BVA9502596 DOCKET NO. 93-07 461 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Pittsburgh, Pennsylvania THE ISSUE Whether new and material evidence has been presented to reopen a claim for service connection for an acquired psychiatric disorder, to include post-traumatic stress disorder (PTSD). REPRESENTATION Appellant represented by: Paralyzed Veterans of America, Inc. WITNESS AT HEARING ON APPEAL Appellant INTRODUCTION The veteran served on active duty from December 1965 to July 1967. This matter comes before the Board of Veterans' Appeals (the Board) on appeal from an April 1991 decision of the Department of Veterans Affairs (VA) Regional Office (RO) which, in essence, denied the veteran's attempt to reopen his claim for service connection for a psychiatric disorder, including PTSD. CONTENTIONS OF APPELLANT ON APPEAL It is contended that a January 1991 statement from the veteran's uncle, official reports concerning the shipboard fire in November 1966 and the veteran's testimony constitute new and material evidence to reopen his claim for service connection for a psychiatric disorder. It is also contended that he was diagnosed with an active psychosis within one year of discharge from service and that his psychiatric problems began in service, even prior to the stressor of seeing his friends killed in a fire aboard ship. It is otherwise contended that he has PTSD as a result of his stressful duty in service as a bomb handler on a ship in the Gulf of Tonkin and particularly as a result of the shipboard fire in which his friends were killed. The presence of a personality disorder predisposes to the development of PTSD which may occur concomitantly with a personality disorder. His representative points to Chapter 20 of the Physician's Guide for Disability Evaluation Examinations, IB 11-56 (March 1, 1985), relating to the misdiagnosis of PTSD prior to 1980 as a personality disorder, substance abuse disorder or even schizophrenia. It is asserted that an independent medical opinion should be obtained. 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 files. 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 new and material evidence to reopen the claim for service connection for an acquired psychiatric disorder (other than PTSD) has not been submitted. It is also the decision of the Board that new and material evidence to reopen the claim for service connection for PTSD has been submitted and the claim is reopened, but that the preponderance of the evidence is against the claim for service connection for PTSD. FINDINGS OF FACT 1. All relevant available evidence necessary for an equitable disposition of the veteran's appeal has been obtained by the RO. 2. In January 1976 the Board denied the veteran's claim for service connection for a psychiatric disorder. 3. The evidence received since the Board's 1976 decision does not tend to show that an acquired psychiatric disorder began in service or is related to any incident in service or that a psychotic disorder was manifested to a degree of 10 percent within one year of service. 4. The Board initially denied the veteran's claim for service connection for PTSD in August 1983, but he has recently submitted official documents concerning his claimed inservice stressor which are new and probative or relevant to the issue. 5. The veteran was not engaged in combat in service. 6. He does not have PTSD resulting from a stressor in service. CONCLUSIONS OF LAW 1. Evidence received since the January 1976 Board decision denying service connection for a psychiatric disorder (other than PTSD) is not both new and material and the veteran's claim is not reopened. 38 U.S.C.A. §§ 1101, 1110, 1112, 1113, 5107, 5108, 7104 (West 1991); 38 C.F.R. §§ 3.156, 3.303, 20.302 (1994). 2. Evidence received since the August 1983 Board decision denying entitlement to service connection for PTSD is both new and material and the veteran's claim is reopened. 38 U.S.C.A. §§ 1110, 5107, 5108, 7104 (West 1991); 38 C.F.R. §§ 3.156, 20.302 (1994). 3. PTSD was not incurred in or aggravated by service. 38 U.S.C.A. §§ 1110, 5107 (West 1991). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Board finds that the veteran has presented a claim which is "well-grounded" or plausible within the meaning of 38 U.S.C.A. § 5107(a). The Board is also satisfied that the duty to assist mandated by 38 U.S.C.A. § 5107(a) has been fulfilled as there is sufficient evidence of record to make an equitable decision in the veteran's appeal. It appears that all available relevant medical records have been obtained, and, as will be explained below, an independent medical expert's opinion is not necessary. In order to avoid confusion and for clarity of the decision, the Board will consider and discuss the claimed psychiatric disorder as the separate entities of an acquired psychiatric disorder not including PTSD and PTSD. For service connection to be granted, it is required that the facts, as shown by the evidence, establish that a particular injury or disease resulting in chronic disability was incurred in service, or, if pre-existing service, was aggravated therein. 