BVA9507370 DOCKET NO. 92-08 465 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Manchester, New Hampshire THE ISSUE Entitlement to service connection for an acquired psychiatric disorder to include post-traumatic stress disorder (PTSD). REPRESENTATION Appellant represented by: Veterans of Foreign Wars of the United States WITNESS AT HEARING ON APPEAL The veteran ATTORNEY FOR THE BOARD J. Johnston, Associate Counsel INTRODUCTION The veteran had active service from November 1975 to July 1976. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an April 1991 rating decision of the Manchester, New Hampshire, Department of Veterans Affairs (VA) Regional Office (RO). The Board twice previously remanded the case for additional evidentiary development. The case is now ready for appellate review. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends that the RO erred in denying service connection for PTSD which either originated during service or existed prior to service and was aggravated as a result of inservice stressors. She indicates that those stressors were her exposure to weapons fire and an attempted rape during military service. DECISION OF THE BOARD In accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991), following review and consideration of all evidence and material of record in the veteran's claims folder, and for the following reasons and bases, it is the decision of the Board that the preponderance of the evidence is against a claim for service connection for an acquired psychiatric disorder to include PTSD. FINDINGS OF FACT 1. All relevant evidence necessary for an equitable disposition of the appeal has been obtained. 2. The veteran is not shown to have manifested an acquired psychiatric disorder, other than PTSD, during service or a psychosis within one year after separation from service. 3. Any PTSD shown preexisted service and is not shown to have increased in severity during service. 4. Any other chronic acquired psychiatric disorder now present was not manifested during service or for many years after separation from service and is not of service origin. CONCLUSION OF LAW An acquired psychiatric disorder, including claimed PTSD, was not incurred in or aggravated by service and a psychosis may not be presumed to have been incurred in service. 38 U.S.C.A. §§ 1101, 1111, 1112, 1113, 1131, 1137, 1154(b), 5107(a) (West 1991); 38 C.F.R. §§ 3.303, 3.304(f), 3.307, 3.309 (1993). REASONS AND BASES FOR FINDINGS AND CONCLUSION The veteran's claim for service connection for a psychiatric disorder is well-grounded within the meaning of 38 U.S.C.A. § 5107(a), in that it is plausible. All of the facts have been properly developed and no further assistance is necessary to comply with the duty to assist required by law. Id. The veteran's physical examination for enlistment in September 1975 indicated that she was psychiatrically normal. In the accompanying report of medical history, the veteran indicated that she had never had trouble sleeping, never had depression or excessive worry, and never had nervous trouble of any sort. She also indicated that she had never been treated for a mental condition and that she had not consulted or been treated by any clinic, physician or practitioner within the past five years for other than minor illnesses. The service medical records do not show any complaint, finding or treatment for any chronic acquired psychiatric disorder during service. In May 1976, the veteran was noted to have been an attempted rape victim who had been provided Librium for anxiety. The assessment was anxiety neurosis-situational stress. A mental status examination conducted in conjunction with her administrative discharge for cause found the veteran to be normal with no psychiatric abnormality. The veteran's medical examination for discharge indicated she was psychiatrically normal and, in the accompanying report of medical history the veteran again noted that she had no trouble sleeping, no depression or excessive worry, no nervous trouble of any sort and that she had no significant medical problem. Service personnel records show that the veteran was awarded a Marksmanship Badge with the M-16 rifle. Records also document that the veteran lost seven days for being absent without leave from March 31 to April 6, 1976 for which she received nonjudicial punishment. She was notified of proposed administrative separation in June 1976 on the basis of poor attitude, lack of motivation, lack of self-discipline, inability to adapt, failure to demonstrate promotion potential, an inability to accept instructions and directions, and clearly substandard performance. The notification indicated that the veteran had been counseled on her deficiencies on three occasions. The veteran's DD Form 214 indicates the veteran was separated for cause prior to the expiration of her term of enlistment and was awarded a general discharge under honorable conditions. In December 1990, over fourteen years after service, the veteran filed a formal claim for service connection for PTSD. In February 1991, she submitted a statement providing a factual basis for her claim. She indicated that in July 1971, she witnessed her stepfather shoot her mother three times and then take his own life by shooting himself in the head. She said this incident was very traumatic and that she was sent to first one then another private psychiatrist for counseling. She stated that she talked about this incident but that nothing "really emotional came out of me." She reported that during basic military training for qualification with the M-16 rifle, she began shaking and having anxiety because there were too many weapons