BVA9501860 DOCKET NO. 90-20 620 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Los Angeles, California THE ISSUES 1. Entitlement to service connection for psychiatric disability. 2. Entitlement to service connection for drug dependence. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD P. J. McCarty, Associate Counsel INTRODUCTION The veteran had active service from September 1968 to March 1970. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 1989 decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Los Angeles, California, which denied service connection for psychiatric disability and drug dependence. In December 1990, the Board remanded the case for further development. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends, essentially, that service connection is warranted for psychiatric disability and drug dependence as they initially manifested in service. 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 the claim of entitlement to service connection for a psychiatric disability, and that the claim of entitlement to service connection for drug dependence is not well grounded. FINDINGS OF FACT 1. All relevant evidence necessary for an equitable disposition of the appeal has been obtained. 2. The veteran was diagnosed as having a personality disorder in service, and was subsequently discharged due to that disorder. 3. An acquired psychiatric disability was not shown to be present during service or within one year thereafter. 4. The claim for service connection for drug dependence is not plausible. CONCLUSIONS OF LAW 1. A chronic acquired psychiatric disability was not incurred in or aggravated in service nor may it be presumed to have been so incurred. 38 U.S.C.A. §§ 1101, 1110, 1112, 1113 (West 1991); 38 C.F.R. §§ 3.303, 3.307, 3.309 (1993). 2. The veteran's diagnosed personality disorder is not a disease for which service connection can be granted. 38 C.F.R. § 3.303(c) (1993). 3. The claim for service connection for drug dependence is not well-grounded. 38 U.S.C.A. § 5107(a) (West 1991). REASONS AND BASES FOR FINDINGS AND CONCLUSION As a preliminary matter, the Board finds that the veteran's claim for service connection for psychiatric disability is plausible and capable of substantiation, and thus well grounded within the meaning of 38 U.S.C.A. § 5107(a) (West 1991). The Board is satisfied that all relevant facts have been obtained regarding that claim, and that no further assistance to the veteran with respect to this claim is required to comply with 38 U.S.C.A. § 5107(a). For further reasons set forth below, the Board finds that the veteran has not meet his burden of submitting evidence to support a belief that his claim of entitlement to service connection for drug addiction is well grounded. see Grottveit v. Brown, 5 Vet.App. 91 (1993); Tirpak v. Derwinski, 2 Vet.App. 609 (1992); Murphy v. Derwinski, 1 Vet.App. 78 (1990). I. Entitlement to service connection for psychiatric disability. The veteran's entrance examination is negative for diagnosis or treatment of a psychiatric disability. His service medical records reveal that in March 1970, he was discharged from service for unsuitability after he was diagnosed as having a passive- aggressive personality disorder which was found to have pre- existed his service. He was also diagnosed as having an inadequate personality manifested by inadaptability, an immature presentation, and general instability. There was, however, no evidence of acquired mental disease. In December 1974, the veteran sought treatment at the Camarillo State Hospital for drug abuse. He reported that he had a seven year history of drug abuse and that he primarily abused hallucinogens. The diagnosis was drug dependence, hallucinogens, severe with mild social maladjustment. An October 1978 psychiatric examination of the veteran by Laurence M Currier, M.D., revealed that the veteran was diagnosed as having schizophrenia, chronic, undifferentiated type. At that time, the examiner noted that the veteran was grossly emotionally disturbed. He stated that the veteran thought, talked, and moved very slowly, his face was blank, and he said nothing spontaneously. He was disoriented in all three spheres. His affect was essentially one of detachment and neutrality with no evidence of depression or elation. The examiner opined that there was no organic brain syndrome and found that veteran had an extremely childish personality, marked social regression, and had no capacity to handle any responsibility or self-direction. A January 1980 psychiatric examination of the veteran by Michael B. Coburn, M.D., revealed that the veteran was diagnosed as having organic brain syndrome with psychosis, secondary to probable multiple drug use and particularly to overdose of LSD. The examiner noted that the veteran was unable to inform him of any complaint. He was grossly disturbed, minimally communicative, and spoke only with part words and sentences. He was grossly unable to manage to find his way around the examiner's office. History obtained from his wife indicated that the veteran had been grossly impaired for approximately five years, with deterioration over a six month period following a massive overdose of LSD, and prior continuous use of LSD which followed emotional problems in the military. The examiner noted that the veteran was not grossly mentally impaired until he used, overused, and then overdosed on LSD. Apparently, on one evening in approximately 