BVA9508461 DOCKET NO. 89-20 466 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Winston-Salem, North Carolina THE ISSUES 1. Entitlement to service connection for post traumatic stress disorder (PTSD). 2. Whether new and material evidence has been submitted to reopen a claim for entitlement to service connection for a psychiatric disorder, other than PTSD. REPRESENTATION Appellant represented by: H. Russell Vick, Attorney at Law ATTORNEY FOR THE BOARD Jeffrey A. Pisaro, Counsel INTRODUCTION The veteran had active service from July 1970 to September 1973. By rating action in May 1977, service connection for a psychiatric disorder was denied. The veteran was informed of that action by letter in June 1977; however, he did not file a timely appeal therefrom and that action became final. In August 1988, the veteran requested that his claim for entitlement to service connection for a psychiatric disorder be reopened, and he requested entitlement to service connection for PTSD. This matter came before the Board of Veterans' Appeals (Board) on appeal from a January 1989 rating decision of the Winston-Salem, North Carolina, Regional Office (RO). The case was remanded by the Board to the RO in April 1990 for due process reasons. In October 1990, the Board issued a decision denying service connection for a psychiatric disorder to include PTSD. On June 2, 1993, the United States Court of Veterans Appeals (Court) issued a memorandum decision which vacated the Board's October 1990 decision, and remanded the case to the Board for further development. Judgment in accordance with the Court's decision was entered on June 29, 1993. The Court expressly retained jurisdiction for the limited purpose of entertaining an application for attorney fees and expenses. Copies of the memorandum decision and judgment have been placed in the claims folder. The case was remanded by the Board to the RO in April 1994 for additional development of the evidence. The case was received and docketed at the Board in March 1995; the claims file was received by this section of the Board on March 22, 1995. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends that the RO erred by failing to grant service connection for a psychiatric disorder to include PTSD. He maintains that a psychiatric disorder was incurred during service, and that he currently suffers from PTSD as a result of his wartime experiences in Vietnam. The veteran asserts that he was exposed to multiple stressors in Vietnam while performing his duties as a security policeman to include incoming rocket and sniper fire, searching Vietnamese employees who might have weapons before they were admitted to the base, witnessing wounded being unloaded, and having an airman on drugs hold a gun to his head for an hour and threatening to shoot him. DECISION OF THE BOARD The Board, in accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991), has reviewed and considered all of the evidence and material of record in the veteran's claims files. Based on its review of the relevant evidence in this matter, and for the following reasons and bases, it is the decision of the Board that new and material evidence has not been submitted to reopen the claim for entitlement to service connection for a psychiatric disorder, and that the preponderance of the evidence is against the claim for entitlement to service connection for PTSD. FINDINGS OF FACT 1. All relevant evidence necessary for an equitable disposition of the veteran's appeal has been obtained by the RO. 2. The veteran's claim for entitlement to service connection for a psychiatric disorder was denied by rating action in May 1977. 3. Additional evidence submitted since May 1977 is merely cumulative and does not raise a reasonable possibility of changing that prior outcome. 4. The veteran was not engaged in combat during his service in Vietnam. 5. Objective demonstration of an inservice stressor has not been shown. 6. The veteran does not currently suffer from PTSD as a result of his wartime experiences in Vietnam. CONCLUSIONS OF LAW 1. Evidence received since the May 1977 rating decision is neither new nor material, and the veteran's claim for service connection for a psychiatric disorder, other than PTSD, has not been reopened. 38 U.S.C.A. §§ 5107, 5108 (West 1991); 38 C.F.R. § 3.156(a) (1994). 2. The May 1977 rating decision which denied service connection for a psychiatric disorder is final. 38 U.S.C.A. §§ 1110, 5107, 7105 (West 1991); 38 C.F.R. §§ 3.104(a), 20.302(a) (1994). 3. PTSD was not incurred in or aggravated by service. 38 U.S.C.A. §§ 1110, 1154, 5107 (West 1991); 38 C.F.R. § 3.304 (1994). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The veteran's claims are well grounded within the meaning of 38 U.S.C.A. § 5107(a). That is, the Board finds that he has presented claims which are plausible. See Murphy v. Derwinski, 1 Vet.App. 78 (1990). The Board is also satisfied that all relevant evidence has been properly developed and that no further duty to assist is necessary under 38 U.S.C.A. § 5107(a). In April 1994, the Board remanded the case to the RO to allow the veteran to contact a service comrade, [redacted], who reportedly has eyewitness knowledge regarding a putative stressor. The RO sent a letter to the veteran's attorney in April 1994 asking for [redacted]'s home address. In response to a May 1994 Congressional inquiry, a June 1994 statement from the Department of the Air Force indicated that the Air Force Worldwide Locator showed that a Master Sergeant [redacted] was on the retired roster; however, his address was exempt from disclosure due to privacy reasons. It was further detailed how a letter could be forwarded to Sergeant [redacted] through the Air Force Locator. In June 1994, the veteran requested a time extension stating that he only had [redacted]'s Social Security number and service number. In August 1994, the