Citation Nr: 25004589 Decision Date: 04/03/25 Archive Date: 04/03/25 DOCKET NO. 08-19 172 DATE: April 3, 2025 ORDER Entitlement to service connection for an acquired psychiatric disorder, to include schizoaffective disorder is denied. FINDING OF FACT An acquired psychiatric disability was not present during the Veteran's active service, is not shown to be otherwise etiologically related to such service, a psychosis did not manifest to a compensable degree within a year of the Veteran's separation from service, and there is no indication that it is otherwise related to his active service. CONCLUSION OF LAW The criteria for service connection for an acquired psychiatric disability, to include schizoaffective disorder have not been met. 38 U.S.C. §§ 1131, 5107 (2024); 38 C.F.R. §§ 3.102, 3.303 (2024). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from February 1989 to November 1989. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a May 2007 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In August 2017, the Board denied the claim on appeal. The Veteran appealed the decision to the United States Court of Appeals for Veterans Claims (Court) which, in a January 2019 Memorandum Decision set aside the Board's August 2017 decision that denied entitlement to service connection for an acquired psychiatric disorder and remanded the claim for action consistent with its decision. In August 2019, the Board remanded the Veteran's claim. In November 2021, the Board once again denied the Veteran's claim. The Veteran appealed the denial of his claim to the Court. In August 2022, the Court granted a Joint Motion for Remand (JMR) filed by the parties vacating the Board's November 2021 decision which denied the claim on appeal. Specifically, the parties found that the Veteran's notice of hearing was sent to the wrong address of record. In May 2023, the Veteran testified at a hearing before the undersigned Veterans Law Judge (VLJ). A copy of the transcript is associated with the claims file. In September 2023, the Board denied the Veteran's claim. The Veteran once appealed the September 2023 Board decision to the Court. In a September 2024 Memorandum Decision, the Court vacated the Board's denial of the claim of entitlement to an acquired psychiatric disorder and remanded the issue to the Board for action consistent with a Memorandum Decision. Specifically, the Court ordered the Board to provide adequate reasons and bases for its denial of the claim. The Veteran contends that he has a psychiatric disorder due to service. Specifically, he testified that he had anxiety during service and drank alcohol to self-medicate. He indicated that his symptoms have progressed since service. The Veteran submitted lay evidence regarding harsh treatment from superiors and being suffocated with a blanket and beaten by his fellow soldiers during service. A review of the Veteran's service treatment reports (STRs) does not reveal any complaints, findings, or treatment for a psychiatric disorder. The Veteran reported chest pain in July 1989 diagnosed as costochondritis, pneumonia, and viral syndrome. Additional testing including an echocardiogram (EKG) revealed a first degree atrioventricular (AV) block, left axis deviation, left anterior hemiblock, and myxomatous mitral valve. The Veteran's service personnel records were obtained in an effort to gain more insight as to why the Veteran was discharged from service, and whether any psychiatric problems may have begun in service and played a role in the Veteran's discharge. The reason for the Veteran's separation was noted as "Unsatisfactory Performance". The additional personnel records that were obtained do not lend any additional information as to the specific reason(s) for the Veteran's unsatisfactory performance. The record simply states that the Veteran was discharged without personal notice per NGR 600-200, and a notice was mailed to his last known address. This is noted as a General discharge per AGTX Order 223-6 para 4. There is no evidence that supports his assertion that he was physically assaulted or treated harshly by his superiors and fellow soldiers. There is no evidence to suggest the Veteran had a psychiatric disability that contributed to his discharge. Post-service treatment reports reveal a diagnosis of schizoaffective disorder in June 2002. The records also variously document reports of chest pain at times. The Veteran was eventually diagnosed with coronary artery disease (CAD) first observed in June 2015. At a VA examination in June 2016, the examiner indicated that the Veteran did not meet criteria for a diagnosis of schizoaffective disorder; however, the diagnosis has been present in his records since about 2001. The examiner issued an opinion based on an in-person examination, a thorough review of the claims file, and an interview with the Veteran. The examiner opined that it was less likely than not that the Veteran's claimed schizoaffective disorder had its onset during service, was manifested to a compensable degree within one year of service, or was