Citation Nr: 0005842 Decision Date: 03/03/00 Archive Date: 03/14/00 DOCKET NO. 98-09 978A ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Montgomery, Alabama THE ISSUES 1. Entitlement to service connection for post traumatic stress disorder (PTSD). 2. Entitlement to service connection for asbestosis. 3. Entitlement to an earlier effective date for the payment of additional compensation by reason of a dependent spouse. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD D. Havelka, Associate Counsel INTRODUCTION The veteran's active military service extended from February 1943 to September 1945. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 1998 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Montgomery, Alabama. That rating decision denied entitlement to service connection for post traumatic stress disorder (PTSD) and asbestosis. A March 1998 letter informed the veteran that increased disability benefits because of a spouse had been awarded effective February 1998. In October 1999, a hearing was held before Bettina S. Callaway, who is the Board member making this decision and who was designated by the Chairman to conduct that hearing, pursuant to 38 U.S.C.A. § 7102(b) (West 1991). In numerous pieces of correspondence the veteran has asserted various claims for service connection for hypertension, diabetes mellitus, hearing loss, tinnitus, and a right knee disorder. Some of these appear to be original claims and some are claims to reopen. These issues have not been adjudicated by the RO. They have not been developed for appellate consideration and are not properly before the Board at this time. These issues are referred to the RO for action deemed appropriate. FINDINGS OF FACT 1. The RO has obtained all relevant evidence necessary for an equitable disposition of the veteran's appeal. 2. The veteran engaged in combat with the enemy. 3. The veteran's own statements regarding the occurrence of stressors in service are credible and consistent with the circumstances or conditions of service. 4. The medical evidence of record provides a diagnosis of PTSD. 5. The earliest medical reports dealing with any asbestos related disorders are dated decades after service and do not relate the disorder to the veteran's military service. 6. There is no medical opinion, or other competent evidence linking any current asbestos related disorder to the veteran's active military service. 7. The veteran was awarded an increased rating for his service connected psychiatric disorder in an October 1996 rating decision. The effective date of this increase was October 21, 1994. This resulted in a combined disability rating of 30 percent. 8. The veteran was notified of the increased rating by letter dated October 22, 1996. This letter indicates that VA Form 21-8764 was included as an enclosure and the narrative of the award letter informed the veteran to review the enclosed form. 9. The veteran submitted VA form 21-686c, Declaration of Status of Dependents, to the RO with a copy of his marriage license; this information was received at the RO January 15, 1998. This evidence was not received within one year of the date of notice. 10. The earliest claim of record in which the veteran sought payment of benefits by reason of a dependent spouse, with the appropriate evidence as requested by VA, was the form submitted in January 1998. CONCLUSIONS OF LAW 1. Post traumatic stress disorder was incurred in active military service. 38 U.S.C.A. §§ 101(16), 1110 (West 1991); 38 C.F.R. §§ 3.303, 3.304(f) (1999). 2. The appellant has not presented a well grounded claim for service connection for asbestosis or any other asbestos related disorder, and therefore there is no statutory duty to assist the appellant in developing facts pertinent to this claim. 38 U.S.C.A. §§ 101(16), 1110, 5107(a) (West 1991); 38 C.F.R. § 3.303(b) (1999). 3. The criteria for entitlement to an earlier effective date for the payment of benefits by reason of dependent spouse are not met. 38 U.S.C.A. §§ 1115, 5107, 5110, 5111 (West 1991); 38 C.F.R. §§ 3.31, 3.205, 3.400, 3.401 (1999). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS I. Post Traumatic Stress Disorder Service connection for PTSD requires: (1) medical evidence establishing a diagnosis of the condition; (2) credible supporting evidence that the claimed inservice stressor occurred; and, (3) a link established by medical evidence, between current symptoms and an in-service stressor. If the evidence establishes that the veteran engaged in combat with the enemy and the claimed stressor is related to that combat, in the absence of clear and convincing evidence to the contrary, and provided that the claimed stressor is consistent with the circumstances, conditions, or hardships of the veteran's service, the veteran's lay testimony alone may establish the occurrence of the claimed in-service stressor. 38 C.F.R. § 3.304(f) (1999). In general, establishing service connection for a disability requires the existence of a current disability and a relationship or connection between that disability and a disease contracted or an injury sustained during active service. 