BVA9500338 DOCKET NO. 91-50 283 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Portland, Oregon THE ISSUE Entitlement to service connection for an acquired psychiatric disorder, claimed as post-traumatic stress disorder. REPRESENTATION Appellant represented by: John C. Keenan, Attorney WITNESSES AT HEARING ON APPEAL The appellant, his spouse, and his physician ATTORNEY FOR THE BOARD Frank L. Christian, Counsel INTRODUCTION The veteran served on active duty from August 1966 to August 1972 and from August 31, 1977, to September 14, 1977. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a rating decision of December 1989 from the Department of Veterans Affairs (VA) Regional Office (RO) in Portland, Oregon. Jurisdiction of the veteran's claims file has since been transferred to the VA Regional Office, Boise, Idaho. CONTENTIONS OF APPELLANT ON APPEAL The appellant contends that the RO erred in failing to grant service connection for an acquired psychiatric disorder, claimed as post-traumatic stress disorder (PTSD), because it did not take into account or properly weigh the medical and other evidence of record. It is contended that the appellant has PTSD as a consequence of combat stressors experienced during his period of service in the Republic of Vietnam. It is contended that PTSD was diagnosed by both private and VA health care professionals and that the VA is bound to accept that diagnosis. It is contended that the VA psychiatric evaluation conducted in October 1992 was inadequate and insufficient in duration, that the examiner did not have access to the veteran's claims file, that the report of such examination should be disallowed as evidence, and that another VA psychiatric evaluation should be scheduled. 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 for entitlement to service connection for an acquired psychiatric disorder, including post-traumatic stress disorder. FINDINGS OF FACT 1. All relevant evidence necessary for an equitable disposition of the instant appeal has been obtained by the RO. 2. The record does not show that the veteran engaged in combat with the enemy; a verifiable stressor is not demonstrated. 3. The evidence as a whole does not establish a link between the veteran's current psychiatric disability and any event of the veteran's military service. 4. An acquired psychiatric disorder, exclusive of PTSD, was not manifest during active service or on service separation examination; and a psychosis was not demonstrated during the initial post-service year. 5. A personality disorder was diagnosed during the veteran's second period of active service. CONCLUSIONS OF LAW 1. An acquired psychiatric disorder, claimed as PTSD, was not incurred in or aggravated during active service; and the service incurrence of psychosis may not be presumed. 38 U.S.C.A. §§ 1101, 1110, 1112, 1131 (West 1991); 38 C.F.R. §§ 3.304(f), 3.307, 3.309 (1993). 2. Personality disorders are not diseases within the meaning of applicable regulations providing for payment of VA disability compensation benefits. 38 C.F.R. § 3.303(c) (1993). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Board finds initially that the appellant's claim is "well grounded" within the meaning of 38 U.S.C.A. § 5107(a) (West 1991), which mandates a duty to assist the veteran in developing all pertinent evidence. The record shows that the RO has obtained the veteran's service medical records, service administrative records, military unit operation reports, private and VA medical records, and medical and administrative records from the Social Security Administration. Further, the appellant has been afforded VA psychiatric evaluations in October 1987 and in October 1992 and testified at a personal hearing on appeal held at the RO in February 1991. On appellate review, we see no areas in which further development might be fruitful. Letters from the veteran, his spouse, and his attorney, received in early 1994, faulted the VA neuropsychiatric evaluation of October 1992 as inadequate, unprofessional, incomplete, and conducted without the veteran's medical records. The Board notes that the cited examination report appears on its face to be complete and comprehensive and to comply with applicable provisions of the Physician's Guide for Disability Evaluation Examinations pertaining to the conduct of VA neuropsychiatric evaluations. Further, the examination report indicates that, in fact, the examiner had access to the veteran's claims file and medical history. The Board finds no basis to disallow this report from the evidentiary record. In order to establish service connection for claimed disability, the facts, as shown by evidence, must demonstrate that a particular disease or injury resulting in current disability was incurred during active service or, if preexisting active service, was aggravated therein. 