Citation Nr: 25001908 Decision Date: 02/10/25 Archive Date: 02/10/25 DOCKET NO. 17-58 415 DATE: February 10, 2025 ORDER Service connection for an acquired psychiatric disability, variously diagnosed, is granted. FINDING OF FACT A current psychiatric disability is etiologically related to the Veteran's military service, including foreign service in the Congo. CONCLUSION OF LAW The criteria for service connection for an acquired psychiatric disability, variously diagnosed, have been met. 38 U.S.C. §§ 1110, 1116, 5107; 38 C.F.R. §§ 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Air Force from June 1957 to June 1961, with additional reserve service. This appeal is before the Board of Veterans' Appeals (Board) on appeal from an October 2015 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified during an October 2020 central office hearing. A transcript of this proceeding has been associated with the record. Historically, the Board denied two distinct service connection claims (for bipolar disorder and PTSD) in May 2023. Upon receipt of a Joint Motion for Partial Remand (JMPR), the Court of Appeals for Veterans Claims (Court) vacated the Board's determinations and remanded the matters for further review in August 2024. Given the evidence of record and the analyses required, the Board has combined the distinct psychiatric claims and expanded the matter on appeal as set forth herein. Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009). Briefly, the Board's May 2023 decision incorrectly identified Disabled American Veterans as the Veteran's current representative. The record reflects that the Veteran revoked his authorization in February 2019, and has not subsequently identified a new representative. Rather, he continues in this appeal pro se. Service Connection The Veteran is pursuing direct service connection for an acquired psychiatric disability, to include bipolar disorder and posttraumatic stress disorder (PTSD). Generally, service connection may be granted directly as a result of disease or injury incurred in service based on nexus using a three-element test: (1) The existence of a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred in or aggravated by service. See 38 C.F.R. §§ 3.303(a), (d); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). With specific regard to PTSD claims, three elements must be present: (1) A current medical diagnosis of PTSD in accordance with 38 C.F.R. § 4.125(a); (2) medical evidence of a causal nexus between current symptomatology and a claimed in-service stressor; and (3) credible supporting evidence that the claimed in-service stressor actually occurred. 38 C.F.R. § 3.304(f); Cohen v. Brown, 10 Vet. App. 128 (1997). Turning to the instant case, there is competent evidence of a current disability. Notably, the Veteran was diagnosed with unspecified depressive disorder following June 2022 VA examination; although the same examiner denied that the Veteran demonstrated PTSD in accordance with VA regulations, an affirmative diagnosis was offered in a September 2023 private treatment letter, in accordance with the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria. The private examiner further diagnosed the Veteran with bipolar disorder and attention-deficit/hyperactivity disorder (ADHD). Upon these competent diagnoses and the Veteran's reports of current symptoms, the first element of direct service connection-a current disability, classified herein as an acquired psychiatric disability, variously diagnosed-is met. The record is in controversy with respect to the Veteran's reported in-service incurrence. Specifically, the Veteran attributes his current symptoms to the trauma incurred during service in the Congo, during which he was routinely exposed to the victims of traumatic injuries such as rape and mutilations, in addition to the circumstances of combat including sniper and mortar fire. See, e.g., December 2014 lay statement; October 2020 hearing transcript; January 2022 lay statement. In assessing the claimed in-service incurrence, the Board acknowledges that its May 2023 decision found as follows: Moreover, the Board acknowledges that the Veteran claims that his claimed psychiatric disorder is related to his active service, to include service during the Congo Independence Crisis. The Veteran's personnel records contradict the Veteran's claims as his personnel records do not detail any history of foreign service. The [JSRRC] Coordinator found a lack of evidence to corroborate the Veteran's alleged reports of in-service events in the Republic of Congo. See May 2023 Board decision, p. 8. It is true that there is certain evidence of record which contradicts the Veteran's reports of foreign service in the Congo. See generally service personnel records (SPRs) (denying any foreign service assignments); see also September 2015 JSSRC memorandum (noting a lack of evidence to corroborate the claimed in-service stressors). However, the Court's August 2024 vacatur found as follows: Appellant's personnel file confirms that he was part of the 1607th Field Maintenance Squadron at Dover Air Force Base (AFB)supporting the transport wing. The 1607th Air Transport Wing was involved in the Congo airlift, which Appellant contends is the stressor associated with his psychiatric condition. However, there is no indication in the record that any unit history had been requested, and the September 4, 2015, statement from the [JSRRC] regarding the formal finding of a lack of information required to corroborate stressor(s) associated with a claim for