around and some fellow service members accidentally pointed them in her direction. After transferring to Signal School at Fort Gordon, Georgia, she said she started having dreams of blood involving people that she didn't know and torture dreams which caused her sleeplessness. She reported feeling depressed. After transfer to West Fort Hood, Texas, she described being told about a fellow serviceman who had died in the day room of her assigned barracks after injecting himself with some tainted drugs. She said this was too much for her, that she wasn't adjusting well to military life and that she went absent without leave (AWOL) for about seven days thereafter. She said she returned to duty of her own volition and went to the Mental Hygiene Clinic at Fort Hood for treatment for being jumpy, nervous and constantly anxious. She said she was prescribed 5 milligrams of Librium to be taken whenever she was anxious. She said she took them as needed but that they didn't work so she took the whole bottle and went to bed. She reported that she continued to take Librium and to go to the mental hygiene clinic. She said her time at Fort Hood was miserable and that she felt she would do better if she got out of the military. She said soldiers were returning from Vietnam and talking about their experiences and she had mental images of shooting and seeing someone wounded and being shot at and seeing bleeding and dead bodies. The veteran also submitted a statement indicating that she had attempted unsuccessfully to obtain medical records of her treatment with two private physicians prior to service. She also submitted copies of a resume and a Standard Form 172, Application for Federal Employment, which indicated that she had successfully attended undergraduate college and had maintained fairly constant employment after service. The veteran's first documented treatment for anxiety after service was a VA admission in June and July 1985, nine years after service. Treatment records from that admission indicate that the veteran reported excessive anxiety, worry and confusion over issues revolving around her legal separation from her husband who was reportedly somewhat abusive and alcoholic, her relationship with a domineering mother who was attempting to secure custody of the veteran's young child, and her relationship with her parents-in-law. The veteran reported her relationships regarding her mother and husband as her primary stressors. She also reported being stressed by her job and complained of having panic or anxiety attacks. The initial diagnosis was depression and anxiety. These records notably contain no reference to the stressful incidents later alleged to have occurred during service and which form the basis for her claim for service connection for PTSD. One record entry indicated that the veteran attempted suicide in service because of loneliness. Another entry indicated that the veteran was in the Army from November 1975 to July 1976 and "Lots of drugs then. I wanted out." During a psychosocial adjustment interview, the veteran reported a series of traumatic events throughout her life, including at age 7 her father died of a heart attack and at age 15 she witnessed her stepfather shoot her mother and himself. A clinical assessment summary indicated that the veteran reported that her mother sent her to a psychiatrist at age 15 because she did not grieve her stepfather's death. There were complaints of insomnia and being awakened due to stressful dreams but the stressor was reported as difficulty facing her problems for another day. The veteran also reported having suicidal thoughts but was not found to have any actual suicidal or homicidal ideation. There was no evidence or history of any psychotic process. The discharge summary provided an Axis I diagnosis of dysthymic disorder and an Axis II diagnosis of adjustment disorder with depressed mood. Immediately after the above VA admission, the veteran was seen at a private mental health center. A summary evaluation again repeated the veteran's contemporaneous stressors as being her relationship with her mother and husband and also recounted the preservice shooting incident she had witnessed. The report indicated that her marriage was stormy and produced one girl, then age four, and that part of the veteran's need to go into the hospital was because of difficulties with her husband about support and obtaining a divorce. The summary also contained a comment that the veteran probably left the Army due to pressure from her mother who indicated that she needed her at home. This report contained no firm diagnosis but did describe a diagnostic impression of depression. The report contained no references to any stressful incidents which occurred during the veteran's military service. Another evaluation from the same private mental health clinic dated in December 1987 indicated that the veteran had requested entry into a short-term work group for adult children of alcoholic parents. The veteran had previously participated in a woman's assertiveness training group from January to May 1986. During initial counseling, the veteran focused principally on childhood trauma, particularly the shooting incident. Later, she spent time attending to relationships, past and present. The closing diagnosis for Axis I was PTSD, delayed, and a diagnosis on Axis II was deferred. However, the summary of this treatment contains no complaint of or reference to any incident of the veteran's active service. In March 1991, the veteran sought a consultation with a VA psychologist for the purpose of clarifying her psychiatric diagnosis. After psychological testing, the examiner reported