38 U.S.C.A. § 1110 (West 1991); 38 C.F.R. § 3.303 (1993). For the showing of a chronic disease in service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time, as distinguished from merely isolated findings or a diagnosis including the word "chronic." Continuity of symptomatology is required where the condition noted during service is not, in fact, shown to be chronic or where the diagnosis of chronicity may be legitimately questioned. When the fact of chronicity in service is not adequately supported, then a showing of continuity after discharge is required to support the claim. 38 C.F.R. § 3.303(b). However, personality disorders are not diseases or injuries within the meaning of the VA laws and regulations. 38 C.F.R. § 3.303(c). Where, as here, the veteran served 90 days or more, and a psychosis becomes manifest to a degree of 10 percent within one year of service discharge, it will be considered to have been incurred in service, notwithstanding there is no record of evidence of such disease during service. This presumption is rebuttable by affirmative evidence to the contrary. 38 U.S.C.A. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309. A decision of the Board is final as to conclusions based on evidence on file at that time and will not be subject to revision on the same factual basis, absent clear and unmistakable error, which is not claimed in this case. 38 U.S.C.A. § 7104; 38 C.F.R. § 20.302. If new and material evidence is presented or secured with respect to a claim which has been disallowed, the Secretary shall reopen the claim and review the former disposition of the claim. 38 U.S.C.A. § 5108; 38 C.F.R. § 3.156. The United States Court of Veterans Appeals has held that the Board must perform a two-step analysis when a veteran seeks to reopen a claim based on new evidence. First, the Board must determine whether the additional evidence is "new" and "material." Second, if the Board determines that new and material evidence has been added to the record, the claim is reopened and the Board must evaluate the merits of the veteran's claim in light of all the evidence, both new and old. Manio v. Derwinski, 1 Vet.App. 140 (1991). "New" evidence means more than evidence which was not previously of record. To be "new," the additional evidence must be more than merely cumulative. Colvin v. Derwinski, 1 Vet.App. 171 (1991). To be "material," the additional evidence must be probative of the issue at hand. Also, to be "material," there must be a reasonable possibility that the new evidence, when viewed in the context of all the evidence, both old and new, would change the outcome of the previous decision. Smith v. Derwinski, 1 Vet.App. 178 (1991). An acquired psychiatric disorder The Board denied the veteran's claim for service connection for a psychiatric disorder in January 1976, August 1983 and December 1985. However, the last two decisions were, in essence, decisions on the veteran's attempt to reopen his claim, and the last decision on the merits of the claim was the 1976 decision. Therefore, the question is whether new and material evidence to reopen the claim has been received since the Board's denial in 1976. Glynn v. Brown, 6 Vet.App. 523 (1994). Private clinical records from 1962 to 1966 included notations that the veteran had been a behavior problem at home in April 1962 and that he continued with school problems in May 1963. Service medical records are devoid of indications of a psychiatric disorder. However, a May 1967 letter from a Navy district legal officer to the veteran's mother indicated that arrangements had been made to obtain psychiatric evaluation of him. On his initial claim for compensation in May 1968, he reported having been treated by a psychiatrist in 1964 for mental problems. The veteran was hospitalized at a VA facility from June to August 1968, for evaluation of complaints of high blood pressure. On psychiatric consultation history was given of hospitalization at age 15 for emotional problems and dropping out of school at approximately the same time. After evaluation the psychiatrist concluded that the veteran was suffering from severe personality problems and maladjustment. On psychological testing during hospitalization he gave a history of being happy until he incurred a head injury at age 15. The accident was followed by erratic behavior such as truancy, minor deliquencies and fights with schoolmates which resulted in referral to juvenile court and referral to a mental health clinic for psychiatric care. His home situation became increasingly disruptive, and he found it increasingly difficult to control himself physically and emotionally. As an alternative to returning to court, he joined the Navy during which it was increasingly difficult to control his emotions and he experienced blackouts during weekend passes. The behavioral consequences of his growing anxiety in part due to seemingly harsh treatment from his superiors landed him in the brig on many occasions. It was noted that a personality evaluation described him as severely disturbed in danger of plunging into a full-blown psychotic state. On evaluation by a clinical social worker, it was again noted that prior to service he had been referred to a juvenile court because of repeated delinquency behavior and truancy and that during preservice hospitalization in February and March 1964 a diagnosis of passive-aggressive personality had been made. His description of military experiences suggested that he had difficulty adjusting early. He had difficulty with a superior officer and was tranferred to a bomb handling crew, involving heavy lifting and tedious