1975, the veteran took eighty-five doses of LSD and subsequently deteriorated to the point of becoming like an infant. The examiner noted that he was unable to obtain any meaningful past history except the veteran's birth date, that he was raised by his mother along with two siblings, that he had a tenth grade education, and that he spent time in the military during the Vietnam War and possibly experienced some emotional breakdown in service. Mental status examination revealed that the veteran was grossly impaired and who had to essentially be led from room to room. During the interview, he spoke minimally, answered with parts of words and slow scanning speech, and generally remained silent with a piercing stare. A March 1983 psychiatric examination of the veteran by Myron Lind, M.D., revealed that the veteran was unable to provide any meaningful information. History provided by a friend of the veteran indicated that the onset of the veteran's difficulties began during his military service, when he overdosed on eighty- five doses of LSD. Mental status examination revealed that the veteran stared into the distance with somewhat frozen body posture and facial expression, often without blinking. He would start to talk periodically, but would then stop after one or two words were spoken. It appeared that he had expressive aphasia and perhaps receptive aphasia as well. The veteran's daily activities were severely impaired, his interests were severely restricted, and his ability to relate to others was severely impaired. He was diagnosed as having organic brain syndrome, with predominantly expressive aphasia, probably secondary multiple drug use, or perhaps secondary to hypoxia. The examiner found that the veteran was impaired in all areas, and that he was incompetent in regards to managing his affairs, person, or finances. His capacity to relate to others was maximally impaired and his activities and interests were maximally limited. He was found to have no capacity for work of any kind. An April 1994 VA examination report reveals that the veteran stated that he had a long history of polysubstance abuse, including the use of acid, heroin, barbiturates, cocaine, and marijuana. He further indicated that he still smoked marijuana. Mental status evaluation showed that the veteran was well oriented, that his affect and mood were appropriate to his thought content, and that his memory was fair for recent and remote events. There was no evidence of any overt psychotic manifestations, and he had no visual or auditory hallucinations, delusions, or ideas of reference. His insight and judgment were limited. The examiner diagnosed polysubstance abuse, in partial remission; and a personality disorder. There was no evidence of schizophrenia or organic brain syndrome. The examiner commented that the veteran had a long history of antisocial and passive- aggressive behavior with admission that his stay in Vietnam was only two months and was shortened by drug use. The examiner opined that most of the veteran's psychiatric evaluations were essentially related to his polysubstance abuse. Finally, he stated that although he veteran had some symptomatology of post traumatic stress disorder (PTSD), he did not meet the criteria for that diagnosis. A May 1994 VA examination report shows that the veteran reported that he smoked marijuana before his military service, and that his drug use increased in service to include psychedelics and heroin, which he continued to use after his discharge from service. Mental status examination showed that the veteran described having a constant, vague sense of uneasiness, but denied paranoia. He did not describe flashbacks or nightmares. He stated that he avoided people because he did not like them. He reported feeling comfortable around Vietnam veterans and spent his days with these other veterans smoking marijuana, drinking alcohol, and sometimes discussing their experiences in Vietnam. The examiner opined that the veteran's rare responses during psychological testing were due to exaggeration of current symptomatology in light of the veteran's pending compensation claim. The veteran was found to meet the criterion for opioid(heroin) and alcohol dependence, in remission, past hallucinogenic abuse, and for current cannabis abuse. The examiner noted that the veteran's history of drug and alcohol use began prior to his service, although by the veteran's self-report, they worsened in service. The examiner also noted that a secondary diagnosis of antisocial personality disorder was also consistent with the veteran's history, although a firm diagnosis was difficult due to his active drug use. He further indicated that the veteran's previous diagnoses of organic brain syndrome and chronic schizophrenia were probably the result of examinations that were conducted while the veteran was affected by substance abuse or organic mental disorder secondary to substance abuse. The veteran's presentation during his current examination was not consistent with these prior diagnoses. Finally, the veteran also described past and recurrent periods of depression, which the examiner stated would be consistent with a diagnosis of major depression, in remission, but that such a diagnosis was clouded by his active drug abuse. In order to establish service connection for a psychiatric disability, the evidence must show the presence of such a disorder and that it resulted in disease or injury incurred in or aggravated by active service . 