Citation Nr: 0006477 Decision Date: 03/10/00 Archive Date: 03/17/00 DOCKET NO. 94-14 742 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Jackson, Mississippi THE ISSUE Entitlement to service connection for post traumatic stress disorder (PTSD). REPRESENTATION Appellant represented by: Cindy B. Smith, Attorney at Law WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD G. Strommen, Associate Counsel INTRODUCTION The veteran served on active duty from April 1960 to September 1964 and from October 1964 to November 1966. This case comes before the Board of Veterans' Appeals (Board) from a rating decision rendered by the Jackson, Mississippi, Regional Office (RO) of the Department of Veterans Affairs (VA) in which the veteran's claim of entitlement to service connection for PTSD was denied. The veteran subsequently perfected an appeal of that decision. The Board issued a decision in July 1996 also denying the veteran's claim. The appellant appealed the Board's determination to the United States Court of Appeals for Veterans Claims (Court), which vacated the Board's July 1996 decision and remanded the case to the Board for further adjudication pursuant to the Court's Memorandum Decision. FINDINGS OF FACT 1. All information necessary for an equitable disposition of the veteran's claim has been developed. 2. The veteran served on active duty in the Republic of Vietnam. His commendations include the Vietnam Campaign Medal (VCM), the Armed Forces Expeditionary Medal for Vietnam, the Vietnam Service Medal (VSM) with three bronze stars, the Republic of Vietnam Meritorious Unit Citation Gallantry Cross with Palm, the Republic of Vietnam Campaign Medal with 1960 device, and the Presidential Unit Citation (PUC). His relevant duty assignment was on minesweeping boat (MSB) 31, with the Commander Mine Squadron ELEVEN, Detachment ALFA, from July 16, 1966, to October 13, 1966. 3. The veteran has a current, medical diagnosis of PTSD. 4. The veteran experienced inservice stressors which are substantially corroborated by credible supporting evidence showing that he was subject to enemy gunfire while assigned on MSB 31 responsible for the Long Tau/Saigon keeping shipping channel open. 5. Private medical evaluations diagnose PTSD based on verified inservice stressors. CONCLUSION OF LAW PTSD was incurred as a result of active duty service. 38 U.S.C.A. §§ 1110, 1154, 5107 (West 1991); 38 C.F.R. §§ 3.102, 3.303, 3.304(f) (1999). REASONS AND BASES FOR FINDINGS AND CONCLUSION With regard to the veteran's claim for entitlement to service connection for PTSD, the veteran must initially meet his obligation of submitting evidence of a well-grounded claim. See 38 U.S.C.A. § 5107(a) (West 1996); Caluza v. Brown, 7 Vet. App. 498 (1995). To establish a well-grounded PTSD claim, the veteran must submit medical evidence of a current disability, lay evidence of an inservice stressor, and medical evidence of a nexus between service and the current PTSD disability. See Cohen v. Brown, 10 Vet. App. 128 (1997); Caluza, supra. For purposes of determining whether a claim is well grounded, the evidence submitted is generally presumed to be credible. See Robinette v. Brown, 8 Vet. App. 69, 75-76 (1995). The veteran has asserted stressors due to service in Vietnam, and a medical professional has diagnosed him with PTSD as a result of these alleged stressors, presuming this evidence to be credible as required for well-groundedness purposes, the Board finds that the veteran has submitted a well-grounded claim of entitlement to service connection for PTSD. Service connection for PTSD may be granted where the record shows a current, medical diagnosis of PTSD, credible supporting evidence that the claimed in-service stressor actually occurred, and medical evidence of a causal nexus between current symptomatology and the specific inservice stressor. Cohen v. Brown, supra; 38 C.F.R. § 3.304(f) (1999). In determining whether service connection is warranted for a disability, the VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. 38 U.S.C.A. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). With regard to the second element, the validity of the averred stressor, the evidence necessary to establish that the claimed stressor actually occurred varies depending on whether it can be determined that the veteran "engaged in combat with the enemy." 38 U.S.C.A. § 1154(b) (West 1991). When a veteran is found to have 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. See Cohen v. Brown, supra; 38 U.S.C.A. § 1154(b) (West 1991); 38 C.F.R. § 3.304(d), (f) (1999). However, non-combat related stressors require corroboration before they can be accepted as having actually occurred. In the present case, the record reveals that the veteran was normal from a psychological standpoint upon entry into service, and that he currently has several diagnoses of PTSD from VA and private mental health professionals. A May 1993 VA examination report shows a diagnosis of PTSD based on identified symptoms such as intrusive thoughts, nightmares, getting along poorly with others, avoidance of people and certain stimuli of experiences in Vietnam, marked irritability, poor sleep, startle reaction and arousal symptoms. The veteran has been treated on an outpatient basis for PTSD at several VA facilities, and his diagnosis was confirmed in a February 1996 fee basis psychiatric report by a private physician. In January 2000, the same private physician submitted a lengthy statement of treatment for the veteran indicating his progress and symptoms of PTSD. This statement again confirms his diagnosis. Additionally, the veteran's diagnoses have been related to such inservice stressors as his seeing another minesweeping