veteran submitted copies of the certified mail receipt of what the veteran indicated was a letter to Sergeant [redacted] through the Air Force Locator. A copy of the letter to Sergeant [redacted] was not submitted by the veteran. By deferred rating action in January 1995, it was noted that no information regarding Sergeant [redacted] had been received to include his home address or a response to the veteran's inquiry. As all reasonable efforts to obtain the whereabouts of Sergeant [redacted] have been exhausted, the Board finds that the duty to assist has been complied with. 38 U.S.C.A. § 5107(a); Littke v. Derwinski, 1 Vet.App. 90 (1990). I. Whether new and material evidence has been submitted to reopen a claim for entitlement to service connection for a psychiatric disorder. The applicable criteria for the grant of service connection for a psychiatric disorder when the RO considered that claim in 1977 turned on whether the evidence showed that a psychiatric disorder was incurred in or aggravated by service. 38 U.S.C.A. § 1110. The evidence which was of record when the Board considered the claim in 1977 may be briefly summarized. On the April 1970 enlistment examination, the veteran was clinically evaluated as normal psychiatrically. In April 1973, the veteran was referred to the mental health clinic by his squadron commander. Suicidal ideation, acute anxiety, depression, difficulty sleeping, and an expressed inability to get along with supervisors were reported. The veteran stated that he hated his job and was mixed-up as to whether he wanted to stay in the military. The veteran had problems at home with his mother to include financial concerns. His relationship with his mother was poor and he indicated that she was "ill tempered." It was reported that the veteran had taken a lot of leave lately. The impression was anti-social personality and situational depressive reaction. A limited profile for 90 days was recommended; a limited profile was issued that same day. Later in April 1973, it was noted that the veteran had been diagnosed as having an anti-social personality, suicidal ideation, and moderate depression. Disqualification was recommended. At the end of April 1973, it was noted that the veteran had been seen at the mental health clinic for counseling. On the July 1973 separation examination, it was reported that the veteran was undergoing a discharge examination due to anti-social personality and situational depressive reaction for which he had been treated in April 1973. On examination, the veteran was clinically evaluated as normal psychiatrically. It was further noted that he had no mental defects which would justify further action and it was indicated that the veteran was able to distinguish right from wrong and adhere to right. A February 1977 record from Foothills Mental Health Center (FMHC) indicated that the veteran had become emotionally upset while in service in April or May 1973 and had received psychiatric treatment or evaluation. Since that time the veteran had been working, but had lost his job due to nervousness. The veteran had been very tense, agitated, and depressed. The diagnoses were depressive neurosis and anxiety neurosis. The prognosis was fair. In February 1977, the veteran filed a claim for service connection for a nervous condition. He cited the February 1977 statement from FMHC in support of his claim. On VA psychiatric examination in April 1977, it was reported that the veteran had been in Vietnam for one year and had not been in combat. While in service, he had been seen for complaints of anxiety and depression, but on careful evaluation he had been diagnosed with an anti-social personality and situational depression. At the time of discharge, the record further showed that the veteran had been carefully evaluated and found to be in good health. Following service, the veteran had been attending community college and working as a security guard and health care technician. Presently, he was working at a convenience store. His primary complaint was that he had a "bad temper." On psychiatric examination, the veteran was vague and evasive, and he showed no evidence of tension or anxiety. He smiled during the interview, was somewhat guarded, and at times was covertly hostile. There was no evidence of delusions, illusions, hallucinations, or ideas of reference. The veteran was oriented to time, place, and person. Memory for recent and remote events was fair. Judgment, reasoning and insight were poor. Intelligence was estimated as being average. The diagnosis was passive aggressive personality. The degree of incapacity was listed as none, and the veteran was deemed competent. By rating action in May 1977, the RO denied service connection for a nervous condition. The rating action noted that the veteran's passive aggressive personality, also diagnosed as anti- social personality with situational depression, was a constitutional or developmental abnormality, and was not a disability under the law. The veteran received written notification of that action by letter in June 1977 and, as he failed to file a timely appeal therefrom, that action became final and is not subject to revision on the same factual basis. 38 U.S.C.A. § 7105; 38 C.F.R. § 3.104(a). In order to reopen his claim, the veteran must present or secure new and material evidence with respect to the claim which has been disallowed. 