the Veteran testified that his unit again went to Panama City and underwent gunfire as rebels attempted to get to the canal. The Veteran states that his unit set a rocket launcher off, as well as other weapons, that killed approximately 30-40 people by mistake. The Board notes that the Veteran stated at his Board hearing that he was with the 177th mechanized battalion while in Panama. The Veteran testified that the hostility he experienced in Panama lasted only approximately 30 days. After this, he returned in Fort Clayton in Panama and became a cook. The Board notes that the Veteran's personnel records state that the Veteran's military occupational specialty was initially an infantryman and he was later reassigned as a cook. The Veteran's August 2014 formal appeal to the Board states that the Veteran feared hostile military action while in Panama and that he now lives in a state of fear and horror as a result. 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 question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. As noted above, this matter was previously before the Board in March 2018 and was remanded for further development. Specifically, the Board instructed the Agency of Original Jurisdiction (AOJ) to obtain outstanding VA treatment records, ask the Veteran if he had any separately stored service mental health treatment records, contact the Veteran and request information regarding his in-service stressors and forward this information to the JSRRC, and finally, schedule the Veteran for another VA examination to determine the etiology of any diagnosed psychiatric disorders. Subsequently, the Veteran's outstanding VA treatment records were obtained, and in September 2018, the Veteran was asked about any separately stored service mental health treatment records and information about his in-service stressors. Additionally, in November 2021, a records response was received from the Veterans Benefits Administration, Office of Field Operations stating that comprehensive research on the Veteran's claimed stressors (assignment to Company A, 4th Battalion, 20th Infantry, in Panama, during the period September 1, 1968 to October 31, 1968, his unit, 177th Mechanized Division, set off a rocket launcher and other weapons that killed 30-40 people) was completed. The response stated that the Veteran's service personnel records are silent for assignment with the 177th Mechanized Division. Additionally, a review of the annual historical supplement 4th Battalion (Mechanized), 20th Infantry, 1968, does not document the unit launching a rocket that killed approximately 30-40 people. The response stated that the Historical Supplement documents that during the month of October 1968, the unit stood at R1 Alert Status while political turbulence prevailed in the Republic of Panama, but no details of this political turbulence or any involvement of unit was noted. Therefore, the records response concluded that there is no evidence located to support documentation of the claimed incident. A separate November 2021 records response was received discussing the Veteran's other asserted stressor (while assigned to Company A, 4th Battalion, 20th Infantry, in Panama, during the period September 1, 1968 to October 31, 1968, his unit was involved in a fight and shooting, and a medic in his unit was killed and thrown into the water). The records response states that the Veteran's service personnel records are silent for assignment with the 177th Mechanized division and the annual historical supplement 4th Battalion (Mechanized), 20th Infantry, 1968, does not document any of the incidents described by the Veteran. Therefore, the response concluded that there is no evidence located to support documentation of the claimed incident. Pursuant to the Board's March 2018 remand, the Veteran underwent a VA PTSD examination in February 2022. The examiner stated that the Veteran is diagnosed with depressive disorder with mood congruent psychotic features and alcohol use disorder in sustained remission. The examiner stated that the Veteran does not meet the diagnostic criteria for PTSD. The examiner opined that the Veteran's depressive disorder with mood congruent psychotic features is less likely than not related to his military service. The examiner stated that the Veteran reported having mental health difficulties prior to his military service, to include alcohol use, nightmares, and cutting/self-harming behaviors. The examiner stated that there is no evidence that the Veteran's military service caused his depressive disorders and there are multiple inconsistencies as to the details of the Veteran's stressors in Panama, which are likely due to the Veteran's psychotic symptoms. Regarding the Veteran's previous diagnosis of PTSD in the record, the February 2022 VA examiner stated that the diagnosis was removed from the Veteran's chart sometime after 2010 and when it was first diagnosed, there was no evidence that a comprehensive PTSD evaluation was performed. According to available notes, the diagnosis was made due to nightmares and vague stressors, which are different than the stressors reported at the time of the February 2022 examination. The February 2022 VA examiner stated that the original physician that diagnosed the Veteran with PTSD changed the diagnosis to dysthymia with hallucinosis, which the VA examiner found to also be less likely than not related to the Veteran's military service. The February 2022 examiner also stated that the Veteran's anxiety disorder is less likely than not related to his military service and that it is unclear what anxiety disorder is being referred to, or perhaps anxiety symptoms. Finally, the examiner stated that the Veteran's alcohol abuse is not related to his military service as the record reflects that the Veteran began drinking prior to his military service. The examiner's opinions are probative, because they are based on an accurate medical history and provide an explanation that contains clear conclusions and supporting data. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). The Board concludes that, while the Veteran has a current diagnosis of depressive disorder, the evidence of record persuasively weighs against finding that the Veteran's diagnosis of any acquired psychiatric disorder began during service or is otherwise related to an in-service injury, event, or disease. The Board acknowledges that the Veteran believes his acquired psychiatric disorders are related to an in-service injury, event, or disease. However, the Veteran in this case is not competent to provide a nexus opinion regarding this issue. The issue is medically complex, as it requires knowledge of interpretation of complicated diagnostic medical testing. Therefore, it is outside the competence of the Veteran in this case because the record does not show that he has the medical training or credentials to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). Consequently, the Board gives more probative weight to the VA medical opinion. Therefore, entitlement to service connection for an acquired psychiatric disorder is not warranted. In reaching the above conclusions, the Board has considered the applicability of the benefit of the doubt doctrine. However, as the persuasive weight of the evidence is against the Veteran's claim, that doctrine is not applicable in the instant appeal. See 38 U.S.C. § 5107 (b). MICHAEL MARTIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Mountford, 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.