boat struck by enemy fire and having to help with the killed and wounded, seeing friends killed, being fired upon by the enemy constantly, being reprimanded and demoted for firing back on the enemy, and shooting and killing a Vietnamese citizen who roused him from sleep, startling him. Therefore, based on these medical diagnoses, the Board determines that the veteran currently has PTSD. However, the inquiry does not end with a diagnosis because this only satisfies the first element required for service connection for PTSD, the stressors relied upon for the PTSD diagnoses must still be verified, and his PTSD must be related to a verified stressor. As stated previously, stressors which can be established as having occurred during combat can be verified solely by the credible lay testimony of the veteran, but all non-combat stressors require additional corroboration. See Cohen v. Brown, supra; 38 U.S.C.A. § 1154(b) (West 1991), 38 C.F.R. § 3.304(d), (f) (1999). In the present case, the veteran's stressors include seeing another minesweeping boat struck by enemy fire and having to help with the killed and wounded, seeing friends killed, being fired upon by the enemy constantly, being reprimanded and demoted for firing back on the enemy, and shooting and killing a Vietnamese ferry boat driver who roused him from sleep, startling him. Under the regulations, the first determination must be whether or not the veteran was engaged in combat during any of his alleged stressors. After a review of the record, the Board concludes that the veteran was in fact engaged in combat while serving in Vietnam. The veteran's DD 214 corroborates his unit attachment, his MOS, and his service in Vietnam. The RO contacted the U.S. Armed Services Center for Research of Unit Records (USASCRUR) regarding verification of the veteran's stressors. The USASCRUR responded by confirming the veteran's unit attachment for the period from July 16, 1966 to October 13, 1966 with the Commander Mine Squadron ELEVEN, Detachment ALFA, on a minesweeping boat (MSB), and submitted copies of the command history for 1967. The veteran's attorney obtained a copy of the command history for the veteran's unit for 1966 and submitted this document. The 1966 document confirms that the veteran's unit was involved in dangerous duty and that the MSB's engaged in contact with the enemy on numerous occasions. Also of record is a copy of the citation for the veteran's receipt of the Presidential Unit Citation for the period from June 1966 to February 1967. The citation notes that the veteran's unit and the MSB's were required to conduct two sweeps between Long Tau and Nha Be daily, which required 12 to 14 hours of particularly dangerous duty during which the MSB's approached within twenty-five yards of enemy infested river banks. It was noted that in June and July 1966 the taxing nature of the duty was magnified by enemy ambushes on different occasions along the length of the Long Tau river. It was also noted that MSB's engaged the enemy at close quarters during this time and subsequently. There were over 30 ambushes and the unit lost two MSB's to enemy fire. The veteran was on MSB 31, which is not discussed specifically in the narratives of assaults on MSB 54 in August 1966 and MSB 15 in September 1966, while he was in the unit. Given this evidence, the Board finds that the veteran engaged in combat with the enemy while serving on MSB 31 in Commander Mine Squadron ELEVEN, Detachment ALFA. Moreover, the statements verify his stressors of being shot at by the Viet Cong and firing on the enemy. However, there is no verification of his demotion as a result of the latter action. Although it is not clear that the veteran's boat, MSB 31 was present when the other MSB's were struck, there is also no indication that his MSB was not present and unable to render the direct assistance provided by another MSB or that his MSB did not become aware of these actions shortly thereafter. Accordingly, providing the veteran with the benefit of the doubt, the Board finds that his stressor of having witnessed another MSB blown up by enemy fire is corroborated. As for the veteran's stressor of shooting a Vietnamese citizen who startled him by waking him up, this incident is not related to his combat experiences, and therefore must have corroboration before it can be verified. Unfortunately, there is no corroboration for the latter stressor, and the veteran has not provided any lay statements or other evidence to corroborate this incident. Therefore, this non-combat related stressor cannot be verified. Thus, there is credible service evidence which tends to support the veteran's stressors that he engaged in contact with the enemy, was shot at constantly, and that an MSB in the vicinity where he was serving was hit by enemy fire. Having verified some of the veteran's asserted stressors, the inquiry must turn to whether or not a medical connection has been made between his verified stressor and his current diagnosis of PTSD. As noted earlier, the October 1997 private medical statement and the February 1992 VA examination report relates the veteran's PTSD with his experiences in Vietnam, specifically including the stress surrounding his exposure to enemy contact and the ambush on the other MSB. Accordingly, the veteran has presented a current medical diagnosis of PTSD, a verified stressor during service, and a medically acknowledged connection between his verified stressor and his PTSD diagnosis; therefore, as he has satisfied all the requirements for a claim of entitlement to service connection for PTSD, his claim is granted. ORDER Entitlement to service connection for PTSD is granted. JEFF MARTIN Member, Board of Veterans' Appeals