BVA9503788 DOCKET NO. 93-12 775 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office and Insurance Center in St. Paul, Minnesota THE ISSUE Entitlement to service connection for post-traumatic stress disorder. REPRESENTATION Appellant represented by: The American Legion WITNESSES AT HEARING ON APPEAL Appellant and his spouse ATTORNEY FOR THE BOARD Ronald R. Bosch, Counsel INTRODUCTION The veteran served on active duty from August 1966 to August 1968. This appeal arose from an August 1991 rating decision by the Department of Veterans Affairs (VA) Regional Office and Insurance Center(RO&IC) in St. Paul, Minnesota. The RO&IC denied entitlement to service connection for post-traumatic stress disorder. The above determination was affirmed in subsequently issued rating decisions. The case has been forwarded to the Board of Veterans' Appeals (Board) for appellate review. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends that he has post-traumatic stress disorder as the result of his exposure to personal life threatening stressors in connection with his service in Vietnam. 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 record supports a grant of service connection for post-traumatic stress disorder. FINDINGS OF FACT 1. The veteran served with the United States Army in Vietnam as an ammunition records clerk and is a recipient of decorations including a Vietnam Service Medal and a Vietnam Campaign Medal with 1 Overseas Service Bar. 2. The veteran was exposed to psychologically traumatic events during service of such magnitude as to provoke significant symptoms of distress in almost anyone. 3. The veteran has post-traumatic stress disorder as a consequence of his military service. CONCLUSION OF LAW Service connection for post-traumatic stress disorder is granted. 38 U.S.C.A. §§ 1110, 1154, 5107 (West 1991). REASONS AND BASES FOR FINDINGS AND CONCLUSION Initially, the board finds that the appellant's claim is well grounded within the meaning of 38 U.S.C.A. § 5107(a) (West 1991), in that in view of his documented service as an ammunition records clerk with the United States Army in Vietnam, it is at least plausible that he has post-traumatic stress disorder. The Board is satisfied that all relevant facts have been properly developed and that no further assistance to the claimant is required in order to comply with 38 U.S.C.A. § 5107(a). The appellant has contended that he has post-traumatic stress disorder which is directly related to his exposure to traumatic events associated with his service as a United States Army ammunition records clerk in Vietnam. His service documentation on file substantiates that he indeed was a member of Army units which periodically engaged enemy forces in Vietnam and were subject to mortar and rocket attacks, ambushes, and loss of life as a result of contact with substantial numbers of enemy forces. The Board has considered and is cognizant of the circumstances, conditions, and hardships attendant to the veteran's service in Vietnam. 38 U.S.C.A. § 1154. The nature of the appellant's service is not in doubt in view his statements on file describing the nature of his service in the combat zone, and his testimony presented at a hearing held at the RO. The Board construes the above evidence as entirely credible in nature. The question remaining in the disposition of the veteran's appeal is whether he in fact has post-traumatic stress disorder as a consequence of the nature of his service in Vietnam. The Board must respond in the affirmative. A review of the record discloses that chronic psychiatric symptomatology became apparent during 1991 when the veteran sought help on an outpatient basis at the local VA outpatient clinic. A May 1991 VA mental health clinic report shows that he was reported to have an extensive alcoholism history particularly between 1966 and 1968. His ex-wife reported that he had had a significant behavioral change since aggravation of symptoms following the Persian Gulf War. A mental status evaluation concluded in clinical assessments of probable major depression, possibly recurrent. Although the predominant symptom seemed to be major depression, the examiner noted that aggravation of post- traumatic stress disorder should be considered. Alcohol abuse was also noted. A November 1991 VA consultation report shows the veteran reported manning an ammunition depot in Vietnam. He described "incoming" fire on a regular basis and full scale ground attacks during at least one of which part of the fire base was overrun. He reported he had experienced much fear that the ammunition depot would blow up. Although it was hit by rocket fire, it did not blow up. He viewed body bags. He reported nightmares of incoming fire one year after his return from service as well as occasional startle reaction. He did not recall instances described by his wife wherein he yelled at her and hit her. His recent stressors appeared to be the Gulf War. He stated that