38 U.S.C.A. § 1110 (West 1991); 38 C.F.R. § 3.303, 3.304 (1998); Cuevas v. Principi, 3 Vet. App. 542, 548 (1992); Rabideau v. Derwinski, 2 Vet. App. 141, 143 (1992). Establishing service connection for PTSD requires (1) a current medical diagnosis of PTSD (presumed to include the adequacy of the PTSD symptomatology and the sufficiency of a claimed in-service stressor); (2) credible supporting evidence that the claimed in-service stressor occurred; and (3) medical evidence of a causal nexus between current symptoms and an in-service stressor. Cohen v. Brown, 10 Vet. App. 128, 138 (1997); Moreau v. Brown, 9 Vet. App. 389, 394- 95 (1996); 38 C.F.R. § 3.304(f) (1998) amended by 64 Fed. Reg. 32807-32808 (June 18, 1998). In the present case the veteran has been service connected for a psychiatric disorder ever since his separation from service in September 1945. The initial diagnosis was "anxiety reaction." The veteran was separated from service by medical proceedings as a result of this anxiety and the diagnosis has persisted ever since. More recent VA medical treatment records, dated in the 1990s, reveal diagnoses of post traumatic stress disorder and depression. These records relate the PTSD to combat stressors of the veteran's service on troop transport ships during World War II. The veteran's separation papers reveal that he served in the Navy during World War II, and that he served on troop transport vessels. The RO obtained copies of the veteran's service personnel records. These records indicate that the veteran was authorized to wear "Amphibious Force Insignia." A June 1944 record specifically indicates that the veteran served "as a member of Control Party during the assault phase of an offensive amphibious operation against enemy territory." There are numerous other entries which indicate that the veteran participated in numerous amphibious assaults during his Navy service. The Board finds this evidence compelling and finds as fact that the veteran engaged in combat with the enemy. The stressors alleged by the veteran relate to his combat experiences engaging in amphibious assault operations. As such, the claimed stressors are consistent with the circumstances, conditions, and hardships of the veteran's service, and the veteran's lay testimony alone establishes the occurrence of the claimed in-service stressors. In February 1995 a VA psychiatric examination of the veteran was conducted. The diagnosis was post traumatic stress disorder and anxiety traits. Treatment records from a VA mental hygiene clinic reveal that the veteran was treated in October 1999. Again the diagnosis was PTSD. The symptoms manifested by the veteran were anxiety and somatic complaints. The competent medical evidence of record reveals that the veteran has current diagnoses of PTSD. This medical evidence relates the disorder to stressors suffered by the veteran during combat. The evidence of record reveals that the veteran engaged in combat with the enemy and his claimed stressors are consistent with such service. Therefore, the evidence of record supports a grant of service connection for post traumatic stress disorder. The Board is somewhat puzzled by the veteran's pursuit of this claim. It appears that the veteran's true motivation is to obtain an increased rating for his service connected psychiatric disorder. As noted above, the veteran has been service connected for a psychiatric disorder since his separation from service in 1945. The diagnosis was anxiety reaction with migraine. At present the diagnosis of the veteran's psychiatric disorder is PTSD with symptoms of anxiety and somatic complainants. It is clear to the Board that the diagnosis of PTSD is a refinement or re-evaluation of the veteran's service connected psychiatric disorder which has existed, and been service connected, since 1945. The diagnosis of PTSD was not recognized by the medical community in 1945 and the diagnosis of anxiety reaction was the most appropriate at the time. However, since the issue is phrased as one of service connection, the Board has dealt with it as such. II. Asbestosis Service connection may be established for a current disability in several ways including on a "direct" basis. 38 U.S.C.A. §§ 1110, 1131 (West 1991); 38 C.F.R. §§ 3.303(a), 3.304 (1998). Direct service connection may be established for a disability resulting from diseases or injuries which are clearly present in service or for a disease diagnosed after discharge from service, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(a), (b), (d) (1998). Establishing direct service connection for a disability which has not been clearly shown in service requires the existence of a current disability and a relationship or connection between that disability and a disease contracted or an injury sustained during service. 38 U.S.C.A. §§ 1110, 1131 (West 1991); 38 C.F.R. § 3.303(d) (1998); Cuevas v. Principi, 3 Vet. App. 542, 548 (1992); Rabideau v. Derwinski, 2 Vet. App. 141, 143 (1992). The law provides that "a person who submits a claim for benefits under a law administered by the Secretary shall have the burden of submitting evidence sufficient to justify a belief by a fair and impartial individual that the claim is well grounded." 