BVA9505134 DOCKET NO. 92-14 706 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUES Entitlement to service connection for a psychiatric disorder, to include post-traumatic stress disorder. Entitlement to service connection for residuals of a right toe injury. Entitlement to an increased rating for right eye hyperopic amblyopia, currently rated 30 percent disabling. REPRESENTATION Appellant represented by: The American Legion ATTORNEY FOR THE BOARD Heather J. Harner, Associate Counsel INTRODUCTION The veteran served on active duty from June 1948 to July 1950 and from June 1951 to December 1951 with additional service in the United States Army Reserve. This appeal to the Board of Veterans' Appeals (Board) arises from an August 1991 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends service connection is warranted for a psychiatric disorder, to include post-traumatic stress disorder (PTSD). He claims he experienced traumatic events in service, including working in a morgue and driving dead and wounded servicemen back to base. He contends as well that service connection is warranted for residuals of a right toe injury. He avers he injured his toe during service and continues to suffer residual effects of this injury. He also asserts that his service-connected right eye disability is more disabling than currently evaluated. He requests relief in the form of an increased rating. 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 veteran's claim for entitlement to service connection for PTSD. It is further the decision of the Board that the veteran has not met the initial burden of submitting evidence sufficient to justify a belief by a fair and impartial individual that his claim for entitlement to service connection for residuals of a right toe injury is well grounded. Lastly, it is the decision of the Board that the preponderance of the evidence is against a grant of an increased rating for right eye hyperopic amblyopia. FINDINGS OF FACT 1. A psychiatric disorder was not manifested in service. 2. Records subsequent to service have shown the presence of a personality disorder and anxiety reaction. 3. PTSD was initially diagnosed on a May 1991 VA compensation examination based upon stressors reported by the veteran. 4. Due to the veteran's failure to cooperate in the development of evidence to support his claim, the underlying stressors noted in the May 1991 examination are not verified. The VA has otherwise obtained all relevant evidence regarding the veteran's claim for entitlement to service connection for a psychiatric disorder, to include PTSD. 5. The veteran has presented no evidence relating any post- service anxiety disorder to service. 6. The veteran has not presented evidence which would establish that his current right toe disability is attributable to an injury in service. 7. There is no allegation or evidence that the veteran is totally blind in his nonservice-connected left eye. 8. The veteran has light perception in his right eye; he does not have enucleation or cosmetic defect of the eye. CONCLUSIONS OF LAW 1. A personality disorder is not a disability for which compensation benefits are payable. 38 C.F.R. §§ 3.303, 4.127 (1994). 2. An acquired psychiatric disorder, to include PTSD, was not incurred in or aggravated by service. 38 U.S.C.A. §§ 1110, 1131, 5107 (West 1991); 38 C.F.R. § 3.303 (1994). 3. Evidence of a well-grounded claim for entitlement to service connection for residuals of a right toe injury has not been presented. 38 U.S.C.A. §§ 1110, 1131, 5107 (West 1991). 4. A rating in excess of 30 percent for right eye hyperopic amblyopia is not warranted. 38 U.S.C.A. §§ 1155, 1160, 5107 (West 1991); 38 C.F.R. § 4.84a, Code 6070 (1994). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS Entitlement to service connection for a psychiatric disorder, to include post-traumatic stress disorder. In August 1994, the Board deemed the veteran's claim to be well- grounded and remanded the case to the RO for further development of the claim for entitlement to service connection for PTSD. The RO was to request the veteran to provide as much specific information as possible regarding his claimed stressful event[s] in service, including the unit with which he served, dates of stressor events, names of victims and other witnesses to the events, locations of the events, and any other relevant details. The purpose of this request was to obtain verification of his claimed stressors. Verification of the occurrence of stressors is one of the necessary components in establishing service connection for PTSD. In September 1994 the RO mailed to the veteran at his address of record a letter requesting such information. After the expiration of sixty days, the veteran had not responded to the request and the case was returned to the Board for final disposition based upon the evidence of record. Because proceedings before the Board are ex parte and non- adversarial in nature, the VA is required by statute and by case law to assist appellants in developing well-grounded claims. 38 U.S.C.A. § 5107 (West 1991). "The duty to assist is not always a one-way street. If a veteran wishes help, he cannot passively wait for it in those circumstances where he may or should have information that is essential in obtaining the putative evidence." Wood v. Derwinski, 1 Vet.App. 190, 193 (1991). If the veteran wished to fully develop his claim, he had a corresponding duty to assist by providing the requested information. We therefore hold that, even though the veteran's claim has not been fully developed, the VA has fulfilled its duty to assist him. We will thus proceed to evaluate the veteran's claim based on the evidence currently of record. Service connection may be granted for any disability resulting from injury suffered or disease contracted in line of duty, or for aggravation in service of a pre-existing injury or disease. 38 U.S.C.A. §§ 1110, 1131 (West 1991). 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. 