Citation Nr: 0005508 Decision Date: 02/29/00 Archive Date: 03/07/00 DOCKET NO. 95-43 344 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Oakland, California THE ISSUE Entitlement to an effective date earlier than September 16, 1982 for the award of service connection for post traumatic stress disorder. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD C. L. Krasinski, Counsel INTRODUCTION This matter comes before the Board of Veterans' Appeals (the Board) on appeal from a rating decision dated in March 1995, of the Department of Veterans Affairs (VA), Oakland, California, Regional Office (RO). FINDINGS OF FACT 1. The veteran served on active duty from March 1966 to December 1968. 2. On September 16, 1982, the RO received the veteran's application for compensation benefits for a "combat flashbacks" and "delayed stress ". The RO construed this application as a claim for entitlement to service connection for post traumatic stress disorder. Service connection was granted for post-traumatic stress disorder effective September 16, 1982. 3. The RO was not in receipt or possession of any evidence between December 4, 1968 and September 16, 1982 that can reasonably be construed as a formal or informal claim of entitlement to VA benefits based on post traumatic stress disorder. 4. The veteran did not meet the eligibility criteria for service connection for post traumatic stress disorder on April 11, 1980. CONCLUSION OF LAW An effective date earlier than September 16, 1982, for the award of service connection for post traumatic stress disorder is not warranted. 38 U.S.C.A. § 5110 (West 1991 and Supp. 1999); 38 C.F.R. §§ 3.114, 3.155, 3.157, 3.400 (1999). REASONS AND BASES FOR FINDINGS AND CONCLUSION Factual Background The veteran served on active duty from March 1966 to December 1968. Service in Vietnam is indicated by the evidence of record. A December 1968 VA treatment record reflects treatment of an inflamed left tonsil. On December 20, 1968, the RO received the veteran's original application for compensation and pension. He filed a claim for service connection for tonsillitis and skin disease (fungus). In May 1969, the RO denied the veteran's claim for disability compensation because he failed to report to a scheduled examination. There is no mention of a psychiatric disability in any of these records. VA records , of hospitalization from June 24, 1980 to July 3, 1980 at the San Francisco, California VA Medical Center reflected diagnoses of fever with probable viral syndrome, hepatitis, hyponatremia, leukopenia, and history of I.V. drug use. Post-traumatic stress disorder was not mentioned. VA treatment records from the VA Medical Center in San Francisco, California, dated from June 1980 to November 1980, indicate that the veteran underwent neurological work-up and was evaluated for syncopal episodes. A December 1980 treatment record by Dr. E.D. reveals that the veteran reported having episodes of loss of consciousness. The examiner indicated that it was unknown what was causing the intermittent symptoms. A January 1981 medical record by Dr. K.C. indicates that the veteran was admitted for further evaluation for episodes of syncope. It was determined that the veteran had non-specific syncope. Treatment records dated in April 1981, indicate that the veteran reported having "minor spells." It was further noted that the veteran reported drinking and using amphetamines. On March 19, 1981, the RO received the veteran's claim for non service-connected pension benefits, due to a neurological condition and a drug problem. In a May 1981 rating decision, the RO denied entitlement to nonservice-connected pension benefits. An August 6, 1982 VA treatment record from the Antabuse clinic at the Baltimore, Maryland, VA medical center, indicates that the veteran has been on Antabuse; he wished to continue and he needed a refill. VA hospitalization records, for hospitalization from September 14, 1982 to January 7, 1983, reflect a discharge diagnosis of chronic alcoholism and sociopathic personality. The veteran was discharged to report for admission to the post traumatic stress syndrome program at the VA Medical Center in Coatesville, Pennsylvania, on January 11, 1983. During his hospitalization at the Coatesville VA facility, the veteran was diagnosed with post traumatic stress disorder. Subsequent medical records, including the report of a May 1983 VA psychiatric examination, confirmed the diagnosis of post traumatic stress disorder. On September 16, 1982, the VA received the veteran's claim for compensation benefits for "combat flashbacks (delayed stress)." The veteran indicated that he had been shot down in Vietnam in a helicopter. He indicated that he had received psychiatric treatment at the General Hospital Community Hospital in 1976 and 1982; the VA Medical Center in San Francisco, California, in 1980; and at the VA Medical Center in Baltimore, Maryland in August 1982. The veteran stated that the stress started manifesting three to five years earlier. He indicated that he was presently a patient at the VA Medical Center at Perry Point, Maryland. A June 1983 rating decision established service connection for post traumatic stress disorder. A 30 percent disability evaluation was assigned from September 21, 1982. A 100 percent temporary total evaluation pursuant to 38 C.F.R. § 