38 U.S.C.A. § 5107(a) (West 1991)(emphasis added). Establishing a well grounded claim for service connection for a particular disability requires more than an allegation that the disability had its onset in service or is service-connected; it requires evidence relevant to the requirements for service connection and of sufficient weight to make the claim plausible and capable of substantiation. See Franko v. Brown, 4 Vet. App. 502, 505 (1993); Tirpak v. Derwinski, 2 Vet. App. 609, 610 (1992); Murphy v. Derwinski, 1 Vet. App. 78, 81 (1990). The three elements of a "well grounded" claim are: (1) evidence of a current disability as provided by a medical diagnosis; (2) evidence of incurrence or aggravation of a disease or injury in service as provided by either lay or medical evidence, as the situation dictates; and, (3) a nexus, or link, between the inservice disease or injury and the current disability as provided by competent medical evidence. See Caluza v. Brown, 7 Vet. App. 498, 506 (1995), aff'd per curiam, 78 F.3d 604 (Fed. Cir. 1996); see also Epps v Gober, 126 F.3d 1464, 1468 (Fed. Cir. 1997); 38 U.S.C.A. § 1110 (West 1991); 38 C.F.R. § 3.303 (1998). Generally, competent medical evidence is required to meet each of the three elements. However, for the second element the kind of evidence needed to make a claim well grounded depends upon the types of issues presented by a claim. Grottveit v. Brown, 5 Vet. App. 91, 92-93 (1993). For some factual issues, such as the occurrence of an injury, competent lay evidence may be sufficient. However, where the claim involves issues of medical fact, such as medical causation or medical diagnoses, competent medical evidence is required. Id. at 93. However, the United States Court of Appeals for Veterans Claims (known as the United States Court of Veterans Appeals prior to March 1, 1999) (hereinafter, "the Court") has held that in cases involving service connection for asbestos related disorders veterans must "satisfy all three of the elements required for a well- grounded claim." Nolen v. West, 12 Vet. App. 347, 350 (1999) (emphasis in original). The veteran claims that he developed asbestosis as a result of asbestos exposure during his Naval service from February 1943 to September 1945. In January 1997 the veteran submitted a statement detailing his history of asbestos exposure. The veteran asserts that during his Navy service he was exposed to asbestos during his duty aboard ship. He alleges exposure as a gunner, and during a period of ship repair. However, the veteran also reported significant post- service exposure to asbestos during his employment in machine shops for over three decades. The veteran has submitted private medical records to support his claim. An April 1993 report from Dr. Mitchell, a private physician, reveals that the veteran had complaints of progressive onset of dyspnea over the past 2 years. The examination report indicates that the veteran's asbestos "exposure history is significant. The patient worked as a mechanic for 16 years, 1972 to 1988, at Union Carbide where he had occasion to be intermittently exposed to asbestos materials without the benefit of face mask protection." Pulmonary function tests were indicative of restrictive lung disease. X-ray examination of the chest revealed pleural thickening and fibrotic changes. The diagnosis was "pulmonary asbestosis." On an accompanying exposure questionnaire the veteran listed his dates of asbestos exposure from 1950 to 1987. An October 1996 note from Dr. Coleman, another private physician, indicates a diagnosis of chronic obstructive pulmonary disease (COPD) and asbestosis. An August 1997 letter from Dr. Lester, states that "enclosed is a copy of a study indicating that [the veteran] does have chest x-ray findings that are probably due to asbestosis." In February 1998 a VA pulmonary examination of the veteran was conducted. The veteran reported onset of shortness of breath, dyspnea, since 1992. The veteran reported a history of asbestos exposure dating from service in 1944 and spanning his private employment which ended in 1989. Examination revealed slightly diminished breath sounds in both lung fields. However, there was no clubbing and the lungs were clear to auscultation. Pulmonary function tests were within normal limits. X-ray examination revealed calcified granulomas. The diagnosis was "history of asbestos exposure, clinically stable at this time." As noted above, in order for the veteran's claim for service connection for asbestosis to be well grounded he must meet all three elements required of a well grounded claim: (1) evidence of a current disability as provided by a medical diagnosis; (2) evidence of incurrence or aggravation of a disease or injury in service as provided by either lay or medical evidence, as the situation dictates; and, (3) a nexus, or link, between the inservice disease or injury and the current disability as provided by competent medical evidence. Nolen v. West, 12 Vet. App. 347, 350 (1999); Caluza v. Brown, 7 Vet. App. 498, 506 (1995), aff'd per curiam, 78 F.3d 604 (Fed. Cir. 1996); see also Epps v Gober, 126 F.3d 1464, 1468 (Fed. Cir. 1997); 38 U.S.C.A. § 1110 (West 1991); 38 C.F.R. § 3.303 (1999). With respect to the first element, evidence of a current disability as provided by a medical diagnosis, there is equivocal evidence of a current asbestos related disability. The April 1993 private examination report diagnoses the veteran with asbestosis and contains an x-ray report and pulmonary function test results which support such a diagnosis. However, the February 1998 VA examination did not reveal findings of asbestosis and only a history of exposure was noted. The existence of a current asbestos related lung disability