BVA9503127 DOCKET NO. 90-52 365 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUE Entitlement to service connection for an acquired psychiatric disorder. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD G. Wm. Thompson, Counsel INTRODUCTION The veteran had active service from July 1972 to August 1973. In February 1976, the RO denied service connection for a nervous disorder. It does not appear that the appellant was properly notified of the action. As the claim is still active, a decision will be rendered on a de novo basis. The issue of entitlement to service connection for a psychiatric disorder was previously before the Board of Veterans' Appeals (Board) in May 1991, April 1992, and March 1994, and on those occasions, the case was remanded for additional development. The Department of Veterans Affairs (VA) St. Petersburg, Florida, Regional Office (RO) has returned the case to the Board for further appellate consideration. Extensive efforts have been made in this case to secure additional records. With the receipt of records from Columbia Area Mental Health Center in June 1994, and their assurance that the location of the clinicians that treated the veteran in the early 1970's is unknown, it is believed that there are no further reasonable avenues for development and this case will be considered on the basis of the evidence of record. CONTENTIONS OF APPELLANT ON APPEAL The veteran asserts that the RO erred in not finding that the evidence of record supports a grant of service connection for an acquired psychiatric disorder. She reports that she required psychiatric care in service, and that psychiatric care continued after service, to the present. 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. 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 preponderance of the evidence is against a grant of service connection for an acquired psychiatric disorder. FINDINGS OF FACT 1. Evidence sufficient for an equitable disposition of the veteran's appeal has been obtained by the RO. 2. The veteran had symptoms including anxiety and depression in service; the diagnosis was situational adjustment reaction. 3. The veteran received private and VA treatment for personality disorders and adjustment problems after service. 4. An acquired psychiatric disorder was not demonstrated in service; was first diagnosed in the mid-1980's; and a psychosis was not manifested to a compensable degree within one year after service. 5. The instant case does not involve such an unusual or complex medical question as to require an opinion from an independent medical expert outside the VA. CONCLUSIONS OF LAW 1. The present case does not involve such medical complexity or controversy so as to require the Board to obtain an independent advisory or expert medical opinion outside the VA. 38 U.S.C.A. § 7109(a) (West 1991). 2. An acquired psychiatric disorder was not incurred in or aggravated by active military service; and a psychosis may not be presumed to have been incurred therein. 38 U.S.C.A. §§ 1101, 1110, 1112, 1113, 1137 (West 1991); 38 C.F.R. §§ 3.303(a)(c)(d), 3.307, 3.309 (1994). REASONS AND BASES FOR FINDINGS AND CONCLUSION The veteran's claim is well-grounded and the VA has met its duty to assist by obtaining or attempting to obtain all relevant evidence. The requirements mandated by 38 U.S.C.A. § 5107(a) have been fulfilled. When, in the judgment of the Board, expert medical opinion, in addition to that available within the Department, is warranted by the medical complexity or controversy involved in an appeal case, the Board may secure an advisory medical opinion from one or more independent medical experts who are not employees of the Department. 38 U.S.C.A. § 7109(a) (West 1991). Basically, the applicable law and regulations provide that service connection can be established if a particular disease or injury, resulting in disability, is incurred coincident with service, or if a chronic disease, as specified in 38 U.S.C.A. § 1101, is manifested to a compensable degree within one year thereafter. Congenital or developmental defects as such are not diseases or injuries within the meaning of applicable legislation. 38 U.S.C.A. §§ 1110, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309 (1994). History The veteran's service medical records show that in November 1972, she was seen at a base clinic complaining of anxiety after she had difficulty adjusting to life in the barracks. She was referred to a psychiatrist who found no psychiatric disorder. She was returned to duty. In June 1973, she was seen at a base clinic for agitation. She had received a court martial a day earlier. Situational anxiety was noted and Valium was prescribed. Situational reaction was the diagnosis in July 1973, after she complained of diffuse anxiety, insomnia and an inability to concentrate. In late July 1973, situational difficulties were noted. she was thought to have psychosomatic problems due to exogenous depression. She was considered a suicide risk. Three days before her separation from service, in August 1973, she was noted to be very hyper - anxiety reaction was noted and Valium was prescribed. Her service records indicated that while in service she received a court martial and had difficulties generally associated with disciplinary problems. She was discharged for unsuitability. After service, a private physician referred the veteran to the Columbia Area Mental Health Center, where she presented with symptoms including depression. Passive aggressive personality was diagnosed, and she received outpatient treatment from November 1973 to July 1974. VA records show that in the mid 1970's she was hospitalized and received treatment for schizoid personality involving various traits. In the mid-1980's she was described as having a borderline and inadequate personality, adult situational adjustment problems and adult adjustment reaction with depressed mood. In the 1984, depressive neurosis was diagnosed, along with diagnosis of adjustment disorder and a personality disorder. VA outpatient clinic records show that in November 1988 the diagnostic impressions for the veteran were alcohol and sedative dependence. During a June 1991 VA hospitalization, a bipolar disorder was noted. A psychiatric examination for the veteran, requested by the Board and conducted in May 1992, showed an Axis I diagnosis of bipolar disorder, and an Axis II diagnosis of a personality disorder. Summary Whatever the veteran's problems in service, the evidence of record does not show that she had an acquired psychiatric disorder. The symptoms of anxiety and depression were associated with the situational adjustment reaction diagnosed in service, all related to her court martial and various disciplinary problems. The Board notes that information recorded for clinical purposes indicates that she reported some problems with depression prior to service. This information has been gleaned from various histories as provided by the veteran. Depression was one of several symptoms reported during service and after service, and there is no objective medical evidence to show that it was more than a manifestation of the situational adjustment problem, and her personality disorder. It is for consideration that when treated shortly after service, the diagnosis was a personality disorder A bipolar disorder, a psychosis, was first diagnosed many years following her separation from service. Recent diagnoses for the veteran still include a personality disorder A personality disorder is not a disease or disability for VA compensation benefit purposes. 38 C.F.R. § 3.303(c). Furthermore, as pointed out earlier, it was approximately a decade after the veteran's active service before an acquired psychiatric disorder was found. There is no medical evidence showing that the post-service acquired psychiatric disorder is related in any manner to the veteran's active military service. There is no basis for an award of service connection for an acquired psychiatric disorder. 38 U.S.C.A. §§ 1101, 1110, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309. The Board would note, with respect to the contentions raised by the representative in connection with the present appeal, that the instant case does not present such a complex or controversial medical question as to warrant its submission to an independent medical expert, outside the VA framework, for an opinion. The Board finds that the scope of the medical issue presented in this case falls within the area of rating judgment and that the Board has appropriately carried out its appellate function. ORDER Service connection for an acquired psychiatric disorder is denied. RENÉE M. PELLETIER 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.