an absence of organic brain pathology and that the veteran placed in the bright-normal range of intellectual ability. He said the veteran might be suffering from a distress syndrome of moderate proportions and that her personality was basically schizoid. He also noted she appeared to be irritable, hostile and suspicious. He reported that the veteran's testing strongly suggested a diagnostic impression of PTSD. However, the report contained no reference to any stressors used to support the diagnostic impression. In April 1991, a psychologist assigned to the veteran's private mental health center sent an evaluation to the RO. He recounted the veteran's preservice stressor of witnessing a shooting incident and reported that the veteran's mother was an alcoholic who continued to actively drink. He indicated that the veteran reported joining the Army in 1975 and becoming acutely anxious during basic training on the firing range which produced night terrors, flashbacks, paranoia, increased startle reaction, feelings of panic, and a feeling she was going to be killed by someone making errors while shooting on the firing range. The veteran told the examiner that she sought treatment from a military mental health clinic and that she was prescribed Librium. She had apparently reported being admitted to a VA hospital in 1985 for PTSD. The psychologist said the veteran attended group therapy, assertiveness training and ongoing counseling. In December 1991, the veteran testified at a personal hearing at the RO. She indicated that after witnessing the shooting incident at age 15 the whole family received counseling but that this was no more than a one-time visit. The veteran recounted her entry onto active duty and stated that her participation in weapons training caused her to be extremely nervous. Regarding the attempted rape, the veteran indicated that a fellow service member told her that there was a contract on her life and that he was supposed to kill her and that she could either take poison or that he would have to do it himself. She felt her life was in danger. She said he also told her that he would spare her if she would have sex with him. She said he put his hand on the back of her neck with great force and that she suddenly vomited, grabbed the handle to the door of his vehicle in which they were sitting, and exited the vehicle and ran away. She said she knew the perpetrator as a member of another platoon whom she recognized because "he was always saying hi" but that she did not actually know his name or identify. She said she went to the military mental hygiene clinic on a weekly basis where she was provided Librium. She said she believed the perpetrator's actions were a subterfuge, manufactured in an attempt to coerce her to have sex with him, but at the time she felt that her life was in danger. She said that she was not as trusting or as socially active as she was prior to service, and that she had been taking medication since her separation from military service. She also stated that she had nightmares, insomnia and anxiety. In September 1993, the veteran forwarded a copy of an article which appeared in the September 1993 issue of VA Practitioner entitled "This Man's Army, This Woman's Trauma." The article noted that Vietnam Veteran Outreach Centers show that 26 percent of the women that presented for treatment at these centers had stress related to sexual trauma incurred on active duty. The article also indicated a need to learn more about people's backgrounds to see who was at risk for PTSD because a high percentage of women have premilitary physical and social abuse. Indications of sexual trauma were noted to include depression, difficulty expressing or overuse of anger, fearfulness, phobias, anxiety, restricted affect, headaches, feelings of guilt and embarrassment, sleep disturbances, exaggerated startle reactions, appetite problems, intense need for control, interpersonal difficulties, sexual dysfunction, and drug and alcohol abuse. In October 1993, the veteran underwent a VA psychiatric examination. She recounted that her biological father died at age 7, that she had pneumonia at age 11, that she was hit by a car and received a broken leg at age 13, and her exposure to the family shooting incident at age 15. She stated that her stepfather had been treated for depression prior to the shooting incident and often fought with her mother and that the couple had been working toward divorce. She described her mother as being very control oriented. She said her mother was very adamant about the veteran not expressing feelings during her childhood and that she was not supportive emotionally or financially when the veteran attempted to go to college. She said she joined the service to earn money for school. The veteran stated that her time in the military was marked by feelings of being unsafe. She reported anxiety during weapons training and that she went AWOL secondary to feeling unsafe. She recounted the incident where the fellow service member attempted to extort sexual favors in exchange for not performing a contracted murder. After military service she was married and subsequently divorced with a 12-year-old female daughter. The veteran claimed to have experienced two flashbacks, one during the incident where the serviceman was about to kill her and the other incident at a time that she was not entirely sure of. She stated that she had not had such an incident for a significant period of time. The psychiatrist noted that psychological testing performed prior to his examination suggested unusual and unconventional thinking, sullenness, and antisocial qualities which were consistent