casually related to service, including on the basis of continuity of symptomatology. The rationale was that most of the Veteran's psychiatric symptoms originated during the Veteran's incarceration. It was noted that any auditory hallucinations that the Veteran may have experienced began no earlier than 1991. This is clearly after the Veteran was separated from service in November 1989. The Veteran submitted a private opinion from P. Jindrich, Ph.D., in July 2023. Dr. Jindrich indicated that she conducted a personal interview of the Veteran and reviewed the claims file. She indicated that the Veteran had chest pain and tightness during service with no objective findings to correspond with his subjective symptomatology and he began drinking during service to relieve his anxiety. She indicated that except for minor deviations, testing showed normal cardiac functioning during service and the Veteran has had no subsequent history of heart problems. She noted that the lack of objective findings in service did not correspond with his subjective symptomatology. She stated that medical research suggests that schizophrenia most often starts with more subtle symptomatology such as anxiety, depression, mood swings, and other less obvious symptoms called prodromal symptoms. She indicated that the Veteran's chest discomfort and tightening and episodes of shortness of breath were symptoms of anxiety and thus the first manifestations of his current schizophrenia. Dr. Jindrich concluded that the Veteran entered service without a mental health diagnosis but first experienced a high degree of anxiety in service, manifesting in acute symptoms such as chest tightness and pain, as well as panic attacks and shortness of breath, which are clear evidence of prodromal symptoms of his schizophrenia. The Board concludes that, with respect to the conflicting medical etiology opinions of record, in the case, the most persuasive medical opinion evidence weighs against the claim. The Board finds the 2016 VA opinion to be the most probative evidence of record. After a review of the evidence of record, the examiner concluded that it was less likely than not that the Veteran's claimed schizoaffective disorder had its onset during service, was manifested to a compensable degree within one year of service, or was casually related to service, including on the basis of continuity of symptomatology. The examiner's rationale was that most of the Veteran's psychiatric symptoms originated during the Veteran's incarceration and any auditory hallucinations that the Veteran may have experienced began no earlier than 1991, several years after he left service. The Board finds that the VA examiner's opinion is based upon sufficient facts and data and this opinion is significantly probative. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). Additionally, the Board finds that the opinion is consistent with the evidence of record. The Board has also considered the 2023 private medical opinion in which the examiner concluded that the Veteran's schizophrenia manifested during service. Although Dr. Jindrich indicated that the Veteran's symptoms of shortness of breath and chest pain in service did not correspond with any objective findings, the Veteran's STRs revealed various diagnoses to account for the Veteran's chest pain including costochondritis, pneumonia, and viral syndrome and objective testing which revealed a first-degree AV block, left axis deviation, left anterior hemiblock, and myxomatous mitral valve. Additionally, she noted that the Veteran had no subsequent history of any heart problems. In fact, the Veteran's post service treatment reports document a diagnosis of CAD. Moreover, the STRs do not include reference to complaints of or treatment for anxiety, depression, or panic attacks. As the examiner relied on the incorrect premise that the Veteran's cardiac symptoms during service were not explained by any objective findings or any subsequent cardiac history, the Board finds the examiner's opinion to be of no probative value. (Continued on the next page) ? The Board has also considered the lay evidence of record. The Veteran is competent to describe what he has personally observed or experienced. However, the ultimate questions of diagnosis and etiology in this case extend beyond an immediately observable cause-and-effect relationship and are beyond the competence of lay witnesses. Kahana v. Shinseki, 24 Vet. App. 428 (2011); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). The Board finds that the Veteran's acquired psychiatric disability did not arise during his nine months on active duty. Accordingly, the benefit-of-the-doubt rule is not applicable as the evidence is not in approximate balance, and entitlement to service connection for a psychiatric disorder, to include schizoaffective disorder is not warranted. 38 U.S.C. § 5107(b) (2024); Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc). David H. Robertson Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Cryan, 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.