210902-182843
210902-182843
| Board of Vet. App. | Sep 27, 2021Background
- Veteran served on active duty May 1968–March 1971 in the Republic of Vietnam and received the Combat Infantry Badge; the AOJ conceded an in-service stressor related to Vietnam service.
- Veteran filed a supplemental claim in January 2021 after a January 2020 denial; the May 2021 AOJ decision found new and relevant evidence but again denied the claim; Veteran appealed to the Board in September 2021 and elected Direct Review (Board limited to evidence before May 2021 decision).
- Service treatment records contain no mental-health complaints or treatment for PTSD.
- VA examinations (Dec 2019 DBQ and May 2021 contract exam) concluded the Veteran did not meet DSM‑V criteria for PTSD, though both noted combat stressors (mortar/rocket attacks; a friend killed by sniper).
- A private psychologist (Dr. M.D., Oct 2020) diagnosed PTSD and opined nexus to service; an independent analyst (Dr. C.M., Nov 2020) endorsed that opinion; a spouse’s lay statement corroborated post-service symptoms.
- The Board found the private opinions highly probative, gave less weight to the VA contract exam, concluded the medical evidence on nexus was in equipoise, resolved doubt for the Veteran, and granted service connection for PTSD.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the Veteran has a current DSM‑V diagnosis of PTSD | Dr. M.D. (private) diagnosed PTSD based on history and DSM‑V criteria | VA examiners (Dec 2019, May 2021) found PTSD criteria not met | Board credited private opinion, found PTSD diagnosed under DSM‑V |
| Whether there is a medical nexus between in‑service stressors and current PTSD | Dr. M.D. and Dr. C.M. opined nexus at least as likely as not | VA examiners disagreed and found private opinions unpersuasive | Medical nexus found to be in equipoise; resolved in Veteran’s favor |
| Proper probative weight to assign to medical opinions | Private opinions are thorough, based on interview and record review | AOJ/VA relied on DBQ and contract exam that found no diagnosis | Board gave high probative weight to private opinions, little to May 2021 exam, some to Dec 2019 DBQ |
| Application of benefit‑of‑the‑doubt rule | If evidence is in equipoise, grant service connection | AOJ argued preponderance of evidence did not support claim | Board found equipoise and applied 38 U.S.C. § 5107(b) to grant service connection |
Key Cases Cited
- Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004) (articulates elements required to substantiate service connection: current disability, in‑service event, and nexus)
- Masors v. Derwinski, 2 Vet. App. 181 (1992) (Board must assess credibility and probative value of evidence)
- Wilson v. Derwinski, 2 Vet. App. 614 (1992) (Board’s duty to weigh and evaluate evidence credibility)
- Hatlestad v. Derwinski, 1 Vet. App. 164 (1991) (evidence evaluation and reasons for rejecting favorable evidence)
- Gilbert v. Derwinski, 1 Vet. App. 49 (1990) (preponderance standard and benefit‑of‑the‑doubt rule)