Citation Nr: 0006411 Decision Date: 03/09/00 Archive Date: 03/17/00 DOCKET NO. 96-12 950 ) DATE ) ) On appeal from the Department of Veterans Affairs (VA) Regional Office and Insurance Center in Philadelphia, Pennsylvania THE ISSUE Entitlement to service connection for a psychiatric disorder (other than post-traumatic stress disorder (PTSD)). REPRESENTATION Appellant represented by: The American Legion WITNESSES AT HEARINGS ON APPEAL Appellant, his wife, his mother, and friends ATTORNEY FOR THE BOARD Suzie S. Gaston, Counsel INTRODUCTION The record contains information from the National Personnel Records Center (NPRC) dated in June 1992 which shows the appellant as having active duty from January 18, 1980 to May 23, 1980; then in June 1996 NPRC does not certify any service but there is handwritten note of "ACDUTRA" June 18, 1983 to July 2, 1983 and an indication of active duty from March 1, 1984 to January 16, 1986. Accompanying the June 1996 statement is a copy of the appellant's Reserve Retirement Credit Report which shows information which is not consistent in many respects with the foregoing. For example it shows that the appellant had "IADT" from January 15, 1980 to May 24, 1980 and "ATD" from July 13, 1980 to July 26, 1980, "ACDUTRA" from June 9, to July 8, 1981 and "ATD" from July 11 to July 26, 1981, "ACDUTRA" September 10, 18, 19, 1982 and "ATD" from May 1-16, 1982 and "ATD" June 18-July 2, 1983. No service after that date is shown on the appellant's Reserve Retirement Credit Report. This matter came before the Board of Veterans' Appeals (hereinafter Board) on appeal from a rating decision of July 1995, by the Philadelphia, Pennsylvania Regional Office and Insurance Center (ROIC), which denied the appellant's claim for service connection for a nervous disorder. The notice of disagreement with this determination was received in August 1995. The statement of the case was issued in August 1995. The substantive appeal was received in September 1995. The appellant appeared and offered testimony at a hearing before a hearing officer at the RO in September 1995. A transcript of the hearing is of record. A supplemental statement of the case was issued in March 1996. Subsequently, a rating action in October 1996 confirmed the previous denial of the appellant's claim for service connection for a psychiatric disorder. A supplemental statement of the case was issued in October 1996. Following the receipt of additional medical records, a rating action in June 1997 confirmed the previous denial of the appellant's claim for service connection. A supplemental statement of the case was issued in June 1997. On August 13, 1997, the appellant and his witnesses appeared and offered testimony at a hearing before the undersigned Member of the Board, sitting at Philadelphia, Pennsylvania. A transcript of that hearing is also of record. The appeal was subsequently received at the Board later in August 1997. In October 1997, the Board remanded the case to the ROIC for further development. Following the requested development, a supplemental statement of the case was issued in August 1999. The appeal was received back at the Board in October 1999. In November 1999, the appellant was offered another Board hearing as the Board member who conducted the August 1997 hearing was no longer employed by the Board. The appellant responded in December 1999 that he did not want an additional hearing. Also in December 1999, the appellant submitted additional evidence in support of his appeal directly to the Board. He waived initial ROIC review of this evidence. At his personal hearing in August 1997, the appellant raised the issue of entitlement to service connection for PTSD. This issue has not been developed or certified for appellate consideration; therefore, it is referred to the ROIC for appropriate action. FINDING OF FACT Competent evidence of a nexus between an incident of the appellant's active duty for training period and a psychiatric disorder (other than PTSD), variously diagnosed as a schizophrenic disorder and an adjustment disorder, has not been presented. CONCLUSION OF LAW The appellant has not submitted evidence of a well-grounded claim of entitlement to service connection for a psychiatric disorder (other than PTSD). 