38 C.F.R. § 3.304 (1994). When a veteran's claimed stressor is not related to combat, "the veteran's lay testimony, by itself, will not be enough to establish the occurrence of the alleged stressor. Instead, the record must contain service records which corroborate the veteran's testimony as to the occurrence of the claimed stressor." Zarycki v. Brown, 6 Vet.App. 91 (1993). The veteran claims he experienced traumatic events in service, including working in a morgue and driving dead and wounded servicemen back to base. He does not claim a combat-related stressor. He has not contended that he suffers from any other psychiatric disorder and has presented no evidence to relate any other psychiatric disorder to service. The veteran's DD214 forms show that during his first period of active duty, he had one year and approximately eight months of overseas service. He worked as a truck driver and was assigned to a medical detachment. His second period of active duty was spent entirely in the continental United States. He worked as a tractor operator. The veteran's physical examination for enlistment, conducted in June 1948 reveals that neuropsychiatric evaluation was normal at that time. The report of a physical examination conducted in April 1952 contains the notation that the veteran was psychiatrically normal. There is no indication, and the veteran does not contend, that he received treatment for a psychiatric disorder during service. Between November 1973 and May 1974, twenty-two years following his period of active duty, the veteran was hospitalized at the VA hospital in Tuskegee, Alabama. The hospital discharge report indicates that he received treatment for a passive-aggressive personality disturbance, and a mild anxiety reaction apparently brought on by financial difficulties. He was also treated for several physical problems. While the report of this lengthy hospitalization is rather brief, it contains no mention of any of the veteran's claimed inservice stressors. The certifying physician attributed the veteran's neuropsychiatric difficulties to his inability to cope with problems in his life at that time and to a personality disorder. In this regard, we note that personality disorders are not considered as disabilities under governing regulation and therefore may not be service connected. 38 C.F.R. § 4.127 (1994). When the veteran was examined for compensation purposes in May 1991, the examining psychiatrist recorded the opinion that the veteran suffered from symptoms of PTSD due to his exposure to events which were outside the range of usual human experience. During the interview, the veteran related to the examiner that he had worked in a funeral home prior to service. He said that consequently, he was assigned in service to work in the morgue, but requested to transfer to a different job because of the anxiety which he felt working with dead bodies. He then worked as an ambulance driver. He described seeing many dead and mutilated bodies during the performance of his duties for this job as well. He claims to have nightmares of these sights. He also related to the examiner an incident in basic training involving the explosion of a "dud" shell. He stated he was not hit himself, but helped several servicemen who were seriously injured during the incident. He claimed he experienced nightmares stemming from this incident as well. This diagnosis of PTSD is based upon the veteran's own description of the traumatic events and the claimed stressors were not verified for diagnostic purposes. As the record now stands, without further development as had been requested, the preponderance of the evidence is against the veteran's claim for entitlement to service connection for a psychiatric disorder to include PTSD. The veteran's claimed stressors (the stressors upon which in part the VA examiner based the diagnosis of PTSD) are not corroborated by any evidence other than his own contentions. When the veteran was hospitalized for psychiatric treatment, he apparently did not provide a history of traumatic stress or any other psychiatric disorder involving his active service. Instead, his treating physician attributed his disability to a personality disorder and to current events in the veteran's life. Not until many years later, in conjunction with this claim for disability benefits, did the veteran attribute any psychiatric disability to events in service. His failure to cooperate precluded verification that the claimed events in service actually occurred. In summary, the evidence of record does not provide the requisite nexus between any current psychiatric disability and the veteran's active service. The preponderance of the evidence is against the veteran's claim and service connection for a psychiatric disorder to include PTSD is not warranted. Entitlement to service connection for residuals of a right toe injury. The threshold question to be addressed is whether the veteran has presented a well-grounded claim for service connection for a right toe injury. A well-grounded claim is one which would justify a belief by a fair and impartial individual that the claim is plausible. If the appellant's claim is not well- grounded, the claim must fail and the VA has no further duty to assist him because additional development would be futile. 38 U.S.C.A. § 5107 (West 1991); Murphy v. Derwinski, 1 Vet.App. 78 (1992). Service connection may be granted for any disability resulting from injury suffered or disease contracted in line of duty, or for aggravation in service of a pre-existing injury or disease. 