is questionable at best. If the Board were adjudicating the veteran's claim on the merits there would be a serious question as to whether the veteran does have a current asbestos related lung disability. However, for the purposes of the Board's current analysis we will assume that there is evidence of a current asbestos related lung disability. With respect to the second element of a well grounded claim, incurrence during service, there is again equivocal evidence of asbestos exposure during service. The veteran indicates that he was exposed to asbestos during Navy service aboard a ship during World War II. However, the veteran's employment history shows extensive asbestos exposure subsequent to service for over three decades. The existence of asbestos exposure during service is also questionable. However, for the purposes of the Board's current analysis we will assume that there is evidence of asbestos exposure during service based on the veteran's assertions of such exposure. "The appellant's evidentiary assertions must be accepted as true for the purpose of determining whether the claim is well grounded." Exceptions to this rule occur when the evidentiary assertion is inherently incredible or when the fact asserted is beyond the competence of the person making the assertion. Samuels v. West, 11 Vet. App. 433, 435 (1998). For the purposes of its analysis in the present case the Board assumes that the veteran has a current asbestos related lung disability and that there is evidence of asbestos exposure during service. Nevertheless, the veteran's claim still fails because he has not met the third element required for the claim to well grounded. The veteran has not submitted competent medical evidence of a nexus, or link, between the current asbestos related lung disorder and the alleged asbestos exposure during service. The strongest evidence in this case is the April 1993 private medical examination report. This report unequivocally diagnoses the veteran with asbestosis. However, this examination report specifically relates the veteran's asbestos to his extensive post-service, employment related, asbestos exposure. This examination states "exposure history is significant. The patient worked as a mechanic for 16 years, 1972 to 1988, at Union Carbide where he had occasion to be intermittently exposed to asbestos materials without the benefit of face mask protection." None of the other medical evidence of record in any way relates the veteran's current asbestosis to his military service. In October 1999 the veteran presented sworn testimony before the undersigned member of the Board. The veteran testified that he was exposed to asbestos aboard ships during his Navy service. He also testified that with respect to his post service employment that that "I worked outside and I wasn't exposed to that inside work." The veteran's sworn testimony and other statements are not competent evidence to establish the etiology of his disorder. Medical diagnosis and causation involve questions that are beyond the range of common experience and common knowledge and require the special knowledge and experience of a trained physician. Because he is not a physician, the veteran is not competent to make a determination that his current asbestosis is the result of alleged asbestos exposure during service rather than the result of post-service asbestos exposure. See Espiritu, 2 Vet. App. at 495; Grottveit v. Brown, 5 Vet. App. 91, 93 (1993). We also note that the veteran has been given the opportunity to produce medical evidence from his private physician and this evidence relates the veteran's asbestosis to his post-service exposure. The veteran fails to show the required nexus between his current asbestosis and any asbestos exposure he may have incurred during service. See Caluza, 7 Vet. App. at 506. There is no medical evidence establishing a link to the veteran's active military service. See Rabideau v. Derwinski, 2 Vet. App. 141, 144 (1992); Franko v. Brown, 4 Vet. App. 502, 505 (1993). Therefore, the veteran does not meet the third element required for the claim to be well grounded. See Caluza, 7 Vet. App. at 506; Dean v. Brown, 8 Vet. App. 449, 455 (1995); Slater v. Brown, 9 Vet. App. 240 (1996). "A claim for a disability cannot be well grounded unless there is a medical opinion that links the current disability to the appellant's term of service. In the usual case this nexus would consist of a medical diagnosis of a current disability that 'looks backward' to an in-service disease or injury and links the two." Martin v. Gober, 10 Vet. App. 394 (1997); Caluza, 7 Vet. App. at 506; Dean v. Brown, 8 Vet. App. 449, 455 (1995); Slater v. Brown, 9 Vet. App. 240 (1996). The Board notes that the fact pattern in the present case is very similar, if not almost identical, to the fact pattern in Nolen v. West, 12 Vet. App. 347 (1999). In that case the Court held that the veteran's claim was not well grounded because he had failed to submit competent medical evidence of a nexus between his current disability and alleged asbestos exposure during service. Nolen v. West, 12 Vet. App. 347, 350 (1999). The Board must rely on the Court's guidance in this matter and find in the present cast that the veteran's claim is also not well grounded. The Board has thoroughly reviewed the claims file. However, we find no evidence of a plausible