4.29 was assigned effective from January 11, 1983, and a 50 percent evaluation was assigned effective May 1, 1983. A September 1983 rating decision assigned a 100 percent evaluation to the post traumatic stress disorder effective January 11, 1983. In July 1993 statement to the RO, the veteran asserted that he was entitled to a "retroactive award" for post traumatic stress disorder. The veteran argued that service connection should have been established for post traumatic stress disorder since he left active duty and the effective date for his award should be in August 1980, when he first should have been diagnosed with post traumatic stress disorder. In a November 1994 statement, the veteran asserted that he was entitled to an effective date from 1976, when he first complained of blackouts. At a hearing before the RO in February 1995, the veteran stated that he first started to display symptoms of post traumatic stress disorder in 1976. Hearing Transcript, hereinafter Tr., 2. He indicated that he would get into assaults and have blackouts. Tr. 2. The veteran indicated that he was first treated in 1976 at Fort Miley; he did not remember the doctors' names. Tr. 7. In a February 1995 statement, Dr. E.M., a VA psychiatrist, indicated that the veteran has suffered from post traumatic stress disorder for years, and probably suffered from post traumatic stress disorder since shortly after discharge from the service. Dr. E.M. stated that the diagnosis was delayed partly because of the lack of understanding of the disorder and because of the veteran's maladaptive social behaviors that were frequently the focus of attention. In a March 1995 rating decision, the RO determined that entitlement to an earlier effective date for the award of service connection for post traumatic stress disorder was established on the basis of clear and unmistakable error. The RO determined that that the correct effective date for service connection for post traumatic stress disorder was September 16, 1982, which was the date of the receipt of the veteran's application for compensation and pension benefits for service connection for post traumatic stress disorder. The RO indicated that the date of the receipt of the application was September 16, 1982, and the June 1983 rating decision was clearly and unmistakably erroneous in establishing service connection for post traumatic stress disorder from September 21, 1982. The RO indicated that there was no evidence that a claim for service connection for post traumatic stress disorder was filed prior to September 16, 1982. Thus, according to the RO, there was no basis for entitlement to an effective date prior to September 16, 1982, for the award of post traumatic stress disorder. In an April 1995 statement, the veteran asserted that he was treated for post traumatic stress disorder in 1980 at the Perry Point VA medical facility and that he should receive compensation from that date as the report of treatment should have been considered an informal claim. At a hearing before the RO in November 1996, the veteran asserted that he should be assigned a 100 percent rating for the post traumatic stress disorder from September 14, 1982. Tr. 1. He asserted, in essence, that he was hospitalized at Perry Point for post traumatic stress disorder but it was not diagnosed at that time. Tr. 3. In a June 1997 statement, the veteran asserted that he was entitled to a retroactive award to the six months he was hospitalized at Perry Point, Maryland, VA Medical Center in 1981, from August 1981 to December 1981, at 100 percent. A July 1997 rating decision assigned a 100 percent evaluation to the post traumatic stress disorder effective September 16, 1982, pursuant to 38 C.F.R. § 4.29 for hospitalization. A 100 percent evaluation was assigned effective January 7, 1983. In October 1998, the VA Medical Center located in San Francisco, California, indicated that no outpatient treatment records for the veteran were found dated from 1976. At a hearing before the RO in June 1999, the veteran stated that he went to the Fort Miley VA hospital in San Francisco, California, in 1976 for post traumatic stress disorder. Tr. 3 and 6. At the time, he was told this was a readjustment problem. Tr. 3. In an August 1999 supplemental statement of the case, the RO indicated that entitlement to an earlier effective date for the assignment of the 100 percent evaluation for post traumatic stress disorder prior to September 16, 1982 was not established, because the pertinent regulations did not provide for the assignment of an effective date prior to the date of the claim. Pertinent Law and Regulations A specific claim in the form prescribed by the Secretary must be filed in order for benefits to be paid to any individual under the laws administered by the VA. 38 U.S.C.A. § 5101(a) (West 1991); 38 C.F.R. § 3.151 (1999). A "claim" means a formal or informal communication in writing requesting a determination of entitlement or evidencing a belief in entitlement to a benefit. 38 C.F.R. § 3.1(p) (1999). The date of entitlement to an award of service connection is the day following separation from active service or date entitlement arose if the claim is received within one year after separation from service; otherwise, date of receipt of claim, or date entitlement arose, whichever is later. 