38 U.S.C.A. § 1110 (West 1991). Service connection may be established by demonstrating that the disability was first manifested during service and has continued since service to the present time or by showing that a disability which pre-existed service was aggravated during service. A well-grounded claim for entitlement to service connection, therefore, is one which justifies a belief by a fair and impartial individual that it is plausible that the veteran's current disability had its onset in service. In a statement submitted in support of his claim in July 1991 and in the notice of disagreement submitted in November 1991, the veteran asserts that his right toe was injured by the accidental explosion of a dud shell during basic training at Fort Jackson, South Carolina. As described above, the veteran also contends that this incident is one of his PTSD stressors. Also as described above, during a VA psychiatric examination conducted pursuant to the claim for entitlement to service connection for PTSD, he related to the examiner that he was not hit himself, but helped several servicemen who were seriously injured during the incident. While the veteran's service medical records appear to have been reconstructed, there is no indication that the veteran was treated for a right toe injury during service. The report of a medical examination conducted pursuant to the veteran's army reserve duty in April 1952 contains no indication of a previous toe injury or toe disability. The veteran's feet were specifically evaluated as normal at that time. While the report of the veteran's hospitalization at the VA hospital in Tuskegee, Alabama in 1953 and 1954 mentions treatment for his eye disability and dental work, no complaints or treatment regarding his toe are noted. The only report of medical treatment for the veteran's right toe contained in the claims file is a report of VA outpatient treatment dated in February 1992 which indicates the veteran currently suffers from severe degenerative joint disease. The veteran has presented only his own contentions in support of his claim for entitlement to service connection for residuals of a right toe injury. His own contention that he was injured by the explosion of a dud shell during basic training conflicts with the history of not having been physically injured during the explosion which he provided to a VA physician in support of a separate claim for entitlement to service connection for PTSD. He has not presented medical or competent evidence that would establish that his present disability is the result of an injury or other incident in service. The submitted evidence of clinical treatment is so far removed in time from the veteran's periods of active service that it provides no basis for causally relating any current disability to service. Absent any other evidence, the veteran's claim is not well grounded. Entitlement to an increased rating for right eye hyperopic amblyopic, currently rated 30 percent disabling. Initially, we note that the veteran's claim for an increased rating is well grounded. By this, we mean that he has submitted a claim which is plausible. We further conclude the VA has met its statutory duty to assist the veteran in the development of his claim, and that no further assistance is required to satisfy the provisions of 38 U.S.C.A. § 5107 (West 1991). Disability evaluations are determined by the application of a schedule of ratings which is based on average impairment of earning capacity. Separate diagnostic codes identify the various disabilities. 38 U.S.C.A. § 1155 (West 1991); 38 C.F.R. Part 4 (1994). When there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7 (1994). Service connection for traumatic hyperopic amblyopia of the right eye was granted in 1980. A 30 percent disability rating was assigned at that time as the evidence showed the veteran demonstrated only light perception in the right eye and 20/40 visual acuity in the nonservice connected left eye. This rating remains in effect. The veteran also receives special monthly compensation for the loss of use of one eye. When service connection has been established for disability for one eye only, the other eye will be considered to have normal visual acuity for rating purposes. Only when the nonservice- connected eye is blind will the visual acuity of both eyes be taken into account in rating determinations. 38 U.S.C.A. § 1160 (West 1991); 38 C.F.R. § 4.84a (1994). The veteran has contended that his visual acuity is decreasing in both eyes due to the early formation of cataracts. He has not contended, however, that he is entirely blind in both eyes. Upon VA opthalmological examination for purposes of compensation in May 1991, the veteran displayed only light perception in the right eye and 20/40 corrected vision in the left eye. The formation of early nuclear sclerotic and posterior subcapsular cataracts was noted. The remainder of his examination was unremarkable. No enucleation is described in the examination report and no cosmetic defect has been reported. Absent a showing of complete blindness in the nonservice- connected eye, the veteran is in receipt of the highest rating available for a single service-connected eye. Consideration has also been given to the potential application of the various provisions of 38 C.F.R. Parts 3 and 4, whether or not they were raised by the veteran, as required by Schafrath v. Derwinski, 1 Vet.App. 589 (1991). In particular, we find that the evidence discussed above does not suggest that the veteran's right eye hyperopic amblyopia presents such an exceptional or unusual disability picture as to render impractical the application of the regular schedular standards and warrant the assignment of an extraschedular evaluation under 38 C.F.R. § 3.321(b) (1993). For example, the disability does not require frequent periods of hospitalization, nor does it present marked interference with employment that is not already contemplated by the current evaluation. The preponderance of the evidence is against the veteran's claim and an increased rating is not warranted. ORDER Service connection for a psychiatric disorder to include PTSD is denied. The veteran's claim for entitlement to service connection for residuals of a right toe injury is dismissed. A rating in excess of 30 percent for right eye hyperopic amblyopia 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.