38 U.S.C.A. §§ 1110, 1131 (West 1991). Service connection may also be granted on a presumptive basis for certain chronic disabilities, including psychosis, when they become manifested to a compensable degree within the initial post-service year. 38 U.S.C.A. §§ 1101, 1112 (West 1991); 38 C.F.R. §§ 3.307, 3.309 (1993). In determining whether an injury or disease was incurred or aggravated in service, the evidence in support of the claim is evaluated based on the places, types, and circumstances of service as shown by service records, the official history of each organization in which the veteran served, the veteran's medical records, and all pertinent medical and lay evidence. 38 U.S.C.A. § 1154(b) (West 1991); 38 C.F.R. §§ 3.303(a), 3.304 (1993). Even where there is a lack of official records to corroborate that an injury or disease was incurred or aggravated during service (including a period of combat), the VA is required to accept as sufficient proof of service connection satisfactory lay or other evidence that an injury or disease was incurred or aggravated during such period of service, if the evidence is consistent with the circumstances, conditions, or hardships of such service. 38 U.S.C.A. § 1154(b) (West 1991); 38 C.F.R. §§ 3.303(a), 3.304 (1993). 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 the veteran 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. 38 U.S.C.A. § 1154(b) (West 1991); 38 C.F.R. § 3.304(f) (1993). The record shows that the veteran served on active duty from August 1966 to August 1972, including a tour of duty in the Republic of Vietnam from October 1967 to June 1968. He also served a brief period of active duty from August 31, 1977, to September 14, 1977, during which no exposure to combat stressors is alleged or established. Morning Reports obtained from the National Personnel Records Center (NPRC) show that, during the veteran's period of Vietnam service, his military occupational specialty was Operator of Manual Telephone Switchboard (72C20). His DD Form 214 from his first period of active service shows that his military occupational specialty was changed in April 1970, subsequent to his Vietnam service, to Hawk Fire Control Repairman (23Q20). He was not awarded the Purple Heart Medal or the Combat Infantryman Badge, and received no combat decorations or awards for valor. Service medical records from the veteran's first period of active service were obtained from the service department in August 1972 and appear to be complete. These records would not have been affected by the fire at the National Personnel Records Center in July 1973 and are silent for complaint, treatment, or findings of a psychiatric disorder. In a report of medical history prepared in connection with his service separation examination, the veteran denied any history of depression, excessive worry, or nervous trouble of any sort. His service separation examination, conducted in August 1972, disclosed that his psychiatric evaluation was normal. Service medical records from the veteran's second period of active service include a narrative summary showing that he was hospitalized on the neuropsychiatric ward on the day following service entry. He offered a recent history of multiple family problems, financial woes, and current suicidal ideation, and appeared tearful and agitated. He was admitted for observation and evaluation as to suitability for service. A history of ongoing psychiatric evaluation and treatment related by the veteran at the time showed that he came from a very disturbed family background, that his father was a physically abusive alcoholic, that his mother died when he was age 16, and that his childhood was unpleasant. He stated that he began associating with a juvenile street gang at age 11, that he became a "cat burglar," and that he was constantly in trouble at school for fighting, talking back to teachers, and other misbehaviors. He was sent to reform school for one year at age 14 and, following his release, was expelled from several schools for serious misbehavior. He quit school at age 16, lived in a "commune" for one year, and allegedly was given a choice of service enlistment or parole revocation by his parole officer. He stated that, during his initial period of active service, he had several serious problems involving drug use, was once institutionalized in a halfway house, had two suicide gestures, and was hospitalized for one week and subsequently seen in outpatient counseling for psychiatric causes. He claimed that he experienced an "emotional breakdown" while in Vietnam, leading to this transfer back to the United States. Between his periods of active service, he was reportedly married, experienced severe marriage problems, and was divorced. He dated the onset of depression to the Spring of 1975, and he attributed his current depression to the treatment he received during his first day of recruit training. Mental status evaluation disclosed poor eye contact and a mood of moderate depression. His affect was tearful and upset, and his thought content was preoccupied with feelings of failure and inadequacy. He offered subjective and somatic symptoms of depression, including disturbed sleep and appetite and suicidal ideation, but exhibited no symptoms of psychosis. He possessed some insight into his behavior and spoke