claim. Since the veteran has not met his burden of submitting evidence sufficient to justify a belief by a fair and impartial individual that the claim is well grounded, it must be denied. See Boeck v. Brown, 6 Vet. App. 14, 17 (1993) (if a claim is not well- grounded, the Board does not have jurisdiction to adjudicate it). Where a claim is not well grounded, VA does not have a statutory duty to assist a claimant in developing facts pertinent to the claim, but VA may be obligated under 38 U.S.C.A. § 5103(a) to advise a claimant of evidence needed to complete his application. This obligation depends on the particular facts of the case and the extent to which the Secretary has advised the claimant of the evidence necessary to be submitted with a VA benefits claim. Robinette v. Brown, 8 Vet. App. 69, 78 (1995). Here, unlike the situation in Robinette, the veteran has failed to respond to VA requests for information which would have assisted him in developing information related to his allegations of asbestos exposure. Accordingly, the Board concludes that VA did not fail to meet its obligations under 38 U.S.C.A. § 5103(a) (West 1991). III. Earlier Effective Date The veteran contends that he is entitled to an earlier effective date for the payment of benefits by reason of dependent spouse. He contends that additional compensation based on his spouse should have been effective November 1994, which is the date he began receiving service connected disability compensation benefits at a 30 percent disability rating. He asserts that VA Form 21-8764 was not enclosed with the notification letter dated October 1996. He further asserts that VA was on notice that he was married because his wife appeared with him at an August 1996 hearing before a RO hearing officer. Veteran's who are entitled to compensation for service connected disabilities are entitled to additional compensation for dependents, including a spouse, provided that the disability is rated not less than 30 percent disabling. 38 U.S.C.A. § 1115 (West 1991). "Except as otherwise provided, the effective date of an evaluation and award of pension, compensation or dependency and indemnity compensation based on an original claim, a claim reopened after final disallowance, or a claim for increase will be the date of receipt of the claim or the date entitlement arose, whichever is the later." 38 C.F.R. § 3.400 (1999). Awards of additional compensation for dependents shall be effective the latest of the following dates: (1) Date of claim. This term means the following listed in order of applicability: (i) Date of veteran's marriage of birth of his or her child, or adoption child, if the evidence of the event is received within one year of the event otherwise. (ii) Date notice is received of the dependent's existence, if evidence is received within one year of VA request. (2) Date dependency arises; (3) Effective date of the qualifying disability rating provided evidence of dependency is received within one year of notification of such rating; or (4) Date of commencement of veteran's award . 38 C.F.R. § 3.401(b) (1999). "Regardless of VA regulations concerning effective dates of awards, and except as provided in [38 C.F.R. § 3.31](c), payment of monetary benefits based on original, reopened, or increased awards of compensation, pension or dependency and indemnity compensation may not be made for any period prior to the first day of the calendar month following the month in which the award became effective. However, beneficiaries will be deemed to be in receipt of monetary benefits during the period between the effective date of the award and the date payment commences for the purpose of all laws administered by VA except that nothing in this section will be construed as preventing the receipt of retired or retirement pay prior to the effective date of waiver of such pay in accordance with 38 U.S.C. § 5305." 38 C.F.R. § 3.31(1999). For the purposes of this section the term "increased award" means an award which is increased because of an added dependent, increase in disability or disability rating, or reduction in income. The provisions of this section apply to all original, reopened, or increased awards unless such awards provide only for continuity of entitlement with no increase in rate of payment. 38 C.F.R. § 3.31 (1999). The Board notes that in this case the veteran has been service connected for a psychiatric disorder since his separation from service in 1945. His psychiatric disability was rated as 10 percent disabling from February 1948. In October 1994 the veteran filed a claim for an increased rating. In an October 1996 rating decision the veteran was granted an increased rating of 30 percent. The effective date of this increase was October 21, 1994, the date of his claim for an increased rating. The veteran was notified of the rating action and the increased rating by letter dated October 22, 1996. This letter indicates that VA Form 21-8764 was included as an enclosure and the narrative of the award letter informed the veteran to review the enclosed form. The veteran submitted VA form 21-686c, Declaration of Status of Dependents, to the RO with a copy of his marriage license. This information was received at the RO January 15, 1998. This was more than one year after the RO requested dependent information in the October 1996 notice letter with