38 U.S.C.A. § 5108; 38 C.F.R. § 3.156(a). On claims to reopen previously and finally disallowed claims, the Board must conduct a two part analysis. See Manio v. Derwinski, 1 Vet.App. 140, 145 (1991). First, it must be determined whether the evidence presented or secured since the prior final disallowance of the claim is new and material. See Colvin v. Derwinski, 1 Vet.App. 171, 174 (1991). New evidence is evidence that is not merely cumulative of other evidence on the record. Ibid. Evidence is material where it is relevant to and probative of the issue at hand and where it is of sufficient weight or significance (assuming its credibility, see generally, Justus v. Principi, 3 Vet.App. 510, 513 (1992)) that there is a reasonable possibility that the new evidence, when viewed in the context of all the evidence, both new and old, would change the outcome. Sklar v. Brown, 5 Vet.App. 140, 145 (1993); Cox v. Brown, 5 Vet.App. 95, 98 (1993); Colvin, 1 Vet.App. at 174. Second, if it is determined that the evidence is new and material, the Board must reopen the claim and evaluate the merits of the veteran's claim in light of all the evidence, both old and new. Masors v. Derwinski, 2 Vet.App. 181, 185 (1992). The additional evidence submitted since the May 1977 rating action follows hereinafter. It is comprehensive relative to both issues at bar from 1977 to the present, and will serve as the factual repository for Parts I and II of the decision. In September 1988, statements were submitted from multiple individuals. The veteran's nephew indicated that he had observed marked changes in the veteran's behavior following service in the areas of nervousness, sleeplessness, a lack of closeness with family and friends, nightmares and excessive drinking. The veteran's mother indicated that following service the veteran was extremely nervous, that he was unable to sleep at times, and had nightmares relating to his Vietnam service. The veteran's brother indicated that since service the veteran had been extremely nervous with mood swings, and suffered from insomnia and nightmares. Another family member observed that the veteran was nervous, avoided family interaction, drank excessively, and complained of nightmares and difficulty sleeping. In a September 1988 statement, the veteran indicated that he had signed an August 1973 statement accepting his separation from service after he was strongly advised by his commanding officer that with his deteriorating performance he may have had to accept a less than honorable discharge. He further indicated that he had been shunned by other non-commissioned officers and that he did not have the respect of those assigned to him. Although he wanted to stay in the military, he felt that he had no other reasonable alternative. He further indicated that his problems were due to his military service in a hostile combat environment in Vietnam. Received in September 1988 were the veteran's June 1972 military performance evaluation which indicated that the veteran' work from February to June 1972 had been outstanding; a February 1971 letter from the veteran's commander naming him security policeman of the week; and a second letter from the veteran's commander naming him Airman of the quarter for the period from January to March 1971. Received in September 1988 was a copy of a statement from [redacted], Colonel, USAF, Retired, which indicated that he had first met the veteran in 1975. The veteran had stayed with him for awhile in 1985 and he had noticed that the veteran had mood swings, depression, and was an alcoholic. [redacted] indicated that the veteran arrived at Tan Son Nhut Air Base in Vietnam at about the same time that he had left in June 1971, but that he had never known the veteran over there. [redacted] noted that the base was constantly harassed by attempted penetrations of the base perimeter, and by theft and sabotage. The security police were under constant and ever increasing pressure and stress. He indicated that during his tour there were no rocket attacks, but he had heard that there were some after he left. [redacted] considered the military police to have been true heroes, but also potential problems to self and others following service. He further indicated that the security police faced the same pressures, stress and danger as the combat infantryman in the field, and he could easily understand the veteran's depression and excessive drinking. In a September 1988 stressor statement submitted by the veteran, he indicated having served in Vietnam from June 1971 to June 1972 with the 377th Security Police Squadron. The veteran was a perimeter guard in law enforcement and his details included the following: desk clerk, post and patrol, gate duty, prisoner escort, and service on alert units during increased defensive conditions. He also received combat readiness training for Security Police only. Stressors included rocket attacks; friendly machine gun fire from South Korean forces who were reportedly drunk; having another security policeman place a gun to his head and threaten to blow his brains out; that his supervisor, Sergeant [redacted], witnessed the incident but refused to say anything because the Airman was on drugs and was a friend of [redacted]'s; having to draw his service revolver in defense of his life on several occasions due to U.S. military personnel who were drunk, doped up, or psychologically messed up; that race riots broke out on several occasions and he was faced by large numbers of white and black troops; being thrown down and losing his walkie talkie in a rocket attack; serving guard duty in the drug ward which was threatening and stressful; witnessing wounded personnel being unloaded off helicopters while on guard duty; witnessing U.S. forces being beaten up and locked up; hearing distant bombing at night; and having to search Vietnamese employees and being afraid that they may be booby trapped. In October 1988, the veteran submitted extracts from the Viet Vet Survival Guide and from a medical treatise concerning PTSD. Received in October 1988 were the veteran's military performance evaluations from July 1970 to May 1971, from May 1971 to February 1972, and from February to June 1972. During the referenced periods, the veteran was evaluated as outstanding in performing his duties. A performance evaluation from June 1972 to March 