with PTSD but which also suggested someone who was mildly independent, nonconforming, impulsive, energetic, active, mildly rebellious, and showing some dissatisfaction with social adjustment. The PTSD scale noted that the veteran produced a pattern of results greater than two standard deviations above the mean, which was suggestive that the veteran presented a somewhat exaggerated version of her symptomatology. Besides the aforementioned flashbacks, she did not complain of any affective, cognitive or behavioral disturbances. The mental status examination showed the veteran to be in no acute distress, socially appropriate with a full range of affect, and there was a definite sense of exaggeration at times and of acting at other times. Thought content was significant for lack of suicidal and homicidal ideation. Thought processes were logical, coherent and goal- directed without looseness of association, flights of fancy or ideas, of reference. Judgment and insight into her illness was lacking. The psychiatrist concluded that the veteran did not meet the criteria for PTSD in accordance with the American Psychiatric Associations, Diagnostic and Statistical Manual of Mental Disorders, (3rd ed. rev. 1985) (DSM-III-R). He said that although she did apparently fulfill Criterion A by virtue of the shooting experience she witnessed at age 15, she did not meet Criterion B in that she was not currently reexperiencing the incident. It was possible the flashbacks she alluded to could meet condition four of Criterion B, but she had not experienced one of those incidents for quite some time and the examiner did not believe that she was currently reexperiencing this trauma. Furthermore, the examiner concluded that the veteran did not meet the criteria for any Axis I disorder. He did indicate that she presented a number of features which were consistent with a diagnosis of histrionic personality disorder. Pursuant to the most recent remand, The U.S. Army Criminal Investigation Command forwarded a letter to the RO in October 1994 stating that there were no records of a reported attempted rape in May 1976 associated with the veteran's active service at Fort Hood, Texas. In November 1994, the veteran was provided another VA psychiatric examination. The veteran reported her preservice family shooting incident and her anxiety regarding weapons training. She "dated her PTSD symptoms back to this time in military training." She reported that she went on leave to visit a relative for a planned visit on March 31, 1976 but that she felt unable to return "on time" due to PTSD symptoms but that she returned on her own after seven days. She stated that the incident of attempted rape occurred several days after her return to Fort Hood and that the perpetrator was a casual acquaintance with whom she had had no previous social contact and who was a member of her own platoon. After reporting the details of the incident as previously described, she also reported that the perpetrator followed her when she ran from the automobile and asked her to return to the car and ride back with him to their unit location. She said she sensed he had changed his mind and would not hurt her so she re- entered the car and they returned to their unit but she jumped from the car before it had even stopped moving when they were near her barracks. She said this incident caused a surge of PTSD symptoms including autonomic arousal and intrusive recollection of the shooting incident at age 15. She said she reported the incident to her sergeant the following morning but that the sergeant did not take any action and that he told her she should not have gotten into the car. She confirmed that upon reflection she felt the threat to her life was a pretext for sex but that at the time she felt in fear of her life. She confirmed that no sexual contact occurred. In discussing PTSD symptoms, the veteran reported continuing intrusive thoughts of incidents before and during service but reported no nightmares had ever occurred. She reported having had two dissociative-like episodes, including one where her boyfriend slowly put his hand in his pocket and she felt that he might pull out a gun and shoot her. The other was not described. The examiner said these were not classic flashbacks of reexperiencing trauma but were occasions where the veteran dissociated in response to perceived danger. However, she said she had not had any recurrence of these episodes recently. The examiner concluded that the veteran did meet the criteria for chronic PTSD but that it was difficult to determine how much of her current symptoms were secondary to her military experience. The examiner stated that the veteran's exposure to the family shooting incident at age 15 was clearly a severe trauma and that the incident "predisposed her to be vulnerable to any repeated trauma in which her life would be threatened in any way." The examiner stated that incidents during service re-traumatized the veteran "such that she required psychiatric care and hospitalization and did have an overdose." The examiner concluded that "pre-existing PTSD" was "exacerbated" during military service. The Axis I diagnosis was PTSD, severe and chronic. Axis II was deferred but the examiner noted that the veteran did have some "characterological" traits. Service connection may be established for disability resulting from personal injury suffered or disease contracted in line of duty. 38 U.S.C.A. § 1131. Service connection may be granted for a psychosis which becomes manifest to a compensable degree within one year from the date of separation from service. 