38 C.F.R. § 3.400(b)(2). "Date of receipt" means the date on which a claim, information or evidence was received in the VA. 38 C.F.R. § 3.1(r) (1999). 38 C.F.R. § 3.155 (1999), provides as follows: (a) Any communication or action, indicating an intent to apply for one or more benefits under the laws administered by [VA], from a claimant...may be considered an informal claim. Such informal claim must identify the benefit sought. Upon receipt of an informal claim, if a formal claim has not been filed, an application form will be forwarded to the claimant for execution. If received within 1 year from the date it was sent to the claimant, it (the formal claim) will be considered filed as of the date of receipt of the informal claim. 38 C.F.R. § 3.155. If a formal claim for compensation has previously been allowed, or a formal claim for compensation disallowed for the reason that the service-connected disability is not compensable in degree, a report of examination or hospitalization can be accepted as an informal claim for benefits. Acceptance of a report of examination or treatment as a claim for increase is subject to the payment of retroactive benefits from the date of a report or for a period of 1 year prior to the date of receipt of the report. 38 C.F.R. § 3.157 (1999). As to reports prepared by VA or the uniformed services, the date of receipt of such a claim is deemed to be the date of outpatient or hospital examination or date of admission to a VA or uniformed services hospital. 38 C.F.R. § 3.157(b)(1). For reports prepared by a non-VA hospital where the veteran was maintained at VA expense, the date of admission to the hospital is accepted as the date of receipt of claim if VA maintenance was authorized prior to admission. For all other reports, including reports from private physicians, laymen, and state and other institutions, the date of receipt of the reports is accepted as the date of receipt of an informal claim. 38 C.F.R. § 3.157(b). The Court has held that a report of examination or hospitalization may be accepted as an informal claim for benefits, but only after there has been a prior allowance or disallowance of a formal claim for compensation. Crawford v. Brown, 5 Vet. App. 33, 35-6 (1993); 38 C.F.R. § 3.157 (1999). Legal authority also provides that where compensation benefits are awarded pursuant to a liberalizing law, or a liberalizing VA issue approved by the Secretary or by the Secretary's direction, the effective date of such award shall be fixed in accordance with the facts found, but shall not be earlier than the effective date of the law. 38 U.S.C.A. § 5110(g); 38 C.F.R. § 3.114(a). If a claimant requests review of his claim within one year from the effective date of the liberalizing regulation, benefits may be authorized from the effective date of the liberalizing provisions. 38 C.F.R. § 3.114(a)(1). However, if the claimant requests review of his claim more than one year from the effective date of the liberalizing regulation, benefits may be authorized only for a period of one year prior to the date of receipt of such request. 38 C.F.R. § 3.114(a)(3). Where pension, compensation, or dependency and indemnity compensation is awarded or increased pursuant to a liberalizing law or VA issue which became effective on or after the date of its enactment or issuance, in order for a claimant to be eligible for a retroactive payment under the provisions of this paragraph the evidence must show that the claimant met all eligibility criteria for the liberalized benefit on the effective date of the liberalizing law or VA issue and that such eligibility existed continuously from that date to the date of claim or administrative determination of entitlement. The provisions of this paragraph are applicable to original and reopened claims as well as claims for increase. 38 U.S.C.A. § 5110 (g); 38 C.F.R. § 3.114(a). Analysis Initial matters The veteran's claim is well grounded. That is, the claim is not inherently implausible. 38 U.S.C.A. § 5107(a) (West 1991). Once a claim has been determined to be well grounded, VA's statutory duty to assist the veteran in the development of his claim is triggered. 38 U.S.C.A. § 5107; 38 C.F.R. § 3.159. In this case, the Board is of course aware of the veteran's contentions that he was treated for post traumatic stress disorder at various places and times prior to 1982. To the extent possible, VA and other medical records pertaining to medical treatment of the veteran since he left service have been obtained. There is no indication that any extant records have not been obtained. statutory obligation of VA to assist the veteran in the development of his claim is thus satisfied. Once the evidence has been assembled, it is the Board's responsibility to evaluate all of the evidence. 