fluently of his problems, but appeared unable to use his insight to change his behavior. He was completely unmotivated for further service and stated a strong desire for a discharge from service. After several days on the ward, he appeared less depressed. His mood brightened when he was informed that he would be recommended for discharge. At no time did he exhibit symptoms of psychosis, serious clinical depression, or suicidal ideation; and medication was not required. His depressive symptoms, which cleared rapidly, were judged to be a consequence of situational stress and characterological disturbance, not of neurosis. Psychological testing with the Minnesota Multiphasic Personality Inventory (MMPI), history, and clinical observation all supported the diagnosis of severe inadequate personality. The final diagnosis was inadequate personality, severe. He was discharged on September 14, 1977, due to unsuitability--personality disorder, and was not recommended for reenlistment. Treatment records from the Oregon City Orthopedic Clinic, dated in September and October 1984, show that the veteran was seen for treatment of a fractured os calcis, right foot. The examiner noted that the veteran was obviously depressed, citing trouble with child support payments and inability to return to his prior occupation. He stated that he knew that the veteran enjoyed working with guns and suggested that he consider becoming a gunsmith. In an October 1985 "threat letter" to the Social Security Administration, the veteran threatened to kill personnel whom he considered responsible for the denial of Social Security Administration disability benefits. An undated letter from a private orthopedist stated, in passing, that review of the veteran's medical records indicated that psychological factors had been a problem in the past and suggested that they might be situational in nature. A January 1986 letter from R. Turco, M.D., stated that he reviewed the veteran's medical records and performed a psychiatric evaluation on that date. He cited the veteran's October 1985 "threat letter" to the Social Security Administration. He indicated that the veteran's major current complaint was continuing pain from his heel and ankle injury. Apart from his physical complaints, the veteran stated that he was easily angered and experienced difficulty in dealing with other people, which the examiner indicated was "personality oriented." He recounted the veteran's description of his childhood, including his statement that he had difficulty in getting along, was "...a slum child,...a street urchin,...a cat burglar..." who ended up in reform school. The veteran stated that he falsified his age, entered military service, spent six years in the military, and enjoyed it. He stated that he served in Vietnam, Germany, and Korea and experienced a traumatic reaction, primarily anger, while stationed in Nha Trang. He stated that he was "in my element" while in military service. He entered college in 1974, but had problems with the school administration and quit. He recounted a history of various short-term jobs and attributed the loss of those jobs to "office politics," to his being a "rebel," and to conflicts with his supervisors. He was reportedly involved in a gunfight in August 1982 when he "tried to make a citizen's arrest" and shot up another individual's automobile. The veteran's mental status evaluation was described as normal, although he had some suspicious thoughts and a tendency toward paranoid ideation in the context of personality. He did not appear to the examiner to be phobic, anxious, or overtly depressed. The examiner stated that the veteran had unresolved feelings of great importance which had to do with his development, as well as unresolved feelings of hostility regarding "unfairness in life" which were said to relate to his parents, his involvement in the community, and the way he was treated during his development. This sense of difficulty apparently continued throughout the veteran's life, and there had been a major contribution to the sense of anger and disappointment by his Vietnam experiences. The examiner stated that the veteran's overall personality functioning had been marginal throughout his life, that he was able to adapt only when he was in military service, and that he was "a fish out of water" following service and had problems with adjustment in civilian society. It was further indicated that the veteran harbored long-term resentment regarding his early relationships in his family and problems that he had during his development. The examiner stated that there was a long history of antisocial behavior, which continued, as well as elements of impulsivity. The diagnosis was mixed personality disorder, including elements of schizoid, paranoid, passive-aggressive, and antisocial features which predated service entry. A March 1986 private medical summary following psychiatric review offered a diagnosis of personality disorders. An April 1986 decision by an Administrative Law Judge, Social Security Administration, considered the evidence presented, including