hours. He described his disciplinary problems in service. The final diagnosis from this period of hospitalization was unclassified personality disorder. The veteran was again hospitalized from September to December 1968, exhibiting flattened affect, thought blocking and delusional ideas on admission. The final diagnosis was undifferentiated type schozophrenic reaction. On VA examination in May 1969 the examiner found no evidence of any psychosis and diagnosed passive-aggressive personality. After VA hospitalization from January to March 1970 the diagnosis was passive-aggressive personality, but on further hospitalization from March to November 1970 chronic paranoid type schizophrenia was diagnosed. Thereafter, he underwent numerous VA hospitalizations from 1970 to 1975 and was variously diagnosed as suffering from passive-aggressive personality disorder, schizophrenia, alcoholism, depressive reaction, habitual excessive drinking and antisocial personality. In a November 1974 statement the veteran's brother Guy related that the veteran had been a strong, healthy teenager with a positive mental attitude. After he joined the Navy and completed boot camp he (the veteran) transferred to the ship on which the brother served. He was assigned to the garbage and mess cook division which let him down and he soon began to drink and have trouble on liberty. On one occasion he was unconscious and a shipmate said he had been drunk and in a fight the previous day. Further problems with drinking and inability to get along were described, and the brother noted that while the veteran was assigned to the bomb handler division, he seemed restless, unable to sleep, and sweating and developed a rash. He also seemed depressed. His troubles with legal authorities were also described, and it was the brother's opinion that the veteran was very sick but received no treatment in the Navy. The case was referred to the Director of the VA Mental Health and Behavioral Sciences Service, Department of Medicine and Surgery, for an expert opinion concerning the veteran's psychiatric disease. The Director responded that the record revealed the veteran had a life-long history of difficulty relating to authority figures and difficulty with interpersonal relationships beginning in childhood and continuing throughout service and postservice. The correct diagnosis was passive-aggressive personality, and there was no evidence of a thinking disorder or other psychotic manifestations. On the basis of this evidence, in 1976 the Board found, in essence, that the veteran's symptoms in service were not diagnostic of an acquired psychiatric disease but were manifestations of a personality disorder and that the symptoms shown subsequent to service did not represent a chronic psychotic disease within one year after discharge from service. The evidence received since that decision includes numerous VA medical reports of inpatient and outpatient treatment from 1979 to1991. These records contain various diagnoses of personality disorder, bipolar affective disorder, dysthymia and alcohol abuse. However, the records pertain to treatment many years after service and they do not contain medical evidence or opinion that would link any of these psychiatric disorders to service. The veteran is not competent to diagnose his psychiatric symptoms, Espiritu v. Derwinski, 2 Vet.App. 492 (1992), and the evidence does not support his claim that his symptoms in service were misdiagnosed as a personality disorder (except for a 1985 statement from William R. Taylor, M.D., which will be considered below as it pertains to the issue of service connection for PTSD only). The records also are devoid of any information reflecting a diagnosis of chronic psychosis in service or within one year after service discharge, nor do these records relate the onset of any chronic acquired psychiatric disorder (except PTSD) to an incident of service, including the shipboard fire in November 1966. Because these records contain no new information concerning the onset of a chronic acquired psychiatric disorder (except for PTSD), they are not relevant and not new and material. The veteran's testimony at hearings since that decision repeats his testimony in 1975 to the effect that he had no psychiatric problems prior to service and prior to hitting his head while running to a shipboard fire. Although he has elaborated on the incident in hearings since the 1976 decision, with regard to the onset of a chronic acquired psychiatric disorder other than PTSD, his testimony is essentially cumulative, and he is not competent to testify as to whether the symptoms described were diagnostic of a personality disorder, a psychoneurotic disorder or a psychotic disorder. Espiritu. The veteran's brother Guy submitted another statement dated in August 1988, stating that the veteran had only minor problems with the law as a juvenile and had no problems prior to the shipboard fire in 1966. While the credibility of a statement is presumed for purposes of determining its materiality, similarly to determining whether the claim is well grounded, this rule does not apply where the evidentiary assetion is inherently incredible. See King v. Brown, 5 Vet.App. 19 (1993). Here, the brother's 1988 statement is in direct contradiction to his 1974 statement in which he describes the veteran's numerous problems, including problems