BVA9502763 DOCKET NO. 92-10 385 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUES 1. Entitlement to service connection for post-traumatic stress disorder. 2. Entitlement to service connection for tinnitus. 3. Entitlement to service connection for chloracne. REPRESENTATION Appellant represented by: The American Legion ATTORNEY FOR THE BOARD Harold A. Beach, Counsel INTRODUCTION The veteran, who is the appellant in this case, served on active duty from February 1966 to November 1967. He was stationed in the Republic of Vietnam from November 1966 to November 1967. In January 1992, the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida, denied entitlement to service connection for post-traumatic stress disorder, tinnitus, and chloracne. The veteran disagreed with those decisions, and this appeal ensued. In August 1994, the Board of Veterans' Appeals (Board) remanded for further development. The Board requested that the RO obtain copies of the veteran's enlisted efficiency reports. It also requested that the RO contact the veteran and make another attempt to ascertain his stressors in service. Despite its efforts, the RO met with negative results. Thereafter, the claims folder was returned to the Board for further appellate consideration. In June 1968, the RO in Newark, New Jersey, denied service connection for acne vulgaris of the face, chest, and back. The veteran has raised contentions to the effect that service connection is still warranted for that disorder. It is unclear, however, whether he actually wishes to reopen that claim. It is, therefore, referred to the RO for appropriate action. The only skin disorder considered below will be chloracne. CONTENTIONS OF APPELLANT ON APPEAL It is contended by and on behalf of the veteran that he has psychiatric difficulties, primarily as a result of his experiences in the Republic of Vietnam; that he was assigned to a medical unit and performed many emotionally upsetting duties, such as ambulance driver, litter bearer, and graves registration; that he also assisted in surgery; that he saw many mangled and dead bodies; that he was present when a fellow soldier accidentally detonated a grenade; that he witnessed inhumane interrogations; that he talked two fellow soldiers out of suicide; that saw a staff sergeant killed by a booby trap; that he now has intrusive thoughts, nightmares, and flashbacks of those incidents; that he has become introverted and short- tempered; and that service connection is, therefore, warranted for post-traumatic stress disorder. The veteran also contends that he has tinnitus and chloracne as a result of service; that the tinnitus was caused by his exposure to the sound of gunfire; that his chloracne is a residual of his exposure to Agent Orange; and that service connection for those disorders is also warranted. 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 file(s). 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 the evidence is at least in equipoise and thus, with resolution of reasonable doubt in the veteran's favor, supports his claim for service connection for post-traumatic stress disorder. Further, it is the decision of the Board that the veteran has not met the initial burden of submitting evidence sufficient to justify a belief by a fair and impartial individual that the claims for service connection for tinnitus and chloracne are well-grounded. FINDINGS OF FACT 1. All evidence necessary for an equitable disposition of the veteran's appeal has been obtained by the RO. 2. It has been clinically established that the veteran has post- traumatic stress disorder as a result of his medical duties in the Republic of Vietnam. 3. The claim for service connection for tinnitus is not plausible. 4. The claim for service connection for chloracne is not plausible. CONCLUSIONS OF LAW 1. Post-traumatic stress disorder was incurred in service. 38 U.S.C.A. §§ 1110, 5107 (West 1991); 38 C.F.R. §§ 3.102, 3.303(a) (1993). 2. The claim for service connection for tinnitus is not well- grounded. 38 U.S.C.A. § 5107(a) (West 1991). 3. The claim for service connection for chloracne is not well- grounded. 38 U.S.C.A. § 5107(a) (West 1991). REASONS AND BASES FOR FINDINGS AND CONCLUSION I. Post-traumatic Stress Disorder Initially, the Board notes that the veteran's claim for service connection for post-traumatic stress disorder is "well grounded" within the meaning of 38 U.S.C.A. § 5107(a); that is, he has presented a claim which is not implausible. The Board is also satisfied that all reasonable efforts have been expended to develop the evidence. Service connection connotes many factors, but basically it means that the facts, shown by the evidence, establish that a particular disease or injury, resulting in disability, was incurred coincident with service in the Armed Forces. 