his own observation of the veteran and a June 1985 opinion of possible delayed stress syndrome, and determined that the veteran was disabled as defined in the Social Security Act due to post-traumatic left subtalar arthritis, status post fusion of the left subtalar joint with residual pain, and a mixed personality disorder with antisocial, impulsive, schizoid, paranoid, and passive-aggressive traits. The evidence shows that the veteran was hospitalized at a VA medical facility on two occasions in June and July and in July and August 1987. VA outpatient clinic records dated in July 1987 show that he was treated with antipsychotic medications, and no diagnosis of PTSD was shown. A VA hospital summary dated in July and August 1987 stated that the veteran was admitted with complaints of depression after his wife left him. A history of major depression with panic attacks, PTSD, and polysubstance abuse was noted. The diagnoses at hospital discharge included major depression with anxious features, PTSD with marital discord, possible intermittent explosive disorder, and mixed personality disorder. A PTSD questionnaire completed by the veteran in August 1987 stated, in pertinent part, that he was a very problemed [sic] and difficult child in school, that during his Vietnam service he worked 12 hours a day, seven days a week as a switchboard operator in Nha Trang, and that he then spent at least two hours daily filling sandbags. He stated that, in addition to "routine- type harassment attacks," he was present at the beginning of the Tet Offensive, that weapons were locked in racks, and that it caused him to experience nightmares both day and night. He further indicated that he was with a signal unit based at Camp McDermott in Nha Trang and was officially attached to the 1st Field Force. There was no mention of combat service, of killing anyone, or of seeing others wounded or killed. He described his main job as technical, stated that he served in a unit which supported a combat unit, described his military experience as both good and bad, and stated that he had no time to adjust after returning home. He described his adjustment problems as inability to hold a job, to get along with others, to develop or maintain close relationships, or to obey the rules. A report of VA social and industrial survey, dated in October 1987, cited a history offered by the veteran of having an alcoholic father, an unpleasant childhood, and of being sexually molested by an uncle between ages 7 and 12. He reported difficulty in school beginning in the third grade and problems with teachers. He stated that he served in a support unit while in Vietnam and was there during the Tet Offensive. He stated that he was not wounded, although others he served with were killed or wounded. He indicated that he had daily contact with Vietnamese civilians and liked them, and that he witnessed no atrocities. He asserted that he subsequently "threw down his weapon and quit," was sent to see a psychiatrist, and was sent to Bangkok for one week's rest and rehabilitation. When he returned to his unit, he was sent home due to his father's illness. He indicated that during his service in Germany, he was a "renegade," using a lot of drugs, and was perceived as a troublemaker. He stated that he had a "real drug problem" while stationed in Korea, and was given a drug treatment amnesty. He reported an unstable post-service employment history and marital history. He asserted that, following his reentry into military service in 1977, he had a "psychotic break," and further claimed that he was medically discharged. He described his history of difficulty with the police, incarceration, and medical treatment. He asserted that he experienced nightmares relating to his Vietnam experiences on a nightly basis, daily recollections of his Vietnam experiences, and a "very high startle response." He claimed that being around Vietnamese refugees "made him crazy." He claimed that he had no friends but several acquaintances, was not close to anyone, kept in touch with his younger sister, and spent his time sitting around the house, watching television, listening to music, and doing household chores. At night, he watched television and old movies with his wife, and he played pool in a bar once a week. A report of VA neuropsychiatric evaluation, conducted in October 1987, noted that the veteran did not make eye contact, spoke slowly, looked depressed, and did not change expression during the interview. The veteran was described as exhibiting psychomotor retardation, and he claimed both auditory and visual hallucinations, including tracers flying in the air and hearing Vietnamese voices while incarcerated. The veteran asserted that he operated a switchboard while stationed in Nha Trang, Republic of Vietnam. He claimed that he saw "a great deal of combat while stationed in Nha Trang," that he was a perimeter guard during the Tet Offensive, and that he was in a number of fire fights. He stated that they were frequently rocketed or mortared and that he was randomly assigned to "mop-up" groups