1973 indicates that the veteran had performed all duties in an exceptional manner. Also received was a July 1973 statement from a USAF commander which recommended that the veteran be discharged from the Air Force due to character and behavior disorder. Although the veteran's duty performance, military bearing and behavior had been excellent in the past, his performance had started to seriously decline in March 1973. The veteran developed a very poor attitude, his behavior became irrational, he began registering racial complaints that were unfounded, and had contemplated suicide. These problems had become very deep seated and irreconcilable with his duty performance and the required standards of behavior. In November 1988, the veteran indicated that he had been very young and afraid in Viet Nam; that he was constantly afraid of booby traps, especially in packages or parcels; that he felt guilty locking up military personnel; that he saw an Army MP shoot at an American; and he further amplified the previously reported incident when another Security Policeman had held a gun to his head for at least 30 minutes resulting in nightly visions of that person's face. The veteran reported that hatred from that episode had taken control of his life. The veteran's Airman military records were received in November 1988. The veteran served in Vietnam from June 1971 to June 1972 as a security policeman at Tan Son Nhut Air Base. The veteran received the Vietnam Service Medal and the National Defense Service Medal. Also of record is an April 1971 certificate of training for a security police combat preparedness course. On VA psychological evaluation in November 1988, testing showed unconventional or disturbed thinking, depression, hypochondriasis, anxiety, repression and denial, introversion, distrust, immaturity, egocentricity, and agitation. Such profiles were the most common type seen in PTSD, and his score on the Keane PTSD subscale was consistent with that disorder. His profile differed from an average PTSD case in that his test suggested relatively less behavioral problems and more introversion. The assessment was PTSD. On VA psychiatric examination in November 1988, the veteran was oriented to person, place and situation. Affect was appropriate and thoughts were rational. He reported chronic anxiety and depression. Insight and judgment were fair. The veteran reported being subjected to snipers and rockets in Vietnam. His two most stressful episodes were working in a bunker with rocket fire ricocheting off it, and having an Airman accost him with a gun, threatening to shoot him for an hour. The veteran stated that he still clearly recalled that incident. He also mentioned having to search Vietnamese who might have explosives on them. The veteran was bitter and angry about his Vietnam experiences. Reportedly, he cried, was often sad, restless, paced, and was claustrophobic. He had a history of heavy drinking and found it difficult to keep a job. The veteran reported two suicide attempts and he had been married and divorced twice. The examiner noted that the veteran's history met the criteria for PTSD. He had severe stressors, he dreamed of guns and killing, had flashbacks, a short temper, was easily upset, avoided stimuli, and experienced survivor's guilt. The veteran was a loner, concentration was difficult, he was hyperalert, and he was startled easily. Psychological testing was reviewed; that testing did not reveal a pattern of anti-social personality, but did present as PTSD. The diagnoses were PTSD and alcohol dependence. Received in January 1989, were records dating from February 1977 from FMHC. The veteran reported having been tense and nervous for as long as he could remember, and that tension had steadily increased since 1974. He stated that throughout his life he had been frustrated when authorities did not handle situations correctly. Reportedly, his symptoms had become increasingly uncomfortable in recent months. On examination, the veteran held himself tightly, near the edge of his seat. Moods were described as changing from highs to lows in five minutes, and he indicated that he frequently worried about almost everything. He experienced some paranoid ideation. There was no evidence of serious suicidal or homicidal ideation. The initial diagnosis was transient situational disturbance of adult life, and personality disorder. A December 1988 request to the U.S. Army and Joint Services Environmental Support Group (Task Force) included the veteran's allegations that Tan Son Nhut Air Force Base had been subject to repeated rocket attacks, and other guerrilla activities. All available information was requested as to the history of any combat involvement by the 377th Police Squadron and any other combat activity in and around the Air Force base from June 1971 to June 1972. The Task Force supplied a statement in December 1988. Enclosed with the statement were extracts from Air Base Defense in the Republic of Vietnam 1961-1973 which showed the attacks on Tan Son Nhut Air Base during the veteran's tour in Vietnam. It was noted that information provided was general in nature due to the lack of specific stress indicators. If more specific information was to be provided, the Task Force needed specific combat incidents including the date, place and type and full names of friends killed or wounded in action, if applicable. A stress incident described in detail, including the who, what, when and where would very likely be capable of verification. Enclosed extracts showed two attacks on Tan Son Nhut Air Base during the veteran's tour. In August 1971, there was a standoff attack, three standoff rounds impacted on the base, which resulted in no aircraft losses, and no American, Republic of Vietnam, or Vietcong losses (killed or wounded). A second standoff attack in April 1972 resulted in four standoff rounds impacting