38 U.S.C.A. § 1110; 38 C.F.R. § 3.303(a). The veteran maintains that he has post-traumatic stress disorder as a result of his experiences in the Republic of Vietnam; however, his service medical records are completely negative for any complaints or clinical findings of a psychiatric disorder of any kind. Following service, he was treated on a number of occasions for substance abuse and resultant difficulties at work and in his relationship with others. Post-traumatic stress disorder was not clinically reported until 1991, many years after his discharge. That diagnosis was confirmed by a private physician, as well as several VA practitioners. It was also reported during his most recent VA examination. To date, the veteran has been unable to establish service connection, primarily because of his inability to fulfill the stressor criteria. The veteran's personnel records show that he served in Vietnam for just over one year. During that time he was assigned to Company D, 1st Medical Battalion, 1st Infantry Division, as an assistant forward records clerk. He correctly notes his unit headquarters as Phuoc Vinh and his unit's participation in operations such as Junction City. Although he does not have awards and decorations indicative of combat exposure, he reports that he performed duties as a medic and ambulance driver. Indeed, the U.S. Army and Joint Services Environmental Support Group has stated that given his unit of assignment, it is likely that he did participate in medical aid. Interestingly, he reported his medical duties to the VA as far back as May 1982, many years prior to his claim for service connection for post- traumatic stress disorder. During an Agent Orange evaluation, he stated that he had been a medic and ambulance driver. A medic's duties could result in experiences which would be markedly distressing to almost anyone. The veteran's reports of filling body bags and assisting in the treatment of burn victims and traumatic amputees are not only consistent with those duties but sufficient to fulfill the stressor criteria. When attention is directed to the clinical data and to the nature of the veteran's duties in Vietnam, the Board is of the opinion that service connection is warranted. The evidence is at least in equipoise, and as such all reasonable doubt must be resolved in favor of the veteran. 38 U.S.C.A. § 5107(b); 38 C.F.R. § 3.102. II. Tinnitus As with any issue, the threshold question is whether the veteran has presented evidence of a well-grounded claim; that is, one which is plausible. If he has not, the appeal must fail. The VA would have no further duty to assist him in the development of his claim, as such development would be futile. 38 U.S.C.A § 5107(a) (West 1991). See also Colvin v. Derwinski, 1 Vet. App. 171 (1991). The veteran maintains that his tinnitus is the result of his exposure to gunfire in service. While the Board does not doubt his sincerity, it must be emphasized that he is not competent to render such an opinion. Conclusions regarding medical causation must be supported by expert opinion. Espiritu v. Derwinski, 2 Vet. App. 492, 494-5 (1992). In this regard, the Board notes that the veteran's service medical records are completely negative for any complaints or findings of tinnitus or any ear trauma resulting from noise exposure. The only ear disorders in service were reported in September 1967, when he was seen for otitis externa and otitis media. Tinnitus was not clinically reported until 1986, many years after his discharge. It was noted in association with sinusitis, and there were no reports of any relationship to service. Absent such a relationship, the Board finds no plausible basis for service connection. Accordingly, that portion of the claim is not well-grounded. III. Chloracne The veteran contends that he has chloracne as a result of his exposure to Agent Orange in the Republic of Vietnam. A veteran who served in the Republic of Vietnam, during the Vietnam era shall be presumed to have had such exposure. 38 C.F.R. § 3.311a(b). The development of chloracne within nine months of that exposure is sufficient to establish service connection. 38 C.F.R. § 3.311a(c)(2). Even if chloracne does not develop within that time frame, the veteran may still show service connection through the use of sound scientific evidence. 38 C.F.R. § 3.311a(g). In this case, the claims file is completely negative for a diagnosis of chloracne. The veteran did have acne when he entered service and was treated for acne vulgaris and seborrheic dermatitis in service; however, neither of those disorders are at issue here. Absent any findings of chloracne in or after service, there is no plausible basis for service connection. Accordingly, that portion of the claim is also not well-grounded. ORDER Service connection for post-traumatic stress disorder is granted. The claims for service connection for tinnitus and chloracne are dismissed. ROBERT E. SULLIVAN 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.