he had killed someone in Vietnam in a kill or be killed situation. The diagnostic impression was partial post-traumatic stress disorder (at least). On file is a letter dated in May 1992 from George Komaridis, Ph.D., a private therapist. Dr. Komaridis noted the veteran dispensed ammunition to American units in Vietnam. His tent was next to the ammunition depot. His base was constantly under rocket and mortar attacks. At times the base was overrun by the enemy. The veteran described a massive fire fight in which he had killed one of the enemy. As a result of his trauma, he saw himself as a murderous person and avoided thought or feelings associated with the shooting. Until recently he had withheld discussing this subject with anyone. Since his return he had experienced weekly recurrent dreams and nightmares in which he saw himself killing the enemy soldier. His nightmares occurred two to three times weekly. He was very active in his nightmares, struggling both physically and emotionally, swinging and hitting, even after being awakened by his wife. He often tore up his bed sheets and called out for help. Dr. Komaridis noted that the appellant also experienced survival guilt for leaving the Bien Hoa airbase for the United States minutes before a heavy fire fight took place, resulting in many casualties. He described feelings of detachment and estrangement from others. The veteran chose to be alone, trusting only his spouse. He reported experiencing intense psychological stress with hypervigilance and startle reactions or when hearing helicopters or noises similar to those experienced during the war. Dr. Komaridis noted that the veteran experienced a restricted range of affect. He reported that his relationship with his wife and children had been restricted by his lack of affect and distancing. His wife had been directly affected by his nightmares and she reported that he had yelled about "Charlie" in his dreams. Dr. Komaridis noted that the appellant reported difficulty holding up under the stress of acute post-traumatic stress disorder symptoms. His symptoms disturbed his sleeping and waking states. The appellant reported fatigue, depression, isolation and frequent insomnia. In Dr. Komaridis' opinion, the veteran was significantly disabled by his acute post-traumatic stress disorder and withdrawn state. At a July 1992 VA psychiatric examination, the veteran reported that he had served in Vietnam from February 1967 to February 1968. He was not wounded and drank heavily while there. He was assigned to the 1st Infantry Division Support Command. He complained of restless sleep and apparently had nightmares two to five times per week during which he often struck his wife. He did not remember when this happened. Although he denied flashbacks, he stated that he experienced daily memories which were moderately intrusive. He had a startle response and was hypervigilant. He cried sometimes and had suicidal thoughts but had made no attempts. He was suffering from guilt for having killed a man and his post-traumatic stress disorder symptoms seemed to center around this single episode. The occasion of his killing a member of the enemy forces was during a ground assault. He became sick over the incident and continued to have guilt about it. When the Gulf War broke out he began to have increasing difficulties. The mental status evaluation concluded in a diagnosis of post-traumatic stress disorder. The veteran and his wife provided testimony at an RO hearing held in January 1993. He provided information as to his previous Vietnam service and current post-traumatic stress disorder symptomatology. His wife described the changes that had taken place in his behavior subsequent to service. Additional correspondence on file dated in June 1993 from Dr. Komaridis essentially reiterates previously provided information pertaining to the veteran's psychiatric symptomatology confirmed as reflective of post-traumatic stress disorder. The Board's evaluation of the evidence of record permits the conclusion that the veteran has post-traumatic stress disorder related to his combat experiences as an ammunition records clerk in Vietnam. The record confirms a diagnosis of post-traumatic stress disorder by VA as well as non-VA health care professionals. The veteran has been in receipt of psychotherapy from VA as well as non-VA health care professionals. VA and non-VA health care professionals have evaluated his medical records and histories and in view of his psychiatric symptomatology have concluded that post-traumatic stress disorder related to combat experiences in service is present. For the foregoing reasons the Board finds that the evidence of record supports a grant of entitlement to service connection for post-traumatic stress disorder. 38 U.S.C.A. §§ 1110, 1154, 5107. ORDER Entitlement to service connection for post-traumatic stress disorder is granted. BRUCE KANNEE 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.