on the base without loss of aircraft or life (killed or wounded). During the time period in question, there was no record of sapper attack, standoff and sapper attack, multi-battalion attack, sabotage attack, or automatic weapons attack. Treatment records from January 1982 to February 1983 from FMHC include a diagnosis of depressive neurosis in January 1982. Twice weekly supportive psychotherapy and consideration of medication was indicated. Later in January 1982, in a phone conversation, the veteran indicated having attempted suicide that morning. Social Work notations from February to May 1982 reveal that the veteran was having acute problems in his marital relationship. A February 1983 notation shows that the veteran was a very confused and angry young man whose problems had escalated during therapy. He attempted to use therapy time as a way of manipulating others in his life and working on not taking responsibility for anything that happened to him. He abused more than used his time in therapy and consequently decided to terminate. The veteran felt a tremendous amount of confusion and wanted to be rescued. The diagnosis of depressive neurosis was continued. A March 1989 report from Drexel Counseling Service indicates that following three sessions with the veteran and careful review of service and civilian documents, the examiner agreed with the November 1988 VA psychiatric examination report. It was also indicated that the examiner had been the veteran's teacher in the past. The marked contrast between the veteran's behavior before and after his tour of duty in Vietnam to include superior evaluations and promotions followed by rather rapid development of interpersonal problems pointed to the occurrence of a stressful event or events, although a discreet onset of a mental health illness could not be totally discounted. Stressor events recounted by the veteran included being fired on by South Korean troops. It was felt that something traumatic happened to the veteran which resulted in loss of 1) superior evaluations, 2) promotions, 3) a potential career in the Air Force, 4) two marriages, 5) several jobs, 6) the ability to concentrate, 7) homes and property, 8) closeness to family and friends, 9) confidence in his ability to handle situations in life, 10) his ability to control alcohol use, and 11) restful sleep. The veteran's symptoms fit all three categories of the clinical features of PTSD. In summary, there was no substantiation for the original diagnosis of character and behavior disorder (anti- social personality). Of record are VA outpatient treatment records from October 1988 to March 1990. Assessments included PTSD, anxiety, and chronic alcohol abuse. A March 1990 notation from the psychiatry service shows that the examiner had reviewed the November 1988 VA psychological and psychiatric examination reports. It was opined that the veteran could benefit from a specialized PTSD program based on the referenced information. Two comrade statements, which were not dated or provide a home address, were received in December 1993. [redacted], an Air Force Sergeant and comrade of the veteran's in Vietnam, indicated that they had performed prisoner escort duty on a rotational basis going to the prison at Bein Hoi AB. It entailed traveling over jungle areas. They also performed that duty while flying in helicopter with incoming fire. Former Sergeant [redacted] was stationed at Tan Son Nhut with the veteran in 1971 and 1972. While in a sandbag bunker outside the base, there was an exchange of small arms fire. There were near misses, and they feared for their lives. A third statement, received in December and dated in October 1993, from Sergeant [redacted] was to the effect that he served with the veteran from 1971 to 1972. He reported an incident when a deranged, drugged and unreasonable security policeman went over the edge and pulled his Smith and Wesson pistol and took the veteran, himself, and a third individual hostage. For approximately 45 minutes, the crazed Airman held his pistol to the veteran's head saying that he was going to kill all of them. VA outpatient treatment records from November 1992 to October 1993 include diagnostic impressions of PTSD, depression, dysthymia, and anxiety. In May 1993, it was reported that nightmares and flashbacks were getting worse. On numerous occasions, the veteran has submitted duplicates of the evidence which was of record at the time of the May 1977 rating action (i.e., service medical records, February 1977 records from FMHC, and the April 1977 VA psychiatric examination report). It was established in Morton v. Principi, 3 Vet.App. 508 (1992), that duplicates of old records, submitted in support of an application to reopen a claim are not new and material evidence. The additional non-duplicative evidence includes the following diagnostic findings: transient situational disturbance of adult life and personality disorder in February 1977 (FMHC); depressive neurosis in January 1982 and February 1983 (FMHC); an assessment of PTSD on VA psychological evaluation in November 1988; a diagnosis of PTSD on VA examination in November 1988; an assessment of PTSD in March 1989 (Drexel Counseling Service); and outpatient VA treatment records from October 1988 to October 1993 which include impressions of PTSD, anxiety, alcohol abuse, depression, and dysthymia. VA regulations provide that personality disorders will not be considered as disabilities for compensation purposes. See 38 C.F.R. §§ 3.303(c), 4.9, 4.127; Beno v. Principi, 3 Vet.App. 439 (1992). The service medical records demonstrate the diagnosis of a personality disorder. The additional diagnostic findings evidence additional psychiatric disabilities which were first manifest many years after service. Moreover, the record does not contain a medical opinion which would place the onset of any current psychiatric