Citation Nr: 23042628 Decision Date: 08/03/23 Archive Date: 08/03/23 DOCKET NO. 20-05 161 DATE: August 3, 2023 ORDER Entitlement to service connection for posttraumatic stress disorder (PTSD) is granted on a direct basis. FINDING OF FACT The Veteran's PTSD was at least as likely as not caused by his in-service trauma. CONCLUSION OF LAW The criteria for entitlement to service connection for PTSD have been met. 38 U.S.C. §§ 1110, 1154(b); 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active-duty service in the United States Army from March 1990 to August 1991. The Board thanks the Veteran for his service to our country. 1. Entitlement to service connection for PTSD Direct service connection may be warranted if the evidence shows: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship (nexus) between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Although a competent medical opinion is generally required to establish etiology, competent and credible lay evidence of chronicity and continuity of symptomology may also establish etiology. 38 C.F.R. § 3.303(b); Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); Layno v. Brown, 6 Vet. App. 465 (1994). The Veteran generally contends that his PTSD was caused by the trauma of witnessing a murder-suicide of fellow servicemembers in his unit in June 1991 while at Schofield Barracks, Hawaii. See March 2018 VA Form 21-0781; July 2018 VA PTSD examination; September 2018 Notice of Disagreement (NOD); December 2019 VA Form 9; September 2022 Statement. Service treatment records did not document any mental health abnormalities upon entrance to, during, or upon separation from service. See December 1989 examination; March 1991 examination. However, military personnel records confirm that the contended trauma occurred. See June 2018 Memorandum from the United States Army Crime Records Center. In a March 2018 Statement, the Veteran reported the contended trauma, stated that it took a toll on his mind and body, and reported that he has resulting flashbacks, nightmares, and headaches. The July 2018 VA mental health examiner documented the Veteran's report of the in-service trauma, diagnosed PTSD, and listed associated symptoms of: recurrent, involuntary, and intrusive distressing memories of the trauma; recurrent distressing dreams in which the content and/or affect of the dream are related to the trauma; dissociative reactions (e.g., flashbacks) in which the individual feels or acts as if the trauma were recurring (such reactions may occur on a continuum, with the most extreme expression being a complete loss of awareness of present surroundings); avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the trauma; persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame); markedly diminished interest or participation in significant activities; feelings of detachment or estrangement from others; persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings); irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects; hypervigilance; exaggerated startle response; problems with concentration; sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep); depressed mood; anxiety; suspiciousness; mild memory loss, such as forgetting names, directions or recent events; disturbances of motivation and mood; difficulty in establishing and maintaining effective work and social relationships; difficulty in adapting to stressful circumstances, including work or a worklike setting; and inability to establish and maintain effective relationships. The examiner also opined that the Veteran's PTSD was at least as likely as not due to his contended traumatic stressor. In the July 2018 Rating Decision, the Agency of Original Jurisdiction (AOJ) denied the claim, finding that the Veteran was not assigned to the unit of the incident until August 21, 1991, more than 2 months after the traumatic incident occurred; as such, the AOJ found that the Veteran did not experience an in-service trauma that could be linked to his PTSD diagnosis. Crucially, however, military personnel records clearly establish that the Veteran was assigned to that unit in Hawaii from August 15, 1990, to August 7, 1991, placing him there at the time of the June 1991 incident (see oversees service list, assignments list, August 1990 assignment letter to go to Hawaii, and July 1991 reassignment letter to leave Hawaii); accordingly, the Board concedes that the Veteran experienced that in-service trauma. Based on the above, the Veteran's PTSD was at least as likely as not caused by his in-service trauma. Specifically, the Veteran provided probative reports of how his in-service trauma has affected his mental health since service, which were buttressed by the VA examiner's identification of symptoms directly related to that trauma and attribution of the Veteran's mental health symptoms directly to the in-service trauma. Given the lack of mental health problems upon entrance to service, followed by in-service trauma and ongoing mental health symptoms since related to that trauma, the Board finds in favor of the Veteran to grant the claim on a direct basis, resolving it in full. T. Raymond Veterans Law Judge Board of Veterans' Appeals Attorney for the Board H. Daus, 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.