with alcohol, prior to the shipboard fire and does not relate any changes in the veteran in conjunction with the fire. Moreover, neither he nor his uncle whose statement was received in January are competent to make any conclusions as to whether the symptoms exhibited in service were manifestations of a personality disorder or a chronic acquired psychiatric disorder. They are not competent to refute the diagnosis of personality disorder reported on VA hospitalization from June to August 1968. These statements are not new and material. The Board concludes that the veteran has not presented new and material evidence to reopen the claim for service connection for a chronic acquired psychiatric disorder. PTSD With regard to PTSD, the Board initially denied service connection for PTSD in August 1983. However, since that decision copies of the final investigative report of the Department of the Navy Office of the Judge Advocate General concerning the fire on board the veteran's ship in November 1966 have been received. The Board finds that this evidence is new, in that there had been no prior official confirmation concerning this fire, and that it is material, in that it concerns the facts surrounding an incident claimed by the veteran as a stressor leading to the development of PTSD. The claim is, therefore, reopened. The RO has included in its statement of the case a review of the claim essentially on the merits, but in any event the veteran has been afforded an opportunity to present all argument and evidence on the substantive issue. The Board concludes that addressing the substantive issue in the reopened claim will not prejudice the veteran. See Bernard v. Brown, 4 Vet.App. 384 (1993). The veteran served on board the USS Franklin D. Roosevelt (Roosevelt) from March 1966 to May 1967 and was awarded the Vietnam Service Medal with one Bronze Star and the Vietnam Campaign Medal. He has no awards which reflect combat service nor does his military occupational specialty as a radarman or subsequent described duty as an ordnance handler and deck hand connote combat service. Psychiatric treatment records from 1968 to 1975 have been previously described; they do not indicate symptoms of PTSD related to any inservice stressor. They do indicate emotional problems in service and thereafter attributed to a personality disorder and to a psychotic disorder more than one year after service, although the diagnosis of a personality disorder was relatively consistent through these years. VA outpatient treatment records from 1979 through 1981 show depression related to marital, financial and job problems. The first indication of a finding of PTSD was on VA outpatient treatment in March 1982 when the veteran reported that he remained anxious and depressed, that he had nightmares and that he had worked long hours under stress as an ordnance and weapons handler on an aircraft carrier in the Gulf of Tonkin in 1966 and 1967. The examiner noted that there were some criteria for delayed stress syndrome and this should be investigated. On a VA Social and Industrial Survey in September 1982 the veteran described stress and tension related to his duty of loading or disposing of bombs and other explosives on board the Roosevelt in service. The major traumatic event was when the munitions area caught fire and 10 sailors were burned to death. He could not recall whether the fire was the result of enemy attack or other circumstance, but he remembered seeing burning bodies and hearing them scream. On psychiatric examination in September 1982, he indicated that all he knew was that something happened to him in service, and he tried to blank Vietnam out of his mind. On VA psychological testing in December 1982 the diagnostic impression was a personality disorder. The veteran underwent VA hospitalization in February and March 1984. He was admitted with a long list of vague, global complaints, and it was remarked that his complaints appeared to be targeted at acquiring a psychiatric diagnosis worthy of monetary compensation, as he stated that the government owed him disability due to his "stress." On admission he was intoxicated and a long history of episodic alcohol abuse and a history of weekly marijuana use were noted. The relevant diagnoses were alcohol abuse and atypical personality disorder. In a September 1984 statement Joseph G. Hinchliffe, M.D., reported examining the veteran who stated that his problems began while in the Navy. He vividly recalled when some of the people he worked with on board ship were killed, and reported that while in the Navy he began to have severe episodes of depression, difficulty sleeping and dreams of people being blown up and catching on fire. He began to have disciplinary problems. After discharge he had constant feelings of panic, sleeplessness, physical complaints and a nervous twitch and at times decompensated into a full-blown psychotic episode. Dr. Hinchliffe noted numerous hospitalizations over the years with hallucinations, delusions, suicidal preoccupation and irritability particularly with his bosses. He diagnosed PTSD. In a January 1985 statement William R. Taylor, M.D., reported that at the suggestion of Dr. Hinchliffe, he (Dr. Taylor) reviewed the original consultation which he had conducted in May 1967 while the veteran was in service. The records reviewed by Dr. Taylor were his original 