Citation Nr: 22028428 Decision Date: 05/13/22 Archive Date: 05/13/22 DOCKET NO. 15-39 429 DATE: May 13, 2022 ORDER Entitlement to service connection for a psychiatric disorder is denied. FINDING OF FACT The Veteran does not have a service-connectable psychiatric disability. CONCLUSION OF LAW The criteria for service connection for a psychiatric disability have not been met. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. §§ 3.303, 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active duty for training for the Army National Guard from November 1977 to April 1978. The Veteran testified before the undersigned Veterans Law Judge (VLJ) in a videoconference hearing in January 2019. A transcript of that proceeding has been associated with the file. The Board notes that a VA "skin" examination record and private treatment records obtained by VA were uploaded into the electronic record after the March 2022 supplemental statement of the case (SOC) without consideration by the agency of original jurisdiction (AOJ). See 38 C.F.R. § 20.1304. However, the additional evidence is not pertinent to the claims adjudicated herein (any relevant information is cumulative). Thus, there is no need to remand for consideration in the first instance. Service connection may be established for disability resulting from disease or injury incurred in or aggravated by active duty or active duty for training or for disability resulting from injury incurred in or aggravated by inactive duty for training. 38 U.S.C. §§ 101, 106, 1131; 38 C.F.R. §§ 3.6, 3.303. Personality disorders are not diseases or injuries for VA compensation purposes. 38 C.F.R. § 3.303(c). Generally, service connection for posttraumatic stress disorder requires medical evidence diagnosing the condition in accordance with 38 C.F.R. § 4.125(a); a link, established by medical evidence, between current symptoms and an in-service stressor; and credible supporting evidence that the claimed in-service stressor occurred. 38 C.F.R. § 3.304(f). February 1987 VA inpatient records reveal the Veteran's histories of childhood abuse. The Veteran also reported that when he was 19, his mother revealed she was bisexual and he had a homosexual experience that was very upsetting. The records reveal diagnoses of possible bipolar disorder and borderline personality disorder. A March 1987 VA evaluation record reveals the Veteran's history of somatic problems, including general nervousness, fearfulness, and auditory hallucinations. The Veteran reported being a "bad child, bad teenager, and now a bad adult." He reported adjustment problems during childhood and a history of sexual molestation prior to service. The examiner reported that psychological testing was consistent with a person under extreme distress or who is exaggerating or malingering and attempting some other goal for himself. The examiner was unable to determine whether there was an Axis 1 or 2 disorder though there were clearly personality trait disturbances. A March 2014 VA treatment record reveals the Veteran's history that he was there to receive a PTSD diagnosis. The Veteran reported stressors of in-service mistreatment, particularly his article 15s, treatment for spinal meningitis, and an incident where he witnessed a fight. When told that he did not seem to meet the criteria for a PTSD diagnosis, the Veteran reported that he would find someone else who would diagnose PTSD. The examiner reported that the Veteran's trauma did not meet criteria A because the Veteran did not focus on fear of death or injury from the reported stressors. The examiner believed the Veteran had chronic mental illness, with suspicion of a personality disorder. An April 2014 VA mental health initial evaluation record reveals the Veteran's history of stressors including in-service spinal tap, sexual harassment, and physical assault. The record adds that the Veteran endorsed a strong belief that he met the criteria for PTSD. The examiner reported that the Veteran did not endorse symptoms or index traumas that would meet the criteria for PTSD though he appeared to have a mood disorder. A May 2014 VA treatment record reveals the Veteran's history of a "long chain of assaults" in service. He reported that he witnessed an assault by a superior officer and intervened and the officer assaulted him. The examiner reported that there was evidence for a legitimate mood disorder that would benefit from in depth assessment. The examiner stated that the Veteran controlled the conversation and appeared interested only in his goal of obtaining a PTSD diagnosis. The clinician explained that the goal of a PTSD diagnosis was interfering with the clinician's assessment. A January 2020 VA examination record notes diagnoses of PTSD and borderline personality disorder. However, the examiner clarified that the Veteran's reported symptoms and presentation were inconsistent with a diagnosis of PTSD. Instead, the examiner believed the Veteran's symptoms were consistent with borderline personality disorder and provided a