38 U.S.C.A. § 7104. When there is an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C.A. § 5107(b). In Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990), the United States Court of Appeals for Veterans Claims stated that "a veteran need only demonstrate that there is an 'approximate balance of positive and negative evidence' in order to prevail." To deny a claim on its merits, the evidence must preponderate against the claim. Alemany v. Brown, 9 Vet. App. 518, 519 (1996), citing Gilbert, 1 Vet. App. at 54. The Board has the duty to assess the credibility and weight to be given to the evidence. See Madden v. Gober, 125 F.3d 1477 (Fed.Cir. 1997) and cases cited therein. Discussion Review of the record reveals that the RO received the veteran's claim for entitlement to service connection for "combat flashbacks (delayed stress)" on September 16, 1982. The RO construed this claim as a claim for entitlement to service connection for post traumatic stress disorder. There is no evidence in the claims folder that the veteran filed a claim for service connection for post traumatic stress disorder prior to that date. VA law and regulations indicate that unless a claim is filed within one year of service discharge, the effective date for the award of compensation based on an original claim will be the date of receipt of the claim or the date entitlement arose, whichever is later. 38 U.S.C.A. § 5110(a); 38 C.F.R. 3.400. Thus, the correct effective date for the award of service connection for post traumatic stress disorder is May 16, 1982, which is the date of receipt of the claim. The veteran argues that the award of service connection for post traumatic stress disorder should be effective from his separation from active duty. However, there is no evidence showing that the veteran filed a claim for service connection for post traumatic stress disorder within one year of his service discharge in December 1968. As noted above, the claim for service connection for post-traumatic stress disorder was filed on September 16, 1982, many years after he left service. Since the veteran did not file his claim for entitlement to service connection for post traumatic stress disorder within a year after separation from service, the effective date for service connection cannot be earlier than the date of receipt of the veteran's claim, which is September 16, 1982. 38 U.S.C.A. § 5110; 38 C.F.R. § 3.400(b)(2). The veteran filed a claim for entitlement to service for tonsillitis and a skin disease in December 1968. However, in the December 1968 claim, the veteran did not mention or identify post traumatic stress disorder. In March 1981, the veteran filed a claim for entitlement to service connection for a neurological disorder (seizures) and a drug problem. Again, the veteran did not mention or identify post traumatic stress disorder in this claim. The applicable statutory and regulatory provisions require that VA look to all communications from a claimant which may be interpreted as applications or claims--formal and informal--for benefits. In particular, VA is required to identify and act on informal claims for benefits. 38 U.S.C. § 5110(b)(2); 38 C.F.R. §§ 3.1(p), 3.400(o)(2), 3.155(a). See Servello v. Derwinski, 3 Vet. App. 196, 198-200 (1992). As noted above, an informal claim must identify the benefit sought. 38 C.F.R. § 3.155(a). The Board, on its own initiative, has reviewed the record and been unable to identify any earlier communication from the veteran which could be interpreted as a formal or informal claim for entitlement to service connection for post traumatic stress disorder which was received by the VA prior to September 16, 1982 and which meets the requirements of either 38 C.F.R. §§ 3.155 or 3.157. Indeed, there is no medical evidence of post traumatic stress disorder until early 1983, after the veteran filed his claim. The veteran asserts that he had received psychiatric treatment at various VA medical facilities since 1976. He argues that the effective date for the award of service connection should be in 1976, when he was first treated for blackouts. The veteran contends that the blackouts were symptoms of post traumatic stress disorder. The veteran also argues that service connection for post traumatic stress disorder should have been established in August 1980, when he should have been diagnosed for post traumatic stress disorder. The Board observes that there is no objective evidence of diagnosis of or treatment for post traumatic stress disorder prior to the hospitalization in Coatesville in January 1983. To the extent that the veteran's statements are to the contrary, the Board places greater weight on the extensive medical records prior to that date, none of which mentions or suggests post traumatic stress disorder. The Board again points out that the RO made a diligent effort to obtain all of the VA treatment records identified by the veteran. To the extent that the veteran is contending that he was misdiagnosed by various health care professionals prior to 1983, as a lay person with no medical training he cannot offer competent opinions as to medical diagnoses. See Espiritu v. Derwinski, 2 Vet. App. 492, 494-5 (1992). Moreover, even if the veteran had been diagnosed or treated for post traumatic stress disorder prior to his September 1982 claim, it is the date of the claim, not the date of treatment which ordinarily controls with respect to the assignment of an effective date of service connection. See 38 U.S.C.A. § 5110; 38 C.F.R. § 3.400. In addition, there is no evidence in the record, prior to the formal claim received by the RO on September 16, 1982, that indicates any intent on the part of the veteran to apply for benefits or in any way specifically identifies "the benefit sought," (i.e., compensation under the provisions of 38 U.S.C.A. § 1151), as required by § 3.155(a). See Dunson v. Brown, 4 Vet. App. 327, 329-330 (1993). In Brannon v. West, 12. Vet. App. 32 (1998), the Court observed that while the Board must interpret an appellant's submissions broadly, the Board is not required to conjure up issues that were not raised by the appellant. The Court has held that an appellant must have asserted the claim expressly or impliedly. See Isenbart v. Brown, 7 Vet. App. 537, 540-41 (1995). Thus, the Board finds that none of the medical evidence of record dated prior to September 16, 1982 constitutes an informal claim for entitlement to service connection for post traumatic stress disorder, which was not mentioned in any of those records. Moreover, the Board is unable to identify an statement or other evidence prior to September 1982 which meets the regulatory requirements of an informal claim for benefits under the provisions of 38 C.F.R. § 3.155. The veteran's representative argues that the March 1981 claim for nonservice-connected pension benefits due to a neurological disorder and for a drug problem should be construed as a claim for entitlement to service connection for post traumatic stress disorder. The veteran asserts that the neurological symptoms were, in fact, symptoms of post traumatic stress disorder. However, the Court has held that an appellant must have asserted the claim expressly or impliedly. See Isenbart v. Brown, 7 Vet. App. 537, 540-41 (1995). A claim of entitlement to service connection for post traumatic stress disorder was not expressly or impliedly raised in the March 1981 claim. The veteran did not mention post traumatic stress disorder in this claim, and he did not indicate that neurological symptoms were due to post traumatic stress disorder. The Board points out that the medical evidence of record, dated in 1980 and 1981, indicates that the cause for the neurological symptoms was unknown; post traumatic stress disorder was not mentioned. Thus, the Board finds that the March 1981 claim cannot be interpreted as an informal claim for service connection for post traumatic stress disorder pursuant to 38 C.F.R. § 3.155. With respect to the applicability of 38 C.F.R. § 3.157, the Court has held that a report of examination or hospitalization may be accepted as an informal claim for benefits, but only after there has been a prior allowance or disallowance of a formal claim for compensation. In the present case, there was no allowance or disallowance of a claim for compensation for service connection for post traumatic stress disorder prior to the June 1983 rating decision in which the RO awarded service connection for post traumatic stress disorder. Crawford v. Brown, 5 Vet. App. 33, 35-6 (1993); 38 C.F.R. § 3.157 (1999); see also Dunson v. Brown, 4 Vet. App. 327, 329-30 (1993). In this case, the VA hospitalization and examination reports dated prior to September 16, 1982 do not constitute informal claims under the provisions of 38 C.F.R. § 3.157, as the provisions of 38 C.F.R. § 3.157 apply only to claims for increase or to reopen claims which have been previously denied. The Board is cognizant of the veteran's arguments that an earlier effective date is warranted because he believes he had post traumatic stress disorder since separation from military service. As noted above, a lay person the veteran cannot proffer a competent self-diagnosis. See Espiritu, supra. Moreover, the Board is constrained by law and regulations governing the establishment of effective dates for the award of compensation. As noted above, the most significant factor in the assignment of effective dates is the date that a claim for benefits was filed. See 38 U.S.C.A. § 5110; 38 C.F.R. § 3.400. Service connection has been granted for post traumatic stress disorder, a recognition that this disability is indeed directly related to the veteran's military service, although not necessarily existing from the date of his separation from service. In any event, however, the effective date of the grant of service connection cannot be earlier than the date of the receipt of the veteran's claim. Lastly, the Board notes that where pension, compensation, or dependency and indemnity compensation is awarded or increased pursuant to a liberalizing law, or a liberalizing VA issue approved by the Secretary or by the Secretary's direction, the effective date of such award or increase shall be fixed in accordance with the facts found, but shall not be earlier than the effective date of the act or administrative issue. Where pension, compensation, or dependency and indemnity compensation is awarded or increased pursuant to a liberalizing law or VA issue which became effective on or after the date of its enactment or issuance, in order for a claimant to be eligible for a retroactive payment under the provisions of this paragraph the evidence must show that the claimant met all eligibility criteria for the liberalized benefit on the effective date of the liberalizing law or VA issue and that such eligibility existed continuously from that date to the date of claim or administrative determination of entitlement. 