1967 consultation report, Dr. Hinchliffe's September 1984 psychiatric consultation report, the national service officer's June 1982 notice of disagreement, a correction to the veteran's discharge paper awarding him the Vietnam Service Medal and the Vietnam Campaign Medal and a record of discharge for unsuitability along with a telephone conversation with the veteran. Dr. Taylor stated that the veteran had had continuing evidence of PTSD including symptoms of insomnia, nightmares and numerous hospitalizations for psychotic symptoms. Dr. Taylor stated that the onset of the veteran's symptoms was during service when he loaded and unloaded bombs for combat planes and was in an enemy attack in which the enemy blew up a nearby section of the munitions area. Burned men were screaming while the veteran worked nearby removing bombs, missiles and other explosives. The veteran had also described in subsequent interviews having to roll damaged or defective explosives overboard and some would explode on the way down or in the water. Dr. Taylor remarked that when he saw the veteran in the brig in 1967, the history of emotional trauma during "this combat situation" was not obtained although symptoms of irritability, rebelliousness, difficulty cooperating with authority, tension headaches and somatic complaints were described, and because of the history of antisocial activity before service he was diagnosed as an antisocial personality. Dr. Taylor recommended that in view of the history of major emotional stress during combat and the many symptoms of PTSD shown by the veteran in service and thereafter, it was clear that the diagnosis he made in 1967 should be changed to PTSD under the terminology of the "DSM 3." It appeared clear that the disorder originated as a direct result of emotional trauma sustained on active duty. During a personal hearing in May 1985 the veteran reported that after about one month on the bomb squad the ship got into heavy combat, he was working 18 hours a day, and he became run down and started having nightmares and insomnia. After he was on the bomb team for about nine months a bomb hit the ship. He was in the middle of the carrier and heard the explosion. Then there was a fire and smoke and he had to help get rid of the bombs around the hatch. He saw the fire below the hanger bay and he was told to go down there to bring up the bodies. He heard the men screaming and "they got burned up." After that he had nightmares of "screaming and yelling and the bodies all charcoaled." He was anxious all the time and lost 60 pounds. He was depressed and he talked to his brother about it. He also had an amnesia attack and was gone for three days . After that he was in the brig where he was harrassed and started having suicidal thoughts. He also described an incident in which he was involved in a fight as a result of which he was subjected to disciplinary action. He was seen by Dr. Taylor who did not ask him about any of the problems he was having in service. On VA hospitalization in August 1986 the veteran complained of decreased sleep with nightmares, intrusive thoughts of Vietnam, irritability, moodiness and trouble with relationships. He identified significant stressors in Vietnam including an attack on his ship in which men were killed. The diagnoses were bipolar affective disorder and PTSD. A bipolar disorder was diagnosed on VA inpatient and outpatient treatment in 1987 and 1988. At a hearing held in February 1989 the veteran's brother testified that the veteran had no problems on board ship until the fire on board the ship. Immediately after this the veteran became withdrawn and nervous, got rashes on his hands and body, had trouble sleeping and problems carrying out his assigned duties and appeared disoriented. He had had some problems with juvenile authorities but nothing of significance. The veteran described problems beginning with the shipboard fire incident. On VA examination in February 1989, the veteran related the incident in which a bomb exploded in the hatch and he saw many of his friends charred. After that he developed feeling of numbness, emotionlessness and irritability and rage attacks. He had amnesia about the incident for several years but slowly it came back to him. He denied significant symptoms consistent with a conduct disorder, and a diagnosis of an antisocial personality disorder could not be made at that time. The diagnoses were PTSD and bipolar disorder in partial remission. Bipolar disorder was diagnosed after a brief VA hospitalization in April 1990. In January 1991 a VA psychiatrist stated that the veteran came in for his scheduled appointment complaining of severe depression. According to the physician, the veteran argued quite skillfully that he was the victim of chronic depression and that he could not be expected to change or get better. The physician's current assessment was that the veteran was primarily suffering from an affective disorder and chronic characterologic disorder. He noted the veteran had used considerable energy and creativity in enlisting his aid in certifying him disabled. In February 1991 he was seen by another VA psychiatrist for a second opinion because he did not agree with the psychiatrist's opinion that he had a borderline disorder rather than PTSD. The examiner noted that he was a vague historian, not able or willing to provide answers to specific