for "search-and-destroy" activities. He claimed that he saw a number of men killed in close proximity to himself, that there were a number of casualties in his unit, and that he was involved in killing a number of North Vietnamese Army personnel and civilian combatants. The veteran further claimed that he experiences daily flashbacks involving Vietnam experiences, a heightened startle response, avoids war-related movies, is hypervigilant, has lost interest in everything but weapons, experiences survivor guilt, and felt guilt over the killing he did in Vietnam. He stated that he avoided crowds, has trouble with authority figures, cannot get along with supervisors, frequently breaks into tears without reason, and does not work because of a lack of emotional energy. He described himself prior to service entry as "a hard-assed little street rat caught up in seeking pleasure." Mental status evaluation disclosed problems with concentration. The veteran did not display signs of obsessions, delusions, or compulsions. Mental status evaluation was otherwise normal. However, the examiner stated that, based on the available information and current mental status evaluation, the veteran was felt to warrant a diagnosis of PTSD, chronic, and major depressive disorder. A July 1989 letter from a VA psychiatrist to the Social Security Administration stated that she had been working with the veteran since June 1987 for difficulties related to major depression, PTSD, and chronic pain syndrome secondary to a foot injury and tension/migraine headaches. She stated that the veteran suffered from depression, sleep and appetite disturbances, anhedonia, anergia, anxiety, and feelings of worthlessness and guilt. He also reportedly experienced frequent intrusive and distressing recollections of traumatic events in his life, with nightmares and flashbacks, exacerbated with reminders of the trauma. The veteran was said to struggle with emotional lability, irritability, and anger, and to suffer from feelings of alienation and mistrust of others, with subsequent disruption of his personal relationships and social isolation. His feelings of emptiness and loss of identity reportedly interfered with his attempts to pursue meaningful life goals and left him with a state of tension and low self-esteem. These factors were said to have disrupted social and work relationships, and it was noted that he and his family were under financial hardship, which contributed to his psychological distress. A personal hearing on appeal was held at the RO in February 1991. The veteran testified that during his tour of duty in Vietnam he was assigned to Company A, 54th Signal Battalion, 1st Field Force, in Nha Trang. He identified this unit as a headquarters unit and stated that his specific duties were as a switchboard operator. He stated that Nha Trang was a city which was considered impregnable, that it was the in-country rest and rehabilitation center, that 50,000 allied troops were stationed there, and that for that reason none of his unit carried weapons. He further testified that, "as noncombatants, we were not allowed access to weapons," but indicated that following the commencement of the 1968 Tet Offensive, he was issued a rifle and assigned as perimeter guard. He related two stressful incidents occurring shortly after his arrival in Vietnam, the first of which involved Vietnamese children giving him photographs of the cockpits of fighters and helicopters. He did not state why he found that event stressful. The second stressful incident, as related by the veteran, involved his observation of a Vietnamese civilian throwing a case of Prell shampoo over the fence to a waiting Army of the Republic of Vietnam soldier and his subsequent shooting of the civilian, killing him. He further testified that he volunteered to go into a nearby Vietnamese village, which he described as a "rat's nest," to "clean it out." He did not indicate that he personally killed or wounded any more Vietnamese, but stated that he subsequently "threw down [his] weapon and quit." He related that he talked to a psychologist or psychiatrist at the local dispensary, that he was sent on rest and rehabilitation leave, and that, upon his return, he was on his way out of Vietnam within an hour. J. Leone, M.D., a VA psychiatrist appearing as a witness for the veteran, stated that the veteran was admitted to a VA hospital (in 1987) due to "a combination of stressful events." She testified, in pertinent part, that one of the issues of his treatment had to do with childhood trauma, as well as Vietnam trauma, and that she thought that Vietnam trauma had "layered on top of childhood trauma and perhaps exacerbated that...." The veteran's spouse offered her observations and conclusions concerning the veteran's mental status and behavior during the year that they had been together prior to the hearing. She related two "flashback" episodes, the first described as a "stress-related seizure" and the second as a panic episode involving the Tet Offensive. She testified that the veteran sometimes went camping in the