the enclosed VA Form 21-8764. The veteran alleges that he was not provided with VA Form 21- 8764. In his June 1998 substantive appeal he stated that "I contend that the VA did not send me a Form 21-8764 with VA letter dated 10-22-96. Mail does get lost. I obviously would have filled it out if I had received it." Clear evidence to the contrary is required to rebut the presumption of regularity. Ashley v. Derwinski, 2 Vet. App. 307 (1992), (quoting United States v. Chemical Foundation, 272 U.S. 1, 14-15 (1926). While the Ashley case dealt with regularity and procedures at the Board, in Mindenhall v. Brown, 7 Vet. App. 271 (1994), the Court applied the presumption of regularity to procedures at the RO level, such as in the instant case. The Court specifically held that a statement such as the one of this appellant, standing alone, is not sufficient to rebut the presumption of regularity in RO operations. The appellant's contention that the VA Form 21- 8764 was not provided, standing alone, is insufficient evidence to rebut the presumption of regularity. The October 1996 letter to the veteran specifically mentions the VA form in the narrative and also indicates that it was included as an enclosure. In October 1999 the veteran presented sworn testimony before the undersigned member of the Board. The veteran argued that VA "should a knowed, or they did know," that the veteran was married because his wife appeared with him at a hearing before a RO hearing officer in August 1996. However, the veteran also testified that he did not submit a copy of a marriage certificate until 1998. The Board notes that appearance at a hearing with one's spouse does not meet the evidentiary requirements to establish proof of a marriage. VA regulations provide for the type of evidence which is acceptable as proof of marriage. Marriage is established by one of the following types of evidence: (1) Copy or abstract of the public record of marriage, or a copy of the church record of marriage, containing sufficient data to identify the parties, the date and place of marriage, and the number of prior marriages if shown on the official record. (2) Official report from service department as to marriage which occurred while the veteran was in service. (3) The affidavit of the clergyman or magistrate who officiated. (4) The original certificate of marriage, if the Department of Veterans Affairs is satisfied that it is genuine and free from alteration. (5) The affidavits or certified statements of two or more eyewitnesses to the ceremony. (6) In jurisdictions where marriages other than by ceremony are recognized the affidavits or certified statements of one or both of the parties to the marriage, if living, setting forth all of the facts and circumstances concerning the alleged marriage, such as the agreement between the parties at the beginning of their cohabitation, the period of cohabitation, places and dates of residences, and whether children were born as the result of the relationship. This evidence should be supplemented by affidavits or certified statements from two or more persons who know as the result of personal observation the reputed relationship which existed between the parties to the alleged marriage including the periods of cohabitation, places of residences, whether the parties held themselves out as married, and whether they were generally accepted as such in the communities in which they lived. (7) Any other secondary evidence which reasonably supports a belief by the Adjudicating activity that a valid marriage actually occurred. 38 C.F.R. § 3.205 (1999). Review of the evidence reveals that the veteran submitted VA Form 21-686c, Declaration of Status of Dependents, to the RO with a copy of his marriage license and that this information was received at the RO January 15, 1998. There is no evidence that the veteran submitted the evidence required to establish proof of his marriage before this. The veteran has been service connected for a psychiatric disability since 1945. The veteran's marriage certificate indicates that he has been married since 1952. The evidence of record reveals that in the over four decades of time from 1952 to his submission of the marriage certificate in 1998 the veteran had never submitted any evidence to show that he was married. Thus, the proper date of commencement for payments of benefits by reason of a dependent spouse, is determined according to the provisions of 38 C.F.R. § 3.401(b) (1999). The effective date would thus be the date of dependency, or January 15, 1998, which is the latest of the dates found in § 3.401(b). Specifically it is the date upon which the dependency was established by the veteran submitting the required information. Accordingly, the Board finds that the criteria for entitlement to an earlier effective date for the payment of benefits by reason of dependent spouse are not met and the veteran's claim therefor is denied. 38 U.S.C.A. §§ 1115, 5107, 5110, 5111 (West 1991); 38 C.F.R. §§ 3.31, 3.205, 3.400, 3.401 (1999). ORDER Service connection for post traumatic stress disorder is granted. Because it is not well-grounded, the veteran's claim for service connection for asbestosis is denied. Entitlement to an earlier effective date for the payment of additional compensation by reason of a dependent spouse is denied. BETTINA S. CALLAWAY Member, Board of Veterans' Appeals