service connection for PTSD does not show that any such requests were included in VA efforts. See July 2024 Joint Motion for Partial Remand, p. 2. Thus, the matter was remanded to allow for a unit history to be obtained. Upon de novo review of the record, the Board finds that such development is unnecessary and would only serve to unduly delay the adjudication of this Advance on the Docket (AOD) appeal. Rather, the Veteran presents as a competent and credible historian with respect to the claimed foreign service. Layno v. Brown, 6 Vet. App. 465, 469 (1994); Miller v. Wilkie, 32 Vet. App. 249 (2020). His testimony is both well-documented and consistent, absent significant deviations in the 10 years he has been pursuing benefits for the claimed condition. Given that the Veteran's unit history was never obtained, no negative inference can fairly be drawn by the lack of corroborating evidence in his SPRs. Instead, the Board's independent research confirms several key aspects of the Veteran's testimony, including that U.S. forces were deployed to the Congo in support of a United Nations mission during the Veteran's period of service and which would reasonably have exposed the Veteran to the claimed in-service stressors, including combat circumstances and individuals with severe injuries. See, e.g., U.S. Air Force Role in Five Crises: Lebanon, Taiwan, Congo, Cuba, Dominican Republic, https://historyinpieces.com/documents/documents/air-force-role-crises-lebanon-taiwan-congo-cuba-dominican-republic/ (last accessed January 21, 2025). At no time has any of the Veteran's psychiatric examiners concluded that his testimony is not credible. On this basis and in interpreting the evidence in the light most favorable to the Veteran, an in-service incurrence is found, and the second element of direct service connection is met. Thus, the appeal may be granted upon the finding of a nexus between the Veteran's current condition and his military service. Of record are three VA nexus opinions dated June 2022, August 2022, and October 2022. The June and August opinions fail to acknowledge or explicitly state that there is no documentation of treatment for a mental health condition in VA treatment records, despite explicit evidence to the contrary. The October opinion documented multiple treatment notes spanning 1998 to 2003 which address the Veteran's psychiatric history but is otherwise based upon incomplete treatment records; fails to address the Veteran's reported in-service stressors; and offers no insight into the examiner's determination that treatment notes referencing non-service-related stressors are somehow more reliable than those discussing the reported service stressors. As such, the collective opinions are inadequate and do not merit further consideration herein. Rather, the record contains a September 2023 private treatment letter, wherein the examiner confirmed that the Veteran's diagnosis was "more likely than not service related." By way of rationale, the examiner documented the Veteran's testimony regarding the nature of his foreign service; the onset and nature of his psychiatric symptoms; and his current disability picture. The examiner then stated that they had "no reason to doubt" the Veteran's recollections and descriptions of the in-service stressors, as he had remained "clear and descriptive and coherent and cogent in his accounts even under detailed questions and scrutiny." The examiner was also able to verify many of the events the Veteran had recounted and noted his extended history working with the Veteran as a private client. In sum, the examiner concluded that the "key medical evidence is straight forward from a medical perspective." The above opinion is probative evidence in support of the claim. Critically, the examiner offered a definitive opinion with a supporting rationale which directly contemplates the nature of the Veteran's foreign service with the nature and onset of his current symptoms. See Prejean v. West, 13 Vet. App. 444, 448-49 (2000); see also Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 302-04 (2008) (holding that the probative value of a medical opinion comes from the "factually accurate, fully articulated, sound reasoning for the conclusion"). The opinion is explicit and well-founded, having been based upon the written evidence, the Veteran's competent and credible testimony, the examiner's longstanding treatment history with the Veteran, and the examiner's independent research to corroborate the Veteran's claims. There is no evidence that the private examiner misstated a relevant fact in providing their opinion, nor does the record contain any competent and contradictory opinions. Thus, the probative evidence weighs in favor of a nexus between the Veteran's psychiatric disability and his military service, and the third and final element of direct service connection is met. The persuasive evidence of record is in favor of the Veteran's claim, and service connection for an acquired psychiatric disability, variously diagnosed, is hereby granted. Of final note, the Veteran has not raised any other issues, nor have any other issues been reasonably raised by the record, for the Board's consideration. See Doucette v. Shulkin, 28 Vet. App. 366, 369-370 (2017) (confirming that the Board is not required to address issues unless they are specifically raised by the claimant or reasonably raised by the evidence of record). Evan M. Deichert Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Kovarovic, Kate 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.