Citation Nr: 0003596 Decision Date: 02/11/00 Archive Date: 02/15/00 DOCKET NO. 96-18 761 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Philadelphia, Pennsylvania THE ISSUE Entitlement to service connection for post-traumatic stress disorder (PTSD). REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL The veteran and his sister ATTORNEY FOR THE BOARD D. M. Casula, Associate Counsel INTRODUCTION The veteran had active service from June 1950 to November 1956. This matter comes before the Board of Veterans' Appeals (Board) from a March 1995 rating decision of the Philadelphia, Pennsylvania Regional Office (RO) of the Department of Veterans Affairs (VA) which denied service connection for PTSD. FINDINGS OF FACT 1. The record is devoid of medical evidence of a current diagnosis of post traumatic stress disorder. 2. The claim for service connection for PTSD is not plausible. CONCLUSION OF LAW The veteran's claim for service connection for PTSD is not well-grounded. 38 U.S.C.A. § 1110, 5107(a) (West 1991 & Supp. 1999); 38 C.F.R. §§ 3.304 (1999). REASONS AND BASES FOR FINDINGS AND CONCLUSION Factual Background Service medical records are negative for any complaints of or treatment for any psychiatric disorder. Service records show that the veteran received the Purple Heart Medal in December 1950. His DD Form 214 shows that his military occupational specialty (MOS) was light weapons infantryman. A VA hospital discharge summary showed that the veteran was hospitalized from April 1973 to May 1973 for inpatient treatment for alcoholism. It was noted that on mental examination he was anxious, but gave no evidence of psychosis or OBS (organic brain syndrome). A VA hospital discharge summary showed that the veteran was hospitalized from June 1994 to July 1994 for alcohol dependence. On admission he reported that while he was in the Army he saw combat in Korea. He denied any PTSD symptoms and denied any psychiatric treatment. A psychological assessment showed that he had no symptoms of thought disorder, paranoia, anxiety, or clinical depression. It was noted that he seemed to be stable and slept adequately. He was discharged to the Water Street Mission in Lancaster and was to attend as many AA meetings as allowed. In a statement dated in October 1994 the veteran claimed service connection for PTSD and claimed he was a combat infantry soldier in Korea. By rating action in March 1995 the RO denied service connection for PTSD based on the fact that the veteran did not have a diagnosis of PTSD. In September 1995 the veteran testified at a hearing at the RO that his primary MOS was rifle man and that he was assigned to the 24th Infantry Regiment, 25th Infantry Division. He described his involvement in combat in Korea. He testified that he used a ground automatic rifle and was also a machine gunner. He saw many people die, including most of his company. He claimed he started drinking after he was sent home from service. His nightmares reportedly started while he was in the hospital and that he still had regular nightmares about combat. He reported that he avoided things that reminded him of combat. He testified that he would go in his room and drink by himself and that drinking was the only thing that could stop the nightmares. He indicated that he attended a group for people with PTSD on a weekly basis while he was at the Coatesville domiciliary, and indicated that he was told to talk, but did not want to. The veteran's sister testified that he had lived with her off and on since he came back from Korea and that he had nightmares that involved him waking up and screaming and thinking he was in the war. She claimed that the veteran had no problems until after he went into the service, and that when he returned from Korea he was different and did not adjust well back to civilian life. She testified that the veteran talked about the war every night and he became angry and violent and would storm out the door. She indicated that the veteran was living temporarily with another sister and was having the same problems with sleeping. The veteran testified that he was not receiving any treatment at that time and was at Coatesville for a drinking problem. On VA examination in December 1995 the veteran testified that he had no problems prior to service and that was in combat as a machine gunner in the Korean War. He complained of restless sleep and waking up with bad dreams, and stayed by himself most of the time. He had been hospitalized three times since service and the last time was three years prior. He reported that he had not received any psychiatric treatment since then. The diagnoses were history of alcohol abuse, organic mental disorder, dementia secondary to alcoholism. PTSD was not demonstrated. In his substantive appeal (VA Form 9) dated in March 1996 the veteran contended that he was seeking treatment at the Altoona VAMC. In November 1996 the Altoona VAMC essentially notified the RO that there were no records available for the veteran. On VA examination in April 1999 it was noted that the veteran was seen for a Psychiatric Board Examination to determine whether he had PTSD. His claims folder was reviewed prior to the interview. The diagnoses included alcohol dependence and it was noted that he had stressors and severe combat exposure. The examiner noted that PTSD was not demonstrated, but it may be that the veteran's heavy alcohol intake was a means for masking disturbing combat memories. Analysis Service connection connotes many factors, but basically it means that the facts, as shown by evidence, establish that a particular injury or disease resulting in disability was incurred coincident with service in the Armed Forces or, if pre-existing such service, was aggravated therein. 38 U.S.C.A. § 1110, 1131. Such a determination requires a finding of a current disability which is related to an injury or disease incurred in service. Watson v. Brown, 4 Vet. App. 309, 314 (1993). Each disabling condition shown by a veteran's service records, or for which he seeks service connection, must be considered on the basis of the places, types and circumstances of his service as shown by service records, the official history of each organization in which he served, his medical records and all pertinent medical and lay evidence. 38 U.S.C.A. § 1154. Satisfactory lay or other evidence that injury or disease was incurred or aggravated in combat will be accepted as sufficient proof of service connection if the evidence is consistent with the circumstances, conditions or hardships of such service, even though there is no official record of such incurrence or aggravation during active service. 38 C.F.R. § 3.304. Service connection for PTSD requires medical evidence diagnosing the condition in accordance with 38 C.F.R. § 4.125(a); a link, established by medical evidence, between current symptoms and an in-service stressor; and credible supporting evidence that the claimed in-service stressor actually occurred. If the evidence establishes that the veteran engaged in combat with the enemy and the claimed stressor is related to that combat, in the absence of clear and convincing evidence to the contrary, and provided that the claimed stressor is consistent with the circumstances, conditions, or hardships of the veteran's service, the veteran's lay testimony alone may establish the occurrence of the claimed in-service stressor. 38 C.F.R. § 3.304(f). If it is determined that a veteran was engaged in combat, lay testimony from the veteran regarding putative stressors must be accepted as conclusive, provided that the testimony is satisfactorily credible; however, if VA determines that a veteran did not engage in combat, lay testimony by the veteran by itself is not sufficient to establish that a putative stressor occurred. West v. Brown, 7 Vet. App. 70 (1994). As a preliminary matter in considering each claim, the law provides that a claimant for benefits under a law administered by the VA shall have the burden of submitting evidence sufficient to justify a belief by a fair and impartial individual that the claim is well grounded. The VA has the duty to assist a claimant in developing facts pertinent to the claim, if the claim is determined to be well grounded. 38 U.S.C.A. § 5107(a). Thus, the threshold question to be answered is whether the veteran has presented a well grounded claim; that is, a claim which is plausible. If he has not presented a well grounded claim, his appeal must fail, and there is no duty to assist his further in the development of his claim, as any such development would be futile. Murphy v. Derwinski, 1 Vet. App. 78 (1990). As explained below, the Board finds that the veteran's claim for service connection for PTSD is not well grounded. To sustain a well grounded claim, the veteran must provide evidence demonstrating that the claim is plausible; mere allegation is insufficient. Tirpak v. Derwinski, 2 Vet. App. 609 (1992). The determination of whether a claim is well grounded is legal in nature. King v. Brown, 5 Vet. App. 19 (1993). A well-grounded claim is a plausible claim, one which is meritorious on its own or capable of substantiation. Such a claim need not be conclusive but only possible to satisfy the initial burden of 38 U.S.C.A. § 5107(a); Murphy v. Derwinski, 1 Vet. App. 78, 81 (1990). To be well grounded, a claim must be accompanied by supportive evidence, and such evidence must justify a belief by a fair and impartial individual that the claim is plausible. Where the determinative issue involves either medical etiology or a medical diagnosis, competent medical evidence is required to fulfill the well grounded claim requirement of 38 U.S.C.A. § 5107(a ); Lathan v. Brown, 7 Vet. App. 359 (1995). The first element required for a well-grounded PTSD claim is a medical diagnosis of the condition, which is clearly lacking in this case. The record does reflect mental health treatment subsequent to service, for alcohol dependence. Although the veteran has contended that his nightmares are related to his military service, there is no evidence that any medical professional has ever diagnosed PTSD. In fact the medical evidence of record makes no reference to the disorder, other than to indicate that PTSD is not demonstrated. The veteran claimed that he attended a PTSD program at the Coatesville VAMC domiciliary, but then later indicated that he attended Coatesville for his drinking problem. The Board also notes that there are no treatment records, including from the Coatesville VAMC, in the claims folder showing any treatment for PTSD. In the absence of medical evidence showing the presence of current disability (PTSD), the claim for service connection for PTSD does not meet the test of plausibility and must, accordingly, be denied as not well-grounded. In the absence of a current diagnosis of PTSD, it would serve no useful purpose to discuss the evidence concerning the presence of a stressor. ORDER In the absence of a well grounded claim, service connection for PTSD is denied. C. W. SYMANSKI Member, Board of Veterans' Appeals