38 U.S.C.A. §§ 1101, 1112, 1113; 38 C.F.R. §§ 3.307, 3.309. Regulations also provide that service connection may be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). For the showing of chronic disease in service, there is required a combination of manifestations sufficient to identify the disease entity and sufficient observation to establish chronicity at the time, as distinguished from merely isolated findings. Continuity of symptomatology is required only where the condition noted during service is not, in fact, shown to be chronic or where the diagnosis of chronicity may be legitimately questioned. When the fact 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). A veteran will be considered to have been in sound condition when examined for service, except as to defects, infirmities, or disorders noted at entrance to service, or where clear and unmistakable (obvious or manifest) evidence demonstrates that an injury or disease existed prior to service. 38 U.S.C.A. § 1111; 38 C.F.R. § 3.304(b). A preexisting injury or disease will be considered to have been aggravated by active military service where there is an increase in disability during such service, unless there is a specific finding that the increase in disability is due to the natural progress of the disease. 38 U.S.C.A. § 1153; 38 C.F.R. § 3.306(a). Aggravation may not be conceded where the disability underwent no increase in severity during service. 38 C.F.R. § 3.306(b). In the field of mental disorders, personality disorders which are characterized by developmental defects or pathological trends in the personality structure manifested by a lifelong pattern of action or behavior, chronic psychoneurosis of long duration, or other psychiatric symptomatology shown to have existed prior to service with the same manifestations during service, which were the basis of the service diagnosis will be accepted as showing preservice origin. Congenital or development defects, including personality disorders, are not diseases or injuries within the meaning of applicable legislation. 38 C.F.R. § 3.303(c). 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 U.S.C.A. § 1154(b); 38 C.F.R. § 3.304(f). The DSM-III-R provides that PTSD may result when a person experiences an event that is outside the range of usual human experience and that would be markedly distressing to almost anyone; for example, a serious threat to one's life or physical integrity, serious threat or harm to one's children, spouse, or other close relatives and friends, sudden destruction of one's home or community, or seeing another person who has recently been or is being seriously injured or killed as the result of an accident or physical violence. The second factor is that the traumatic event is persistently reexperienced in at least one of the following ways: recurrent and intrusive distressing recollections of the event; recurrent distressing dreams of the event; suddenly acting or feeling as if the traumatic event was reoccurring (including a sense of reliving the experience, illusions, hallucinations, and dissociative [flashback] episodes, even those that occur upon awakening or when intoxicated); and, intense psychological distress and exposure to events that symbolize or resemble an aspect of the traumatic event, including anniversaries of the trauma. The third factor involved is persistent avoidance of stimuli associated with the trauma or numbing of general responsiveness (not present before the trauma), as indicated by at least three of the following: efforts to avoid thoughts or feelings associated with the trauma; efforts to avoid activities or situations that arouse recollections of the trauma; inability to recall an important aspect of the trauma (psychogenic amnesia); markedly diminished interest in significant activities; feeling of detachment or estrangement from others; restricted range of affect, for example unable to have feelings of love; and a sense of foreshortened future (for example does not expect to have a career, marriage, or children, or a long life). The fourth factor involves persistent symptoms of increased arousal (not present before the trauma), as indicated by at least two of the following: difficulty falling or staying asleep; irritability or outbursts of anger; difficulty concentrating; hypervigilance; exaggerated startle response; physiologic reactivity upon exposure to events that symbolize or resemble an aspect of the traumatic event. Duration of disturbances described in the three previous factors must exist for at least one month. If symptoms occur more than six months after the traumatic stressor, a diagnosis should specify delayed onset. American Psychiatric Associations, Diagnostic and Statistical Manual of Mental Disorders, (3rd ed. rev. 1985). In Zarycki v. Brown, 6 Vet.App. 91 (1993), the Court of Veterans Appeals (Court) indicated that where a reported stressor in support of a diagnosis of PTSD is not related to combat and independently corroborated (as in this case) the veteran's lay testimony, by itself, will not be sufficient to establish the occurrence of the alleged stressor. Instead, the record, including but not limited to service records, must contain credible evidence which corroborates the veteran's testimony as to the occurrence of the claimed stressor(s), and the available service records must not contradict the veteran's testimony. Doran v. Brown, No. 93-228 (U.S. Vet. App. Mar. 8, 1994). Should the occurrence of a stressful episode be established, it must also be determined whether the claimed stressful event was of sufficient gravity to support a diagnosis of PTSD as required in DSM-III-R. In the present case, the evidence of record is insufficient to