mountains with his friends, described as bikers and Vietnam veterans, that he kept a gun next to the bed, and that he seldom entered shopping malls and grocery stores with her, but remained in the family vehicle. A transcript of the testimony is of record. A VA hospital summary, dated in February 1991, stated that the veteran was admitted with complaints of anxiety associated with his pending VA hearing. The diagnoses at hospital discharge included PTSD, major depression, rule out benztropine and barbiturate dependency, and borderline personality disorder. A report of VA psychiatric evaluation, conducted in October 1992, cited the veteran's statement that he lives with his wife, has no close friends, and receives Social Security Administration disability benefits. He stated that he sits around, does not do anything, reads gun books, and enjoys working with plants and taking care of his weapons, including "edged weapons, handguns, rifles and shotguns." He stated that he last worked in 1984, prior to a foot injury, and that when he was working he carried a gun all the time. He claimed that, during active service, he was a military policeman, a missile technician, and was in communications and radio. He attributed his current psychiatric illness to stress stemming from his Vietnam experience, claiming that he was assigned to "clean out" a Vietnamese village. He stated that on the first night of the Tet Offensive, he was changed from switchboard duty to small arms infantry. He asserted that in May 1968, he threw down his weapon, was given a bottle of tranquilizers by a psychiatrist, went on rest and rehabilitation leave, and was given a Red Cross compassionate leave. The veteran described subsequent problems in the military "with authority, with rules, with regulations,...," and stated that he got heavily into drug use. He cited recent VA hospitalization and claimed occasional paranoid and psychotic episodes. He further stated that he stays fairly socially isolated. Mental status evaluation disclosed that his affect was somewhat distant, but he had a normal range of affective expressions. His behavior was within normal limits, he showed no significant psychomotor retardation or agitation, and no threatening or suspicious-type behavior was exhibited. Memory was intact, there was no evidence of delusions or hallucinations, thinking was goal-directed, and there was no evidence of a thought disorder, or full spectrum biological symptoms of a major mood disorder. The veteran claimed that his weight and appetite fluctuated and that his sleep was often restless. There was no indication of anhedonia, a lack of energy, a sense of hopelessness, or of suicidal ideation. He indicated that he had hobbies and things he enjoyed doing, expressed positive future plans, and showed no signs of hypervigilance or a heightened startle response. There was no indication of flashback issues or of emotionally reliving post-traumatic events. There was no increased surveillance or other symptoms evidencing a current PTSD. During the interview, he showed no impairment of social abilities, communication abilities, or inability to interact or trust others, and there was no real sense of mistrust or oversuspiciousness. The examiner indicated that he had reviewed the veteran's claims file and the full medical record. He further stated that, irrespective of the veteran's personal history of his Vietnam experiences, he showed no clear evidence on current examination of PTSD syndrome, a generalized anxiety disorder, or symptoms of major depression. No Axis I diagnosis was offered, and a personality disorder developmental disorder was shown as an Axis II disorder. A private hospital summary from CPC Intermountain Hospital, Boise, Idaho, dated in March and April 1993, shows that the veteran was admitted after deciding to discontinue his treatment at a VA medical facility. He stated that he had not gotten along with his VA psychiatrist for five years. He claimed that he was a Vietnam veteran, had flashbacks of his Army experiences, and had flashbacks of experiences during his younger years when, he asserted, he was an enforcer for a motorcycle gang. He claimed that he was in receipt of Social Security Administration disability benefits due to a foot injury and due to PTSD and major depression. He related that he was married and had four children, but was not close to them. He stated that he was generally able to control his unresolved and underlying anger, was not a violent and aggressive person, but felt pressured around people. He was unemployed, and he stated that he spent his days taking his wife to work, sitting around, getting his wife from work, and sitting around. Mental status evaluation disclosed that he was rather withdrawn, had a flattened affect, and showed no evidence of a loss of contact with reality. No delusions were found, and it was unclear whether he was hallucinatory due to claims of trouble with flashbacks or things of that sort. Memory was intact, impulse control was good, judgment was good, and some insight was present with respect to