38 U.S.C.A. § 5107 (West 1991). REASONS AND BASES FOR FINDING AND CONCLUSION A. Factual background. The pertinent facts in this case may be briefly described. The service medical records are negative for any complaints or findings of a psychiatric disorder. Received in April 1992 were private treatment reports dated from April 1981 to January 1989, which show that the appellant received hospitalization and clinical evaluation for several disabilities. These records do not reflect any complaints of or treatment for a psychiatric disorder. The appellant's initial claim for service connection for a psychiatric disorder (VA Form 21-526) was received in December 1994. Submitted in support of his claim were private treatment reports dated from January 1993 to February 1995, reflecting treatment for several disabilities, including a psychiatric disorder. These records indicate that the appellant was seen for a psychiatric evaluation in January 1993, at which time it was indicated that he had no history of psychiatric treatment until May 1992 when he was seen for progressive auditory hallucinations that started a few months before. Following his mental status evaluation, the pertinent diagnoses were adjustment disorder with depressed mood and organic psychotic condition. The records indicate that the appellant was subsequently seen for medication maintenance. At his personal hearing in September 1995, the appellant indicated that he served aboard the U.S.S. Guam for 3 days during which time two helicopters collided and blew up; he noted that people were burned and others had to be fished out of the water. The appellant reported that other helicopters were sent for to take them back to camp. The appellant indicted that he began experiencing hallucinations involving the collision; he stated that he saw a psychiatrist at the base camp who told him that the hallucinations and voices would go away. The appellant related that he was attached to the H&MS 49 unit and was stationed at Willow Grove Naval Air station when the incident occurred; he also indicated that a commanding officer, "Colby," from the unit was killed during the incident. The appellant's wife and friend testified that he began having hallucinations after his period of active duty aboard the U.S.S. Guam. The appellant indicated that he was seeing a psychiatrist once a month; he indicated that he was taking Mellaril and Prozac. He also reported that he had been receiving Social Security Disability benefits for the past five years based on his psychiatric disorder. Of record is a statement from the Office of the Commandant of the Marine Corps, Records Correspondence Section, dated in August 1996, indicating that a search of the unit diaries of H&MS-49 and MAG-49 failed to show any indication of casualties sustained during the period the appellant was on Active Duty for Training from June 18 to July 2, 1983. It was also reported that they had been unable to verify the death of Lieutenant Colonel Kolby through the unit diaries. Received in November 1996 were private treatment reports dated from June 1995 to October 1996, which show that the appellant received ongoing clinical evaluation and treatment for a psychiatric disorder. A psychiatric evaluation conducted in June 1995 revealed a diagnosis of unspecified organic psychosis. At his personal hearing in August 1997, the appellant reiterated the history of the incident that occurred aboard the U.S.S. Guam. One witness who served on active duty for training with the appellant testified that he was also aboard the U.S.S. Guam when two helicopters collided and blew up, resulting in many casualties; he stated that eleven crew members were killed, but he was unable to recall the names of the casualties. The witness reported that he noticed a change in the appellant's attitude and behavior after the incident. The appellant's wife and mother also testified to witnessing a change in his behavior following his period of active duty for training. The appellant reported that although he was told that the voices would go away they did not; he stated that he eventually sought help and was diagnosed with PTSD. The appellant indicated that he also suffered from schizophrenia for which he was taking several medications. Received in April 1998 were private treatment reports dated from January 1993 to March 1998, indicating that the appellant received ongoing clinical attention and treatment for a psychiatric disorder. Received in August 1998 were medical records from the Social Security Administration, dated from May 1992 to January 1993, indicating that the appellant was found to be disabled due to paranoid schizophrenia beginning March 1, 1992. Among these records is a psychiatric evaluation conducted by Dr. Raihana R. Batra in June 1992, wherein he indicted that the appellant had never made a good social adjustment since his service; he also noted that the appellant had a poor work history. Following a mental status evaluation, the pertinent diagnosis was personality disorder, NOS. Among the above records was a private medical statement from Carl D. Herman, M.D., dated in October 1992, indicating that the appellant attended the Drew Community Mental Health Clinic once a month and that he was maintained on Haldol, Lorazepam, and Valporic acid. Following a mental status evaluation, the pertinent diagnosis was schizophrenic disorder, paranoid type. The