BVA9502799 DOCKET NO. 93-07 908 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Baltimore, Maryland THE ISSUE Entitlement to service connection for a psychiatric disorder. REPRESENTATION Appellant represented by: Military Order of the Purple Heart WITNESSES AT HEARING ON APPEAL Appellant, Parents, and Brother ATTORNEY FOR THE BOARD C.A. Skow, Associate Counsel INTRODUCTION The appellant served on active duty from July 1986 to July 1989. This matter came before the Board of Veterans' Appeals (the Board) on appeal from a July 1991 rating decision of the Baltimore, Maryland, Department of Veterans Affairs Regional Office (VARO). CONTENTION OF APPELLANT ON APPEAL The appellant contends that he is entitled to service connection for a psychiatric disorder. 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 entitlement to service connection for a psychiatric condition is warranted. FINDINGS OF FACT 1. Service medical records are negative for complaints, findings, or manifestations of a psychiatric disorder. 2. The appellant displayed increasingly bizarre behavior after discharge which prompted VA hospitalization for a psychiatric evaluation in January 1991. 3. The VA hospital report reflects that stresses in the military caused the appellant's initial psychotic break; the appellant was diagnosed with schizophrenia and treated with Haldol. CONCLUSION OF LAW A psychiatric disorder is shown to have been incurred in service. 38 U.S.C.A. §§ 1101, 1131, 5107(b) (West 1991); 38 C.F.R. § 3.303(d) (1993). REASONS AND BASES FOR FINDINGS AND CONCLUSION The Board finds that the appellant has submitted evidence which is sufficient to justify a belief that his claim is well grounded. 38 U.S.C.A. § 5107(a) (West 1991) and Murphy v Derwinski, 1 Vet.App. 78 (1990). Furthermore, the undersigned believes that this case has been adequately developed for appellate purposes by VARO and that a disposition on the merits is in order. Background The appellant served on active duty from July 1986 to July 1989. Service medical records are entirely negative for complaints, findings, or manifestations of a psychiatric disorder. A VA hospital report reflects that the appellant was admitted for "bizarre behavior" by his father, and treated from January to March 1991 on an in-patient basis. The father reported that 5 days earlier the appellant had telephoned him with severely slow and disjointed speech, and, when the father visited the appellant, he notice bizarre gesturing and a severe poverty of speech. It was noted that, 5 days prior to admission, the appellant was arrested for disorderly conduct when he displayed an "acute psychotic break." History recorded during the hospitalization reflects that the appellant was raised by a divorced mother and that he felt responsible for his family's well-being. He reportedly maintained B averages throughout school and entered the military after high school graduation progressing to the rank of an E-4. The examiner opined that "considering his premorbid level of intelligence and function [obtaining a level of E-4] is clearly below his potential. Clearly the stresses in the military at that time were what caused his initial psychotic break. He was able to do this well in the military only because of his premorbid level of intelligence as well as the denial that he had concerning his illness There was much structure provided him externally in the military and when he left the Army he began to rapidly decompensate." Clinical findings showed cranial nerves intact, and no sensory, reflex, or muscle strength abnormalities were found. However, the appellant was noted to be markedly catatonic, and to have poverty and slowness of motion. The appellant was observed to be thin and comically dressed with bizarre posturing while standing; he had stooped shoulders and bowed toward the right side. The appellant wore glasses without any lenses and was bradykinetic, frequently looking around the room in a "spacey manner." He was oriented times 3 and was alert although his speech was slowed, soft, and somewhat incoherent at times. He was noted to frequently state " I live in Penicillin." and "don't loan your pens or pencils." His affect was flat with occasional inappropriate laughter, his mood was neutral, and his thought processes were unorganized, tangential, and frequently incoherent with some delusional qualities and auditory hallucinations. The appellant was diagnosed with schizophrenia and treated with Haldol. In January 1992, the appellant submitted multiple lay statements from family and friends of the appellant. In the lay statements, family and friends reported that the appellant exhibited strange behavior after discharge. A review of these lay statement shows that they are essentially similar to one another and to the substance of sworn testimony rendered in February 1993. In February 1993, a personal hearing was conducted at VARO. The appellant testified in support of his claim along with his parents and brother. The appellant argued that his psychiatric problems had its onset in service even though he was not diagnosed with a psychiatric disorder until 17 months after discharge. The appellant's parents testified that they first noticed changes in their son's behavior about six months after discharge. They described the appellant as outgoing, talkative, and social prior to service. After discharge, the parents indicated that both the appellant's personality and behavior was different. He was reportedly quiet, withdrawn, irritable, disorganized and confused. They indicated that appellant went for extended periods of time without eating or sleep, and he was noted to feign sleeping on occasions. At the February 1993 hearing, the appellant's brother testified that he first noticed a change in the appellant when the appellant came home to visit shortly before discharge. The brother reported that the change was gradual and marked with increased confusion. The appellant's parents and brother testified that the appellant displayed "strange behavior" which included frequently wearing dark glasses, excessively working or exercising, abruptly disposing of all his personal belongings, talking in a slow and confused manner, walking in a hunched position, and, on one occasion, wrapping his legs in bandages for no apparent reason. They further testified that the appellant's behavior was at its oddest in December 1990, which prompted the appellant's father to admit the appellant to a VA hospital for psychiatric evaluation. Also, at the February 1993 hearing, the appellant testified that he was unaware of the changes in his personality and behavior until he received treatment. He did not recall any incident in service which may have precipitated the onset of mental illness; however, he remembered having had pneumonia, and, subsequently, feeling distrustful and uncommunicative. Additionally, the appellant reported that, during service, he was ridiculed by a drill sergeant because of he was ill and had a temperature. Analysis The appellant is seeking service connection for a psychiatric disorder. Service-connection may be granted for a disability resulting from disease or injury incurred in or aggravated while on active duty. 38 U.S.C.A. § 1131 (West 1991); 38 C.F.R. § 3.303(a) (1993). In the case of any disease diagnosed after discharge, service connection may be granted when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d) (1993). Furthermore, continuity of symptomatology is required where the condition noted during service is not, in fact shown to be chronic or where the diagnosis of chronicity in service is not adequately supported, then a showing of continuity after discharge is required to support the claim. 38 C.F.R. § 3.303(b) (1993). Service-connection is presumed if a veteran manifests a chronic disease, such as psychosis to a degree of at least 10 percent within one year after separation from service. 38 U.S.C.A. § 1112 (West 1991); 38 C.F.R. §§ 3.307, 3.309 (1993). In weighing the evidence of record, the undersigned concludes that the evidence of record is roughly in equipoise. Thus, entitlement to service-connection for a psychiatric disorder is warranted in this case. See Gilbert v. Derwinski, 1 Vet.App. 49 (1990). The Board notes that, while service medical records are negative for a psychiatric disorder and the first objective medical evidence of a psychiatric disorder was not until January 1991, more than 1 year after service, multiple lay statements and sworn testimony reflect bizarre behavior by the appellant occurring both near in time to discharge and thereafter, and the VA hospital report indicates that the "stresses in the military ... caused his initial psychotic break." This evidence, when coupled with the lack of evidence to dissociate the appellant's psychiatric condition from his period of service is considered sufficient to place the evidence of record, as a whole, in equipoise. 38 U.S.C.A. § 5107(b) (West 1991). Accordingly, in view of the above, the Board concludes that entitlement to service connection for a psychiatric disorder is warranted. 38 C.F.R. § 3.303(d) (1993). ORDER Service connection for a psychiatric disorder is granted. KENNETH R. ANDREWS, JR. 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.