38 C.F.R. § 3.114(a). The addition of post traumatic stress disorder as a diagnostic entity in the VA's Schedule for Rating Mental Disorders was a "liberalizing VA issue" for purposes of 38 C.F.R. § 3.114(a). Thus, for post traumatic stress disorder service connection claims, an effective date prior to the date of claim cannot be assigned under 38 C.F.R. § 3.114(a) unless the claimant met all eligibility criteria for the liberalized benefit on April 11, 1980, the effective date of the regulatory amendment adding the diagnostic code for post traumatic stress disorder, and such eligibility existed continuously from that date to the date of claim or administrative determination of entitlement. See VAOPGCPREC 26-97 (July 16, 1997). In this case, the veteran did not meet all of the eligibility criteria for the liberalized benefit on April 11, 1980 because there is no medical evidence of post traumatic stress disorder at that time. Review of the record reveals that treatment records dated from 1980 to 1983 indicate that the veteran had a history of I.V. drug use, alcoholism, and amphetamine use. The treatment records do not reflect a diagnosis of post traumatic stress disorder on April 11, 1980. The evidence of record shows that post traumatic stress disorder was first diagnosed after the veteran's claim for benefits was filed in September 1982. The Board is cognizant of the veteran's argument that an earlier effective date is warranted because he believes that his psychiatric and neurological symptoms, dating back to 1976 and 1980, were symptoms of post traumatic stress disorder. However, the Board is constrained from substituting its own medical judgment in place of the diagnoses and findings provided by the medical professionals of record on and after April 11, 1980. See Allday v. Brown, 7 Vet. App. 517 (1995); Colvin v. Derwinski, 1 Vet. App. 171 (1991). Despite the addition of post traumatic stress disorder to the DSM, those medical professionals did not diagnose post traumatic stress disorder on April 11, 1980, or for several years thereafter. As noted above, the veteran has submitted a February 1995 statement by his VA psychiatrist. The VA psychiatrist indicated that the veteran "probably" had post traumatic stress disorder since separation from service. The Board finds that this medical statement is too speculative to establish that the veteran did, in fact, have post traumatic stress disorder on April 11, 1980. The physician did not provide supporting clinical data or other rationale for this conclusion. Contemporaneous medical records, dated in 1980, do not reflect a diagnosis of post traumatic stress disorder. Thus, the Board finds that this medical opinion has limited probative value and is not sufficient evidence to establish that the veteran had post traumatic stress disorder on April 11, 1980. In summary, after reviewing the record, the Board can find no evidence of a claim of entitlement to service connection for post traumatic stress disorder, formal or informal, filed prior to September 16, 1982. As there is no evidence of record of the veteran filing a prior claim of entitlement to service connection for post traumatic stress disorder, the effective date in this case is September 16, 1982. For the reasons and bases discussed above, the arguments advanced by the veteran do not provide a basis for an earlier effective date. Accordingly, an earlier effective date for an award of service connection for post traumatic stress disorder is not warranted. The benefit sought on appeal is therefore denied. Additional Matter The Board notes that the veteran appears to be asserting that there was clear and unmistakable error because he believes that his post traumatic stress disorder was misdiagnosed as a sociopathic personality disorder, and post traumatic stress disorder should have been diagnosed in 1980. The veteran's assertion of what he calls a misdiagnosis of his disability by VA physicians is basically an assertion of clear and unmistakable error on the part of VA physicians. Medical personnel, whether they work for VA or the service department, are not adjudicators, and as such, cannot commit clear and unmistakable error. See Henry v. Derwinski, 2 Vet. App. 88, 90 (1992). Moreover, an alteration in the diagnosis of a disability cannot give rise to clear and unmistakable error. See Kronberg v. Brown, 4 Vet. App. 399, 401 (1993) (where new evidence resulting in a diagnosis of chronic mononucleosis was unavailable at the time of an initial application for benefits, Board's decision that there was no clear and unmistakable error in the original adjudication was not arbitrary, capricious or an abuse of discretion). Moreover, to the extent he veteran has alleged that VA rating decisions, such as that in June 1983, contain clear and unmistakable error in their reliance on the lack of diagnoses of PTSD in pre-1983 medical records, he has in effect expressed disagreement as to how the facts were weighed or evaluated. Such disagreement in and of itself does not constitute a valid claim of clear and unmistakable error. See Oppenheimer v. Derwinski, 1 Vet. App. 370, 372 (1991); Eddy v. Brown, 9 Vet. App. 52 (1996). Accordingly, a valid claim of clear and unmistakable error has not been raised. ORDER Entitlement to an effective date earlier than September 16, 1982, for the award of service connection for post traumatic stress disorder is denied. Barry F. Bohan Member, Board of Veterans' Appeals The Board notes in passing that this opinion arose in the context of a claim for entitlement to an earlier effective date for service connection for post traumatic stress disorder.