38 U.S.C.A. §§ 1101, 1110 (West 1991); 38 C.F.R. §§ 3.303 (1993). Service connection may be established for a psychosis if the evidence shows that this disability became manifest to a degree of 10 percent within one year from the date of termination of the veteran's service. 38 U.S.C.A. § 1101, 1110, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309. A personality disorder is not a disability within the meaning of applicable legislation providing for compensation benefits. 38 C.F.R. § 3.303(c). While the veteran's service records show that he was diagnosed as having a personality disorder in service, these records do not show that an acquired psychiatric disability was incurred in or aggravated in service. Further, there is no medical evidence of record which establishes that he had a psychosis to a degree of 10 percent or more disabling within one year of his separation from service. The Board notes that although the veteran has expressed his opinion that he has a psychiatric disability which initially manifested in service, he is not qualified, as a lay person, to furnish medical opinions or diagnoses. Espiritu v. Derwinski, 2 Vet.App 492, 494-95. The Board finds that the medical evidence of record overwhelmingly indicates that the veteran was separated from service due to a personality disorder and none of the post- service medical reports discussed above establish that the veteran presently suffers from an acquired psychiatric disability, attributable to service. Although one examiner diagnosed schizophrenia, and two others diagnosed organic brain syndrome several years after service, none opined that these disabilities were related to the veteran's service. Further, a VA examiner later opined that these prior diagnoses were unreliable as they may have been rendered at times when the veteran was under the influence of drugs. Another VA examiner opined that most of the veteran's psychiatric evaluations have been related to his substance abuse rather than his long standing passive-aggressive personality disorder. In light of the above, service connection for an acquired psychiatric disability is not warranted. II. Entitlement to service connection for drug addiction. When claiming entitlement to VA benefits, a claimant must first submit evidence to justify a belief that such a claim is well grounded. Grottveit at 92; Tirpak at 611. When, as here, a determinative issue involves medical diagnosis or medical causation, competent medical diagnosis is required to establish a well-grounded claim. Grottveit at 93. In the present case, the service medical records are entirely devoid of evidence of drug use or drug dependence. Further, the medical evidence of record demonstrates that the veteran was initially treated for substance abuse several years after service, and does not establish a causal relationship between the veteran's present drug dependence and his service. Although the veteran has expressed his opinion that such a relationship exists, he is not qualified, as a lay person, to furnish medical opinions or diagnoses. Espiritu v. Derwinski, 2 Vet.App. 492, 494-95 (1992). Accordingly, without the requisite competent medical evidence establishing that the veteran's claim is plausible, he has not met his burden of submitting evidence that his claim of entitlement to service connection for drug dependence is well grounded. Grottveit at 92; Tirpak at 611. The Board is aware that the veteran on several occasions has been diagnosed as being drug dependent, and that some examiners have reported that the veteran used drugs in service based upon the veteran's self-reported history. Nonetheless, without any credible evidence of drug abuse or addiction in service, or any medical evidence attributing his condition to service, there is no basis upon which the Board may grant service connection for this disability. 38 U.S.C.A. §§ 1101, 1110 (West 1991); 38 C.F.R. §§ 3.303 The Board points out that the United States Court of Veterans Appeals (Court) has provided the Board with guidance regarding claims that are well grounded and those that are not. See Grivois v. Brown, 6 Vet.App. 136 (1994) and Grottveit, supra. In Grivois, the Court reiterated that the VA has no statutory duty to assist a veteran absent evidence of a well-grounded claim, and cautioned VA against volunteering assistance to establish to establish well groundedness. Id. at 140. Although the Board has considered and denied this appeal on a ground different from that of the RO, that is, whether the veteran's claim is well grounded rather than whether he is entitled to prevail on the merits, the veteran has not been prejudiced by this decision. In assuming that the claim was well grounded, the RO accorded the veteran greater consideration than his claim warranted under the circumstances. Bernard v. Brown, 4 Vet.App. 384, 392-94 (1993). To remand this case to the RO for consideration of the issue of whether the veteran's claim for service connection for drug dependence is well grounded would be pointless, and in light of the law cited above, would not result in a determination favorable to the veteran. VA O.G.C. Prec. Op. 16-92, 57 Fed. Reg. 49, 747 (1992). ORDER Service connection for psychiatric disability is denied. Evidence of a well-grounded claim not having been submitted, the claim for service connection for drug dependence is 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.