11-07 575
11-07 575
| Board of Vet. App. | Mar 17, 2017Background
- Veteran served on active duty in the U.S. Navy Dec 1971–Dec 1974; claim on appeal from July 2009 RO denial of PTSD, anxiety, depression, and related psychiatric disorders.
- Veteran testified at a Nov 2014 Board hearing; prior remand in Feb 2015 for development; VA obtained additional records and completed a June 2016 VA psychiatric examination.
- Service records are largely silent for psychiatric diagnoses during active duty; discharge exam (Nov 1974) and numerous reserve/periodic exams through 1989 found him psychiatrically normal; a March 1976 interim report noted mild anxiety and trouble sleeping.
- First post-service VA treatment record with psychiatric diagnosis appears in Oct 1999 (bipolar listed); Vet Center records purportedly show PTSD treatment 1987–1993 but lack supporting documentation.
- VA examiners in 2009 and 2016 concluded the Veteran did not meet DSM criteria for PTSD; the 2016 examiner opined it would be speculative to attribute current psychiatric disorders to service given gaps, post-service stressors, and medical conditions.
- Board found VA satisfied its VCAA duties, the 2016 exam adequate, lay testimony not sufficient to establish PTSD or nexus, and denied service connection for PTSD and other psychiatric disorders.
Issues
| Issue | Veteran's Argument | VA's Argument | Held |
|---|---|---|---|
| Service connection for PTSD | Veteran contends in-service stressors (ship fire, smoke, deaths, alleged nuclear leak, harassment, near-fall) caused PTSD and symptoms since service | VA contends medical evidence does not show DSM PTSD diagnosis or nexus to service; 2016 exam finds insufficient evidence to link disorder to service | Denied — no current DSM-consistent PTSD diagnosis and no probative nexus to service |
| Service connection for other psychiatric disorders (anxiety, bipolar, depression, adjustment disorder, phobia) | Veteran and treating providers contend disorders are related to service stressors | VA contends service records lack contemporaneous psychiatric diagnosis; most probative VA opinion finds etiology speculative and cites post-service onset/gaps | Denied — no competent medical nexus to service; contemporaneous records outweigh lay assertions |
| Adequacy of VA development and examinations | Veteran argued for further development/remand (prior remand occurred) | VA asserts VCAA notice and assistance satisfied; 2016 exam adequate and remand substantially complied with | Held — VA satisfied duties; development adequate; 2016 exam is probative and sufficient |
| Credibility and weight of lay evidence | Veteran, spouse, and friend describe longstanding symptoms and in-service events | VA notes inconsistencies, late reporting, possible secondary gain, and that diagnosis is a medical question beyond lay competency | Board found lay statements not credible on etiology and outweighed by medical evidence; denied benefit of doubt |
Key Cases Cited
- Quartuccio v. Principi, 16 Vet. App. 183 (explains VCAA notice content requirements)
- Mayfield v. Nicholson, 444 F.3d 1328 (Fed. Cir.) (VCAA notice must be provided prior to initial unfavorable RO decision; cure by compliant notice and readjudication)
- Bryant v. Shinseki, 23 Vet. App. 488 (duty at hearings to explain issues and suggest evidence)
- Stegall v. West, 11 Vet. App. 268 (Board remand confers right to substantial compliance with remand directives)
- Jones v. Shinseki, 23 Vet. App. 382 (limitations and expectations for VA medical examiner opinions when examiner cannot provide definitive etiology)
- Caluza v. Brown, 7 Vet. App. 498 (elements required for service connection and probative value of medical opinions)
- Buchanan v. Nicholson, 451 F.3d 1331 (lay evidence may be sufficient absent contemporaneous records but lack of records can be weighed)
- Gilbert v. Derwinski, 1 Vet. App. 49 (benefit of the doubt standard)