warrant a grant of service connection for an acquired psychiatric disorder, including PTSD. Initially, the service medical records do not show that the veteran manifested a chronic psychiatric disorder during service. The sole entry containing an assessment of anxiety neurosis-situational stress revolving around a reported attempted rape does not support a finding that the veteran acquired a chronic psychiatric disorder during service. Moreover, a mental status evaluation associated with the veteran's administrative separation showed no psychiatric abnormality and the examination for separation from service indicated the veteran was psychiatrically normal. Additionally, there is no evidence that the veteran manifested a psychosis to a compensable degree within one year after she was separated from service. The first recorded psychiatric treatment after service occurred in 1985, nine years after the veteran's discharge. VA and private treatment records from 1985 verify a diagnosis of dysthymic disorder which was solely related to post-service events in the veteran's life. During a lengthy inpatient stay, the veteran herself reported that her principle stressors involved her relationships with her husband and her mother. Extensive treatment records during this period do not contain any mention of traumatic stressors which occurred during service other than the fact that the veteran reported attempting suicide due to loneliness. The only other comment regarding military service, was that the veteran said she wanted out. Other than occasional insomnia and a bad dream related to dealing with life, the treatment records from her VA admission in 1985 do not make reference to any PTSD related symptomatology. The private mental health center record from December 1987 which contains the first diagnosis of PTSD fails to indicate whether that diagnosis was provided by a medical specialist with the requisite training and, in any event, fails to describe any stressor(s) or PTSD symptomatology related to those stressor(s) to adequately support a PTSD diagnosis in accordance with DSM-III-R. The private psychologist's report of April 1991 simply restates the veteran's reported history of stressors during service and her reported symptomatology. There is no evidence that this examiner conducted independent psychological testing corroborating his impression of PTSD and anxiety/panic attacks. The veteran is not shown to have PTSD which is related to service. Although the VA psychological consult report from March 1991 indicated that the veteran might be seen to manifest a distress syndrome of moderate proportions, that report does not provide any details of whether the stressors necessarily relied upon to support the test results occurred before, during or after service. Moreover, this testing did not confirm a diagnosis of PTSD but simply provided the results of psychological testing which was consistent with a diagnosis of PTSD. The psychiatric evaluation of October 1993 resulted in a finding that the veteran had no Axis I diagnosis. The examiner evaluated the veteran's symptomatology in accordance with DSM-III-R and found that she did not have or exhibit symptomatology which was prerequisite to a valid PTSD diagnosis. The examiner noted that the only adequate stressor reported to support a diagnosis of PTSD was the shooting incident and that incident occurred prior to service. The examiner did find that the veteran presented a number of features which were consistent with a diagnosis of histrionic personality disorder. However, the most recent November 1994 VA psychiatric examination did provide a positive diagnosis of PTSD which preexisted service based upon the stressor of the preservice family shooting incident which the veteran witnessed at age 15. This diagnosis serves to clearly and unmistakably rebut the presumption of soundness which arises as a result of the psychiatrically normal findings of the veteran's examination for induction to service. 38 U.S.C.A. § 1111; 38 C.F.R. § 3.304(b). The presumption of sound condition at the time of service induction must also be viewed in light of the report of medical history provided by the veteran at that time. The veteran has repeatedly stated that she witnessed the family shooting incident at age 15, and that she was provided psychiatric or psychological counseling thereafter. However, the report of medical history for induction to service completed by the veteran indicated she never had nervous trouble of any sort, that she had never been treated for a mental condition, and that she had not consulted or been treated by any clinic, physician or practitioner within the past five years for other than minor illnesses. Contrary to that history, the evidence now reveals that the veteran had received counseling within five years of service. Had the veteran provided an accurate medical history, she might have been provided a more thorough evaluation of her mental condition at the time of induction. In any event, all evidence currently on file, including the most recent VA psychiatric examination clearly and unmistakably rebuts the presumption of sound condition at induction. The issue then presented for consideration is whether preexisting PTSD was aggravated during the veteran's period of active service. The Board finds that it was not aggravated because the clear preponderance of the evidence on file shows no increase in disability during service. As previously stated, there is simply no record of any complaint, finding or treatment for any mental disorder at any time during or for nine years after service except for the single service medical record entry recording