questions. He was preoccupied with PTSD. He was vague in identifying his affective symptoms and admitted only to poor sleep and mood. Asked if his current medications helped, he gave conflicting answers at different times. His symptoms were described and his chart reviewed. After examination the psychiatrist diagnosed dysthymia, past substance abuse and mixed personality (borderline, antisocial and narcissistic). The report of investigation by the Navy Judge Advocate General's Office revealed that on November 4, 1966, a fire broke out in one of the Roosevelt's hanger bay compartments, that it started as a "big flash of flame," that it burned intensely for an undetermined period of time, that the fire was reported extinguished approximately one hour after it began and that all fires were extinguished approximately one hour after that. Eight men died in the compartment and were removed to sick bay for examination and then transported to Subic Bay for preparation, encasement and further disposition. The bodies showed no evidence of burning or charring. Another seaman sustained injuries which were not expected to result in permanent disability and fifteen other seaman sustained minor injuries while fighting the fire; they were treated and released to duty. The investigators' opinion was that the fire was started by a chemical reaction on inflammable stores in the compartment and that the eight men trapped in the compartment died of asphyxiation. 38 C.F.R. § 3.304(f) (1992) provides that service connection for PTSD requires medical evidence establishing a clear diagnosis of the condition, credible supporting evidence that the claimed inservice stressor actually occurred, and a link, established by medical evidence, between current symptomatology and the claimed inservice stressor. If the claimed stressor is related to combat, service department evidence that the veteran engaged in combat or that he was awarded the Purple Heart, Combat Infantryman Badge, or similar combat citation will be accepted, in the absence of evidence to the contrary, as conclusive evidence of the claimed inservice stressor. "[U]nder 38 U.S.C.A. § 1154(b), 38 C.F.R. § 3.304, and the applicable Manual M21-1 provisions, the evidence necessary to establish the occurrence of a recognizable stressor during service to support a claim of entitlement to service connection for PTSD will vary depending on whether or not the veteran was 'engaged in combat with the enemy.... Where it is determined, through recognized military citations or other supportive evidence, that the veteran was engaged in combat with the enemy and the claimed stressors are related to such combat, the veteran's lay testimony regarding claimed stressors must be accepted as conclusive as to their actual occurrence and no further development for corroborative evidence will be required, provided that the veteran's testimony is found to be 'satisfactory... Where, however, the VA determines that the veteran did not engage in combat with the enemy, or that the veteran did engage in combat with the enemy but the claimed stressor is not related to such combat, the veteran's lay testimony, by itself, will not be enough to establish the occurrence of the alleged stressor. Instead, the record must contain service records which corroborate the veteran's testimony as to the occurrence of the claimed stressor." Zarycki v. Brown, 6 Vet.App. 91, 98 (1993). "Once the occurrence of a stressful episode is established, it must then be determined whether the claimed stressful event was of sufficient gravity to support a diagnosis of PTSD." Zarycki at 98. In this case, the Board finds first that the veteran was not engaged in combat during his tour on the aircraft carrier in Vietnam waters. He has no medals indicating combat exposure, nor does the report of the Judge Advocate General's Office investigation indicate that the carrier was engaged in combat. While bombing missions may have been accomplished by planes from the Roosevelt, there is no evidence that the veteran, stationed aboard the carrier, was engaged in combat. "A veteran seeking service connection for PTSD may not rely on mere service in a combat zone, solely in and of itself, to support a diagnosis of PTSD. Rather, in order to support a diagnosis of PTSD, a stressor must consist of an event during such service 'that is outside of the range of usual human experience and that would be markedly distressing to almost anyone... It is the distressing event, rather than the mere presence in a 'combat zone,' which may constitute a valid stressor for purposes of supporting a diagnosis of PTSD. Zarycki at 99. Moreover, although he claims that his duties as an ordnance handler constituted a stressor which resulted in PTSD, such duties, per se, while perhaps worrisome, do not present the immediate, intense threat or fear contemplated as a stressor to support a diagnosis of PTSD. There is no question that a fire occurred aboard the Roosevelt in which eight seamen died, and this incident, in some circumstances, would constitute a stressor sufficient to support a diagnosis of PTSD. As noted in Zarycki, witnessing another person being seriously injured or killed is an example of a stressor as contemplated for a diagnosis of PTSD. However, in the veteran's case, the Board does not find credible evidence that he has PTSD related to this incident. Although the veteran has stated that all his symptoms began after that incident, preservice private clinical records demonstrate that he had been a behavior problem at home and at school, and on his initial application for compensation in 1968 he reported that he had been treated by a psychiatrist in 1964, before service. A similar history was again given when he was hospitalized at a VA facility in 1968 and he reported having been hospitalized at age 15 for emotional problems. This preservice history was again given to a clinical scoial worker at that time. The inconsistencies in the statements from the veteran's brother concerning the onset of his symptoms concurrent with the fire incident, and, therefore, the lack of credibility if those statements has previously been referred to above, and the preservice history of serious emotional problems prior to service and to the incident claimed as a stressor contradicts the veteran's statements that he had no problems prior to the incident. In his 1991 hearing he testified that he had nightmares before the incident, but on other occasions he has stated that his nightmares began with the incident. He also stated at that hearing and at a February 1989 examination that he had had amnesia for the incident for many years after service, but at other times has claimed nightmares of the incident since service (also see Dr. Taylor's 1985 statement). He also testified in 1985 that he was so anxious in service that he lost 60 pounds, but his service medical records reveal that he weighed 190 pounds at enlistment and 219 pounds at discharge. The veteran's report of the incident is also inconsistent with the facts in significant areas. He has reported that an explosion occurred when the ship was attacked (VA hospitalization in August 1986) and when it was bombed (May 1985 hearing), but the investigation report clearly shows that the fire did not occur as a result of enemy action or bomb explosion. He also reported seeing burning bodies and charred bodies, but the investigation report clearly shows that the men who died died as a result of asphyxiation and their bodies were not charred. Other seamen received only minor injuries which is not consistent with the veteran's description of burning bodies. While there may have been chaos surrounding the incident, the fire was rapidly extinguished. In all, the veteran's description of the incident is inconsistent with the facts, and his credibility with regard to the onset of symptoms with the incident as described is greatly diminished. The veteran has had several diagnoses of PTSD, but the VA psychiatrists who most recently treated and examined him, one at his behest for a second opinion, have concluded that he does not have PTSD. The Board considers that these opinions deserve great weight. Dr. Hinchliffe diagnosed PTSD in 1984, but his diagnosis relied on the history given by the veteran that his problems began in the Navy, a history which is contradicted by the records from 1962 through 1968. The veteran also described to Dr. Hinchliffe nightmares in which he saw people blown up and on fire, which is not in accordance with the facts of the event as described above. Dr. Hinchliffe's diagnosis is not based on a credible history and is, therefore, not credible. In 1985 Dr. Taylor stated that his inservice diagnosis of personality disorder should be changed to PTSD. However, he recommended this "[i]n view of major emotional stress during combat" and many symptoms of PTSD shown in service and thereafter, and again these do not accord with the facts of the case. The veteran did not engage in combat, the description relied on by Dr. Taylor of burned men screaming after the enemy blew up a section of the munitions area is not credible, and the symptoms described by him are consistent with other psychiatric diagnoses. Because the basis for Dr. Taylor's change in diagnosis is not credible, his statement is of little probative value. Similarly, the VA diagnoses of PTSD are based on inaccurate history, particularly of seeing charred bodies. In light of the inconsistencies in the veteran's description of the onset of his emotional problems and the course of those problems, his description of the claimed stressor which is inconsistent with the facts of the incident, the inconsistencies in the history given by him to various psychiatrists on which their diagnosis of PTSD was predicated, and the recent credible findings by VA psychiatrists that he does not have PTSD, the Board concludes that the preponderance of the evidence is against a finding of PTSD related to an stressor in service, and, therefore, the claim is denied. The Board also finds that the case depends significantly on the credibility of the veteran, the various statements submitted on his behalf and on the histories on which the diagnoses of PTSD have been made. Credibility is a question for the Board, and since it is paramount in this case, the opinion of an independent medical expert is not necessary or appropriate. ORDER New and material evidence has not been presented with regard to the issue of service connection for an acquired psychiatric disorder, and the claim is not reopened; the benefit is denied. Service connection for PTSD is denied. HOLLY E. MOEHLMANN Member, Board of Veterans' Appeals (CONTINUED ON NEXT PAGE) 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.