feelings of anger and frustration at the whole world and various institutions. The tentative diagnoses on admission included major depression and PTSD, with some suspected mixed diagnoses. Hospital treatment records dated in March and April 1993 included a reiteration of diagnoses of major depression and PTSD. A letter from a State rehabilitation counselor, dated in January 1994, stated that the veteran had been found to be eligible for vocational rehabilitation services due to PTSD; recurrent major depression; a mixed personality disorder; left foot, ankle, and knee problems; drug and alcohol abuse in remission; ulcers by history; and migraines. It was stated that the veteran could be expected to have difficulty with authority figures and in dealing with stress, tending to become agitated and having periods of decreased productivity. A letter from a Veterans Center social worker, dated in March 1994, reported a history of military and civilian experiences based solely on a history and symptom report obtained from the veteran. The veteran's symptoms reportedly included combat- related nightmares, intrusive thoughts, difficulty sleeping, problems with memory and concentration, flashbacks, and hypervigilance. Service administrative records obtained from the National Personnel Records Center (NPRC) show that the veteran arrived in Vietnam in October 1967 and was assigned to Headquarters, Company A, 54th Signal Battalion, located at Nha Trang, Republic of Vietnam. In March 1968, he was reduced in grade from Specialist Four (SP4) to PFC3. Later in March 1968, he was sent to Bangkok for seven days' rest and rehabilitation (R&R). In April 1968, he was sent on emergency leave for approximately 45 days. Operations Reports and a Unit Chronology from the 54th Signal Battalion reflect that it provided tactical communications in support of the 1st Field Force, operating from the Grand Hotel Main Command Post Complex in Nha Trang and in 16 detachments providing communication support throughout the II Corps Tactical Zone. During the period from November 1, 1967, through January 31, 1968, there was one individual wounded in a bombing incident and one death involving a combat photographer. An Operational Report for the period from February 1, 1968, through April 30, 1968, from the 1st Field Force, Vietnam, shows that the City of Nha Trang was attacked by enemy elements on January 30, 1968. United States troops responded and by February 1, 1968, had eliminated all but scattered pockets of resistance. None of the information cited above reflects that the veteran was personally involved in combat operations at any time during his period of Vietnam service. A letter from the United States Army and Joint Services Environmental Support Group (ESG), received in August 1993 and accompanying the Operations Reports and Morning Reports described above, stated, in pertinent part: "Given Mr. [redacted]'s duty assignment, it is likely that he relayed radio messages. However, we are unable to verify that Mr. [redacted] participated in perimeter patrols. We can only verify, by his DA Form 20, that he was a switchboard operator assigned to a signal unit during his Vietnam tour." The letter further stated that anecdotal incidents, including those related by the veteran, might be true but could not be verified. Service medical records from the veteran's second period of active service included a report of medical history, prepared by the veteran in connection with his service entrance examination, in which he denied any history of depression, excessive worry, or nervous trouble of any sort. His service separation examination, conducted in June 1977, showed that his psychiatric evaluation was normal. A notation by the recruiting officer states that the veteran's enlistment had been authorized by the Commander, Navy Recruiting Area Five, notwithstanding the veteran's reenlistment code from his prior enlistment or his police record. The veteran's service entrance examination, conducted in June 1977, showed that the veteran's psychiatric evaluation was normal. We have carefully examined the record and are convinced that there is insufficient evidence to support a finding of PTSD stemming from the appellant's military service. Contrary to the contentions of the appellant, the Board is not bound to accept his uncorroborated account of his Vietnam experiences, nor is the Board required to accept the opinions of private and VA psychiatrists and social workers that the alleged PTSD had its origins in the appellant's Vietnam service. The Board has the duty to assess the credibility and weight to be given to the evidence. Wood v. Derwinski, 1 Vet.App. 190 (1991). Neither the appellant's military occupational specialty (Operator of Manual Telephone Switchboard) nor his service medical records disclose that the nature of his duties exposed him to a more than ordinary stressful environment, even given the fact that service in a combat zone is stressful in some degree to all who are there, whatever their duties and experiences. Wood, Id. It is reasonable, therefore, for