anxiety neurosis-situational stress after the veteran was reportedly the victim of an attempted rape which was treated with ten milligrams of Librium. While the veteran has reported that she sought and was provided continuing treatment with service mental health care providers such treatment is not corroborated by the service medical records which are not shown to be incomplete. No aggravation of PTSD is shown to have occurred during service because there is no evidence showing any increase in PTSD symptomatology during service or for many years after service. Extensive records of the first psychiatric treatment (nine years) after service in 1985, resulted in a diagnosis of dysthymia which was entirely related to post-service stressors. Records do not show that the veteran has ever required ongoing treatment for PTSD and, other than evaluations conducted for rating purposes, there are no records of ongoing psychiatric treatment for any purpose. Finally, the November 1994 VA psychiatric examiner who concluded that PTSD preexisted service stated preexisting PTSD "predisposed" the veteran to be vulnerable to life threatening situations. The examiner also stated that preexisting PTSD was "exacerbated" during service. While the psychiatrist does not specify whether the "exacerbation" repesented acute activation of pertinent symptomatology or permanent increase in the underlying disability, it appears clear from the overall record, especially the quiescent nature of the psychiatric disability for many years after service, that the exacerbations of her preexisting condition was acute and transitory, resolving without any actual increase in the underlying disability. In regard to the veteran's reported inservice stressors, it is clear that an incident of being exposed to weapons fire on a rifle range would be insufficient, of itself, to qualify as a stressful event that would be considered to be outside the range of usual human experiences and which would be markedly distressing to almost anyone. The veteran volunteered for military service and knew or should have known that her duties would require some exposure to weapons fire. The evidence shows that the veteran was able to successfully complete weapons training and indeed she was able to shoot well enough to earn the award of "marksman" with the M-16 rifle. While the veteran reported being the victim of an attempted rape on one occasion at a service medical facility while on active duty, the actual incident is not corroborated by any independent evidence of record. Moreover, during the personal hearing the veteran stated that although the perpetrator's statement that he was exercising a contract murder frightened her at the time, she now believed that this was simply a subterfuge to coerce sexual favors. Therefore, the veteran herself does not presently believe that the perpetrator actually intended to kill her and there is no indication that she re-experiences this episode through nightmares or flashbacks. During the most recent VA psychiatric examination, the veteran reported that after the purported threat to her life and attempt to obtain sex by extortion of the threat, she actually returned to the perpetrator's vehicle for a return ride to her barracks because she felt that he had changed his mind and that he would no longer try to harm her. This contemporaneous belief in the perpetrator's relative harmlessness, sufficient to allow the veteran to actually get back into the perpetrator's vehicle, tends to show that either the incident did not place her in serious fear of her life and well-being, or if the veteran was fearful, it was only for a short time until she felt the situation had become defused. Finally, the Board finds that the allegations supporting the veteran's present claim are not entirely credible. Numerous treatment records note a reported history that, after the shooting incident involving her stepfather and mother, the veteran received some amount of psychiatric care from age 15 to 18. In a statement submitted to the RO in February 1991, the veteran said she had seen Drs. Shaka and Lianos on at least several occasions prior to service. However, during the personal hearing, the veteran indicated that she was only counseled on a single occasion. The evidence also shows that veteran failed to report these facts in completing her medical history for induction to service. Although the veteran reported attempting suicide during service by an overdose of medication, there is no corroboration of this incident in the service medical records or any other records from service nor is there evidence that the veteran was prescribed any quantity of Librium as alleged. Although there is no clinical evidence that the veteran received any psychiatric treatment after service until 1985, she testified during the personal hearing that she had been taking psychotropic medication ever since military service. While the veteran has reported that she sought and was provided ongoing mental health counseling during service after both the AWOL incident and the purported incident of attempted rape, there are no records of ongoing counseling. In an April 1991 letter to the RO, a private psychologist indicated his understanding that the veteran had been hospitalized at the VA in 1985 for PTSD. However, records of that admission clearly show that treatment was for dysthymia resulting from post-service stressors; there was no diagnosis of PTSD. Although the veteran testified and reported during earlier examinations that she experienced nightmares, she denied having any nightmares either recently or in the past during the November 1994 VA examination. