10-30 449
10-30 449
Board of Vet. App.Jun 15, 2017Background
- Veteran: Army active duty Aug 1990–Jul 1994 (Gulf War service); claimant sought service connection for PTSD and psychiatric disorder (later diagnosed as schizophrenia).
- Procedural history: Initial RO denial Nov 2008; hearings and multiple Board remands (Feb 2014, May 2016) for VA PTSD notice, examination, record association, and addendum opinions; VA exams in Apr 2014, addenda in Jun 2016 and Jan 2017.
- Medical history: No psychiatric diagnosis or treatment documented in service records; first VA mental-health contact in Jul 1997 (provisional/partial PTSD impressions), inpatient psych admission in Nov 2007 with psychosis/schizophreniform diagnosis; formal schizophrenia diagnosis in Apr 2014 VA exam (schizophrenia, multiple episodes, partial remission).
- Claim elements disputed: (1) Whether PTSD is medically diagnosed under DSM criteria and linked to an in‑service stressor; (2) whether schizophrenia manifested in service, continuously since service, or within one year of separation (triggering presumptions), or is otherwise service‑connected.
- Evidence relied upon: VA examinations and addenda concluding no PTSD diagnosis meeting DSM criteria, and that schizophrenia was not present in service nor shown to have continuity since separation; Veteran’s lay reports of PTSD/stressors are not corroborated by medical diagnoses.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Service connection for PTSD (diagnosis + in‑service stressor) | Veteran contends he has PTSD from Gulf War service and reported stressors; he states prior PTSD diagnosis. | VA: no competent medical diagnosis of PTSD in the record; only lay/self‑reports and a provisional 1997 impression not a formal DSM diagnosis; no corroborated in‑service stressor that meets regulatory exceptions. | Denied — no current PTSD diagnosis under DSM; lacking medical nexus/corroborating stressor proof. |
| Service connection for schizophrenia (direct nexus) | Veteran attributes psychiatric disability to service exposure/events. | VA: schizophrenia diagnosed years after service; no in‑service treatment/diagnosis; VA examiners opine nexus less likely than not. | Denied — preponderance of evidence shows schizophrenia not incurred in or caused by service. |
| Presumptive service connection for psychosis (manifestation within 1 year of separation) | If psychosis manifested to compensable degree within 1 year, presumptive connection would apply. | VA: first reported symptoms in 1997 (3+ years post‑separation); no continuity of symptoms or compensable manifestations within one year. | Denied — no evidence of manifestations to compensable degree within one year or continuity since service. |
| Adequacy of VA exam / duty to assist | Veteran argued further development/remand required. | VA/Board: exams and addenda were adequate, considered records and provided rationales; VCAA duties complied with. | Held — VA satisfied notice and assistance duties; exam opinions are adequate and highly probative. |
Key Cases Cited
- Stegall v. West, 11 Vet. App. 268 (Board remand compliance requirement)
- Clemons v. Shinseki, 23 Vet. App. 1 (medical professionals diagnose mental conditions)
- Shedden v. Principi, 381 F.3d 1163 (elements for service connection)
- Walker v. Shinseki, 708 F.3d 1331 (continuity of symptom analysis for chronic conditions)
- Young v. McDonald, 766 F.3d 1348 (limitations of lay evidence to establish PTSD diagnosis)