the Board to require some corroboration of the events that the appellant alleges happened to him in Vietnam. No such corroboration or substantiation is found in the service administrative records, Morning Reports, Operations Reports, and Unit Chronology associated with the record. The Board does not find it credible that a communications specialist would be assigned to combat infantry duties at a time when demands upon the communications network would presumably be at their peak. This is particularly difficult to conceive or accept given the immediate availability of 50,000 troops in the City of Nha Trang (according to the veteran). The Board does not find that the evidence contained in this record is sufficient to establish the existence of a combat stressor. We further find that the reports of private and VA medical examinations, hospital summaries, and outpatient treatment records which diagnose PTSD solely upon the basis of the veteran's claims of combat stressors and his subjective symptom reports are themselves not credible. We find noteworthy that the stressor events described by the veteran expanded with time as the need for stressors to support the diagnosis became apparent. We note, in regard to specific assertions by the veteran, that R&R was part of the routine in Vietnam Service and that the fact that the veteran was sent to Bangkok is no indication that he was having psychiatric problems. Likewise, his leave home to care for an ailing parent and his subsequent posting to a location other than Vietnam are, of themselves, no indica- tion of ongoing psychiatric problems. The Board has carefully reviewed the testimony offered at the veteran's personal hearing on appeal. We question that the two stressors identified by the veteran constitute combat stressors, and we note that neither of the claimed stressors has been verified. If the veteran did not engage in combat with the enemy, or if he did but the claimed stressor is not related to such combat, his lay testimony, by itself, will not be sufficient to establish the occurrence of the alleged stressor. Zarycki v. Brown, 6 Vet. App. 91 (1993) We do not find the veteran's testimony to be credible as it is not consistent with more contemporaneous documentary evidence. With respect to the testimony of the veteran's medical witness, we note her statement that the veteran suffers from the effects of childhood trauma and that his claimed stressful Vietnam experiences are layered over such early trauma. We further note that the individual in question has no personal knowledge of the veteran's experiencing combat stressors and relies entirely upon the inconsistent and ever-changing history provided by the veteran. We do not find this individual's testimony as to the veteran's Vietnam experiences and her diagnosis, which depends entirely upon the veteran's account of combat stressors and his subjective claims of PTSD symptomatology, to be of great probative weight. While the Board does not doubt the sincerity and loyalty of the veteran's spouse, as exemplified in her testimony, we question the accuracy and objectivity of her observations and conclusions with respect to the central issue in this case: Whether the veteran has an acquired psychiatric disorder, including PTSD, as a consequence of combat stressors experienced during his period of active service in the Republic of Vietnam. We further find that her post-hearing letter, dated in March 1994, in which she attacks the objectivity and sincerity of the Hearing Officer and the veteran's representative, as well as the professionalism of the VA psychiatrist who examined the veteran in October 1992, further militates against her credibility. Whatever her professional qualifications, the Board is of the opinion that her personal involvement and interest in the outcome of the veteran's claim is fatal to her objectivity and, ultimately, her credibility. We further find that if major depression, a psychotic disorder, is currently present, such disorder was not manifest during active service, on service separation examination, during the initial post-service year, or for many years following final service separation, and is not shown to be related to service. The personality disorder shown during the veteran's brief second period of active service is a developmental disorder which is not a disease within the meaning of applicable regulations providing for payment of VA disability compensation benefits. 38 C.F.R. § 3.303(c) (1993). We further find that the evidence of record, taken as a whole, shows that the appellant has consistently exhibited a lifelong pattern of maladaptive behavior, which continues, and that this disorder preexisted service entry, was not aggravated during active service, and is unrelated to military service. Based upon the foregoing, the Board finds that service connection for an acquired psychiatric disorder, including PTSD, is not warranted. ORDER Service connection for an acquired psychiatric disorder, including PTSD, is denied. GEORGE R. SENYK 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.