disability during service. The March 1989 statement from Drexel Counseling Service questions whether the veteran had a personality disorder during service, and concludes that he currently suffers from PTSD. The question of service connection for PTSD is being addressed separately without regard to finality of the unappealed decision. The aforementioned statement does not place the onset of psychiatric disability, other than PTSD, during service. Accordingly, the evidence presented by the veteran since May 1977 is cumulative as it does not demonstrate that a psychiatric disability was manifest during service, and it is neither relevant to nor probative of the issue at hand. Hence, the veteran has failed to submit new and material evidence, and his claim is not reopened. II. Entitlement to service connection for PTSD. Service connection will be granted for a disability resulting from disease or injury which was incurred in or aggravated by service. 38 U.S.C.A. §§ 1110. 38 C.F.R. § 3.304(f) provides: Service connection for post-traumatic stress disorder requires medical evidence establishing a clear diagnosis of the condition, credible supporting evidence that the claimed inservice stressor actually occurred, and a link, established by medical evidence, between current symptomatology and the claimed inservice stressor. If the claimed stressor is related to combat, service department evidence that the veteran engaged in combat or that the veteran was awarded the Purple Heart, Combat Infantryman Badge, or similar combat citation will be accepted, in the absence of evidence to the contrary, as conclusive evidence of the claimed inservice stressor. Adjudication of a claim for service connection for PTSD requires evaluation of the supporting evidence in light of the places, types, and circumstances of service, as evidenced by service records, the official history of each organization in which the veteran served, the veteran's military records, and all pertinent medical and lay evidence. 38 U.S.C.A. § 1154(b). In Smith v. Derwinski, 2 Vet.App. 137, 140 (1992), in reviewing the legislative history of 38 U.S.C.A. § 1154, the Court stated that "...the matter of service connection is a factual determination which must be made by the Secretary based upon the evidence in each individual case..." VA Adjudication Procedure Manual, M21-1, Part VI, provides: If the evidence shows the veteran engaged in combat with the enemy and the claimed stressor is related to combat, no further development for evidence of a stressor is necessary...If the claimed stressor is not combat related, a history of a stressor as related by the veteran is, in itself, insufficient. Service records must support the assertion that the veteran was subjected to a stressor of sufficient gravity to evoke symptoms in almost anyone. The existence of a recognizable stressor or accumulation of stressors must be supported. It is important the stressor be described as to its nature, severity and date of occurrence. Relevant statutes and regulations, to include 38 U.S.C.A. § 1154 and 38 C.F.R. § 3.304, in addition to Manual M21-1, mandate an initial determination as to whether a veteran was engaged in combat. See also Hayes v. Brown, 5 Vet.App. 60 (1993). If it is determined that a veteran was engaged in combat, lay testimony from the veteran regarding putative stressors must be accepted as conclusive, provided that the testimony is satisfactorily credible; however, if VA determines that a veteran did not engage in combat, lay testimony by the veteran by itself is not sufficient to establish that a putative stressor occurred. West v. Brown, 7 Vet.App. 70 (1994). If the veteran was not engaged in combat, the service records must corroborate lay testimony as to the facts and circumstances of an alleged stressor. 38 U.S.C.A. § 1154(b); 38 C.F.R. § 3.304(d); Manual M21-1, Part VI. The veteran's AF-Form 7, Airman Military Record, shows that he was in Vietnam from June 1971 to June 1972. His military occupational specialty (MOS) was a security policeman assigned to the 377th Security Police Squadron at Tan Son Nhut Air Base. The veteran was awarded the National Defense Service Medal, and the Vietnam Service Medal. It is clear from the record that the veteran's duties in Vietnam were not combat related. In other words, the veteran's work details would not in the general course entail exposure to combat. Service Personnel Records demonstrate that the veteran did not receive any awards or commendations related to combat service. Neither does the April 1971 certificate of training for a security police combat preparedness course demonstrate involvement in combat. Performance evaluations from May 1971 to June 1972, which encompasses most of the veteran's tour in Vietnam, show that he was a desk clerk in the law enforcement section of the Security Police with responsibilities to the desk sergeant for all activities related to daily operation of the Law Enforcement Desk. He maintained a chronological log of all events occurring during a tour of duty, typed forms, reports, and flight correspondence, maintained communications with the patrols, and dispatched them to the scene of accidents and incidents requiring investigation. The description of the veteran's duties shows that he served mostly in a desk job capacity. In March and June 1972, the veteran was specifically commended by the Base Commander, Director of Personnel, and the Chief of Security Police for his professionalism while performing duties at the Main Gate during a no-notice check for drug abuse. A further entry indicates that the veteran had been an excellent team member of the law enforcement unit having served in the hostile combat environment of Southeast Asia. An additional performance evaluation for the period from June 11, 1972 to March 1, 1973 (the veteran left Vietnam on June 25, 1972) lists the