examiner indicted that there were some aspects of PTSD manifested by psychosis. The examiner also stated that there may be subtle organic factors playing some part as to the appellant's developing a psychotic reaction as opposed to the other more typical character and neurotic reactions to stress. Received in October 1998 were private treatment reports dated from October 1991 to May 1992, indicating that the appellant was brought to a hospital in October 1991, complaining of seeing green men for the past two months; the pertinent diagnosis was organic hallucinosis. The appellant was next seen in May 1992 complaining of severe depression and hallucinations. At that time, the appellant reported being shot in the head two years prior to his visit and several family tragedies, all of which precipitated his depression. The appellant denied any previous psychiatric problems. Following a psychiatric evaluation, the pertinent diagnosis was atypical psychosis. Received in May 1999 was a Microfiche of the appellant's complete 201 file, which provided similar information previously on file regarding periods of active duty and inactive duty for training. Also received in May 1999 was a Microfiche of the complete 201 file of the individual who testified on the appellant's behalf at the August 1997 hearing. These records reflect a period of active duty for training during the period from July 11, 1981 to July 26, 1981. Of record is a private medical statement from the Northwestern Human Services of Philadelphia, dated in July 1999, indicating that the appellant had been receiving treatment for a psychiatric disorder since 1992. It was also reported that the appellant was currently unemployable because of his mental illness. Received in December 1999 from the veteran was a September 1999 statement from a physician at Northwestern Human Services of Philadelphia, an October 1999 statement from Dr. Joel H. Jaffe, a copy of a portion of a page (undated) from the Philadelphia Inquirer regarding a helicopter crash aboard the amphibious assault ship Guam, and a print out from the Philadelphia Inquirer of the same article, which was dated July 21, 1981. The former medical statement noted that the appellant's current diagnosis is psychosis, not otherwise specified. It was further indicated that a concern was that the appellant was additionally suffering from PTSD because he stated that his problems started in 1981 while he was working in the Marines and witnessed the crash of two helicopters. The latter medical statement indicated that the appellant suffered from PTSD related to a 1981 helicopter crash. As noted earlier, the appellant waived initial review of this evidence by the ROIC. B. Legal analysis. The appellant essentially contends that service connection is warranted for a psychiatric disorder which developed as a result of an incident which occurred while on active duty for training. He maintains that, while aboard the U.S.S. Guam, he witnessed the collision of two helicopters, one of which occasionally took him back to his camp. He indicates that, since the incident, he has had constant auditory and visual hallucinations. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated while performing active duty for training or injury incurred or aggravated while performing inactive duty for training. 38 U.S.C.A. §§ 101(24), 106, 1110, 1131 (West 1991); 38 C.F.R. § 3.303(a) (1999). Service connection may be granted for a psychosis when it is manifested to a degree of 10 percent disabling within one year following release from active duty. 38 U.S.C.A. §§ 1101, 1112, 1113 (West 1991); 38 C.F.R. §§ 3.307, 3.309 (1999). The one-year presumptive period, however, does not apply for active duty for training or inactive duty for training. See Biggins v. Derwinski, 1 Vet. App. 474 (1991). The chronicity provision of 38 C.F.R. § 3.303(b) is applicable where evidence, regardless of its date, shows that a claimant had a chronic condition in service, or within the presumptive period after service, and that he still has such condition. See also 38 C.F.R. § 3.303(d). Such evidence, however, must be medical unless it relates to a condition as to which lay observation is competent. If the chronicity provision is not applicable, a claim may still be well- grounded on the basis of 38 C.F.R. § 3.303(b) if the condition is observed during service or during any applicable presumptive period after service, provided that continuity of symptomatology is demonstrated thereafter, and if competent evidence relates the present condition to that symptomatology. Savage v. Gober, 10 Vet. App. 488, 498 (1997). The threshold question to be answered in the appellant's appeal is whether he has presented evidence of a well- grounded claim. Under the law, a person who submits a claim for benefits shall have the burden of submitting evidence sufficient to justify a belief by a fair and impartial individual that the claim is well-grounded. 