detailed rationale. The examiner explained that the Veteran's "PTSD" symptoms were better accounted for with a diagnosis of borderline personality disorder, with the symptoms of depressed mood and anxiety as secondary to, and symptoms of, borderline personality disorder. The examiner added that the diagnosed mental health condition was not likely incurred in or etiologically related to service. The examiner added that the Veteran had symptoms of borderline personality disorder prior to service and that it was not likely aggravated by the in-service meningitis, explaining that there was no clear escalation of symptoms after the claimed in-service stressors or the in-service illness and that the pattern of symptoms remained consistent even as the Veteran experienced other stressors. The examiner reported that the progression of the Veteran's symptoms was highly consistent with the natural progression of borderline personality disorder. An April 2021 VA examination record reveals diagnosis of borderline personality disorder. The examiner noted review of the record and evaluation of the Veteran. The examiner determined that the borderline personality disorder was not secondary to the reported in-service meningitis. The examiner first noted that there was no evidence to support that meningitis was diagnosed in service, noting that the diagnosis was ruled out based on tests of cerebrospinal fluid and other tests. The examiner reported that borderline personality disorder usually develops in childhood and persists through adulthood. The examiner reported that the Veteran had reported physical and sexual assault prior to service and that it was common for personality disorder to develop in response to a traumatic event. The examiner stated that there was no research to support that borderline personality disorder can arise as a result of viral infection. The examiner added that the criteria for a diagnosis of PTSD were not met because several symptoms were absent. The examiner noted that the Veteran reported a military sexual trauma during basic training. The examiner stated that although there was history of behavioral disturbances in service which could be seen as marker evidence of a military sexual trauma, the Veteran had repeatedly reported that the charged infractions in service were due to harassment from superiors for not dropping assault charges against a fellow service member and not due to behavioral changes. After consideration of the evidence, the Board finds service connection is not warranted because the record is absent any competent evidence of a service-connectable disorder or impairment. Although the record includes diagnosis of PTSD and anxiety disorder, the Board finds the VA examiners' determinations that the Veteran does not have an Axis 1 psychiatric disorder are more probative because they are based on evaluation and review of the record and are supported by a rationale. This finding is consistent with the multiple VA treatment records that reveal determinations that the Veteran did not meet the criteria for PTSD. Regarding the VA treatment records reported findings of possible mood disorder, the record is absent any definitive diagnosis of mood disorder, and the 2020 VA examiner determined the mood symptoms were due to the borderline personality disorder. The Board finds the VA treatment records do not provide probative evidence of a mood disorder during the period of the appeal. The Board acknowledges that the record includes probative diagnoses of borderline personality disorder. Personality disorders are not diseases or injuries for VA compensation purposes. 38 C.F.R. § 3.303(c). The Board notes that the record indicates that borderline personality disorder can be due to a traumatic event, and that the Veteran has reported in-service traumatic events. The Veteran has provided varying stressors, including stressors of pre-service sexual and physical abuse, and has reported symptoms attributed to borderline personality disorder prior to service and VA clinicians have determined that the Veteran's borderline personality disorder preexisted service (and thus is not due to an in-service event). The record is absent any probative evidence linking the borderline personality disorder to a superimposed injury or disease in service, and the 2020 and 2021 VA examiners determined there was evidence of a change in the progression of the borderline personality disorder during or due to service. The 2021 VA examiner also determined the in-service infractions were not probative markers of an in-service trauma based on the Veteran's histories regarding the in-service infractions. After consideration of the entire record, the Board finds the record is substantially against the determination that the borderline personality disorder was caused or aggravated by a superimposed event in service. Accordingly, the claim must be denied. T. REYNOLDS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board N. Snyder, 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.