veteran's duties as security sentry to include security alert team leader, close-in sentry, close boundary sentry and preventive perimeter sentry. These records show that the veteran also performed non-desk duties in Vietnam; however, duties on a no-notice drug check, or as a close-in sentry, close boundary sentry, or preventive perimeter sentry, do not demonstrate involvement in combat or combat related situations. The entry designating Vietnam as a hostile combat environment self evidently applies to everyone who served in Vietnam. The entirety of the veteran's personnel records during his time in Vietnam do not evidence the existence of a stressor event or involvement in combat. Accordingly, the Board finds that the veteran was not engaged in combat while he was in Vietnam. It must now be determined whether service records corroborate lay evidence regarding specific non-combat putative stressors. The veteran submitted comprehensive stressor statements (later statements are merely cumulative) in September and November 1988. Putative stressors included rocket attacks including one incident when he was reportedly thrown to the ground; being fired on by friendly troops; potentially deadly encounters with friendly troops who were drunk or otherwise out of control; controlling race riots in his professional capacity; serving guard duty in a drug ward; seeing the unloading of wounded personnel; distant night time bombing; being afraid of booby traps, especially on Vietnamese civilians; witnessing American servicemen mistreating American personnel; and having a service comrade hold a pistol to his head for approximately an hour. The December 1988 Task Force statement indicated that the veteran's putative stressors were general in nature due to the lack of specific stress indicators. More specific information was needed such as specific incidents including the date, place and type and full names of friends killed or wounded in action, if applicable. At no time, despite submitting multiple stressor statements, has the veteran been able to provide specific information. In other words, the veteran has failed to supply the who, what, where, and when to enable the Task Force to conduct a meaningful search. For example, encounters with personnel who were acting out of control due to intoxication or in a riot setting, or being fired on by friendly troops, project scenarios for possible stressor incidents; however, the generic incidents offered by the veteran, without substantiation, lack probative value. Likewise, being afraid of the possible misfortunes of war such as fearing booby traps and hearing distant bombing are omnipresent in a war zone and do not constitute a stressor event. In short, the veteran's proffered stressors are completely anecdotal in nature and unresearchable. During the veteran's tour in Vietnam, the Task Force supplied information which verified that there were two standoff attacks on Tan Son Nhut Air Base with seven rounds impacting on the base resulting in no loss of aircraft or injury to personnel. Whether the veteran was blown to the ground during one of the two attacks is unverifiable, but the service medical records reveal no evidence of treatment, physically or mentally, to corroborate any injury from that experience. Furthermore, the Task Force information shows that Tan Son Nhut Air Base was not exposed to sapper, multi-battalion, sabotage, or automatic weapons attack. It would appear that the wartime environment which confronted the veteran at Tan Son Nhut was frightening, as is the experience in any war zone, yet the deadly elements of war were largely external to the Tan Son Nhut environment. The veteran has submitted four statements from service comrades in support of his putative stressors. In reviewing those statements, the Board has the duty as a fact finder to determine the credibility of lay evidence. Culver v. Derwinski, 3 Vet.App. 292 (1992). One statement was submitted in September 1988 and three statements were received in December 1993. [redacted] reported that the veteran performed escort duty to a prison which entailed travel in jungle areas or flying in helicopters, with enemy fire in both instances. The military personnel records are at odds with [redacted]'s statement as the veteran did not participate in escort details outside of Tan Son Nhut or on helicopters. Similarly, the Task Force information is factually at odds with Sergeant [redacted]'s statement that the veteran was involved in a small arms fire fight, as the Task Force indicated that Tan Son Nhut was not subject to sapper, sabotage, or automatic weapons attack. Of even greater significance are the statements from Colonel [redacted] and Sergeant [redacted]. The [redacted] statement is anecdotal in scope, as it made by an individual who did not serve with the veteran in Vietnam. It also contains the author's opinion regarding the stress levels experienced by security policemen at Tan Son Nhut, all of which does not provide corroboration of a stressor event experienced by the veteran. Although the veteran submitted [redacted]'s statement on several occasions, an original is not in the file. That fact, although relatively benign on its face, takes on a more ominous note considering the facts surrounding the [redacted] statement. The [redacted] statement has significant probative potential, as it depicts an event, which if verified, could be cited as a definitive stressor event. In fact, the [redacted] statement was the wellspring of the Board's April 1994 remand. The Board, as a fact finder empowered with the duty to make determinations as to the credibility of evidence, remanded the case to provide the veteran the opportunity to corroborate his claim through his service comrade. The [redacted] statement was received at the Board in December 1993; however, when the RO sent a letter to the veteran's attorney