38 U.S.C.A. § 5107(a); Tirpak v. Derwinski, 2 Vet. App. 609 (1992). If a claim is not well grounded, the application for service connection must fail, and there is no further duty to assist the claimant in the development of his claim. 38 U.S.C.A. § 5107, Murphy v. Derwinski, 1 Vet. App. 78 (1990). The Court has held that in order for a claim to be well grounded, there must be competent evidence of incurrence or aggravation of a disease or injury in service, of a current disability, and of a nexus between the in-service injury or disease and the current disability. See generally Epps v. Gober, 126 F.3d 1464 (Fed. Cir. 1997); Caluza v. Brown, 7 Vet. App. 498, 506 (1995), aff'd, 78 F.3d 604 (Fed. Cir. 1996) (table). Medical evidence is required to prove the existence of a current disability and to fulfill the nexus requirement. Lay or medical evidence, as appropriate, may be used to substantiate service incurrence. See Layno v. Brown, 6 Vet. App. 465, 469 (1994); Grottveit v. Brown, 5 Vet. App. 91, 93 (1993). After a careful review of the evidentiary record, the Board notes that the service records are negative for any complaints or findings of a psychiatric disorder. The appellant has testified that he witnessed the collision of two helicopters during active duty for training (the date has variously been identified as 1983, but was in July 1981), and evidence recently submitted confirms such an occurrence aboard the U.S.S. Guam and the death of Lt. Col. Kolbe, in July 1981, a period during which the appellant served on active duty for training. The post-service medical records, however, show that the appellant was first treated for psychiatric symptoms in the 1990s, many years after service. Significantly, there is no medical evidence to establish a causal link between the veteran's current psychiatric disorder and military service. While medical evidence has opined that the appellant may be suffering from PTSD due to the helicopter crash, service connection for PTSD has never been the subject of ROIC rating action and service connection for PTSD is not currently before the Board. Rather, the Board's current review is limited to the issue of service connection for a psychiatric disability other than PTSD. The appellant has not offered any medical opinion that attributes his currently diagnosed psychiatric disorder, with diagnoses including schizophrenia, to his active duty for training. However, as previously referenced, a claimant may still obtain the benefit of § 3.303(b) by providing evidence of continuity of symptomatology. Evidence of continuity is determined by symptoms not treatment. However, in determining the merits of a claim, the lack of evidence of treatment may bear on the credibility of the evidence of continuity. The Board notes that there is no evidence that the appellant suffered from the symptoms of any type of psychiatric disorder between 1983 to 1992. Moreover, the correct diagnosis of any psychiatric disability is not within the competence of a lay person. Furthermore, continuity of symptomatology has not been shown. In fact, the evidence of record establishes that a psychiatric disorder was first diagnosed in May 1992. As such, service connection for a psychiatric disorder (other than PTSD) is not warranted. 38 C.F.R. § 3.303. The Board has considered the testimony that the appellant has continually suffered from symptoms of a psychiatric disorder since his active duty for training. Although the appellant's statements and sworn testimony are probative of symptomatology, they are not competent or credible evidence of a diagnosis, date of onset, or medical causation of a disability. See Grottveit v. Brown, 5 Vet. App. 91, 93 (1993); Espiritu v. Derwinski, 2 Vet. App. 492, 494-95 (1992); Miller v. Derwinski, 2 Vet. App. 578, 580 (1992). The appellant lacks the medical expertise to offer an opinion as to the causation of any current disability. Id. In the absence of competent, credible evidence of causation, a well- grounded claim of service connection for a psychiatric disorder (other than PTSD) has not been presented. Similarly, the Board has considered the statements and testimony of the appellant's wife, mother, and his friends, which assert, in essence, that the appellant has exhibited signs of a psychiatric disability since service. The statements and testimony, however, do not provide a basis for relating a psychiatric disorder to service nor are these individuals competent to make that medical connection. See Espiritu v. Derwinski, 2 Vet. App. 492 (1992). ORDER Entitlement to service connection for an acquired psychiatric disorder (other than PTSD) is denied as not well-grounded. BARBARA B. COPELAND Member, Board of Veterans' Appeals