in April 1994, [redacted]'s home address was not forthcoming from the veteran. Nor has the veteran at any time provided [redacted]'s home address. Considering the potential boon that [redacted]'s corroboration could provide to the veteran's claim, common sense dictates that the veteran would provide [redacted]'s home address. Moreover, as the veteran submitted a statement in December 1993, purportedly from [redacted], common sense would also decree that he knew [redacted]'s whereabouts, that he had been in touch with [redacted], and that [redacted] apparently was motivated to assist his former comrade. A June 1994 inquiry to the Air Force Locator demystifies the circumstances surrounding the "[redacted] statement," as it reveals that the veteran had to call on the Air Force to help him locate [redacted]. (The veteran also admitted in writing that he did not have [redacted]'s home address in a separate June 1994 statement). Under such circumstances, the statement allegedly proffered by [redacted] on the veteran's behalf is so lacking in authenticity as to render the statement devoid of any evidentiary value and would also thereby tend to taint other evidence submitted by the veteran. Accordingly, the veteran's credibility is seriously impaired and the [redacted] and [redacted] statements lack probative value. Gilbert v. Derwinski, 1 Vet.App. 49 (1990). Moreover, the [redacted] and [redacted] statements, which were submitted in December 1993 with the [redacted] statement without addresses, are suspect as there is no way to corroborate their authenticity. Although the veteran indicated in August 1994 that he had sent a letter to [redacted] through the Air Force locator, a copy of the actual letter is not of record. Even though the veteran was not required to submit the letter to the file, as he reported that he was sending a copy of the letter for the file, the failure to do so further erodes his credibility. The Board therefore finds that the service records do not corroborate lay testimony as to the facts and circumstances appurtenant to the veteran's putative stressors. The veteran's PTSD claim is also deficient as a verifiable diagnosis of PTSD is not contained in the medical record. The Court has determined that medical evidence is inadequate where medical opinions consist of general conclusions based on history provided by the appellant and on unsupported clinical evidence. See Black v. Brown, 5 Vet.App. 177 (1993). Diagnoses of PTSD have been made on VA psychological evaluation and psychiatric examination in November 1988, and in a March 1989 statement from Drexel Counseling service. PTSD has been assessed on multiple occasions on VA outpatient treatment records in recent years. Those clinical findings, however, lack validity as they are based solely on history provided by the veteran, and on unsupportable clinical evidence. Accordingly, the Board finds that the record does not include a diagnosis of PTSD which was based on verifiable evidence of a stressor event. In Wood v. Derwinski, 1 Vet.App. 190 (1991), the Court stated that the Board was not bound to accept uncorroborated accounts of stressors, or medical opinions which were based on such accounts. That principle is augmented when there is a considerable passage of time between putative stressors and the onset of the alleged PTSD. Classic PTSD symptoms were not reported in the veteran's case until 1988, more than 15 years after the purported stressors in Vietnam. Statements from family members submitted in 1988, offer lay observations as to the onset of symptomatology in the immediate post service years. However, symptoms indicative of PTSD, such as nightmares, although reported by the family members, are absent from the contemporaneous medical records. Lay statements prepared in support of the veteran's claim many years after the fact, lack probative value compared to the medical record which chronicles the veteran's contemporaneous reporting of complaints and symptoms to health care providers. In summary, the veteran was not engaged in combat in Vietnam, his MOS did not entail more than an ordinary stressful environment, there was a considerable passage of time between the veteran's putative stressors and the onset of alleged PTSD in 1988, the veteran's putative stressors are wholly anecdotal and unverifiable, and a verifiable diagnosis of PTSD has not been made. Moreover, the veteran's credibility has been severely compromised undercutting substantial portions of the evidence offered by him. In view of these factors, the Board concludes that the preponderance of the evidence weighs heavily against the veteran's claim for entitlement to service connection for PTSD and, accordingly, there is no doubt which could be resolved in the veteran's favor. ORDER New and material evidence not having been submitted to reopen a claim for service connection for a psychiatric disorder, other than PTSD, the benefit sought on appeal is denied. Entitlement to service connection for PTSD is denied. C.W. SYMANSKI Member, Board of Veterans' Appeals The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___ (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West 1991), a decision of the Board of Veterans' Appeals granting less than the complete benefit, or benefits, sought on appeal is appealable to the United States Court of Veterans Appeals within 120 days from the date of mailing of notice of the decision, provided that a Notice of Disagreement concerning an issue which was before the Board was filed with the agency of original jurisdiction on or after November 18, 1988. Veterans' Judicial Review Act, Pub. L. No. 100-687, § 402 (1988). The date which appears on the face of this decision constitutes the date of mailing and the copy of this decision which you have received is your notice of the action taken on your appeal by the Board of Veterans' Appeals.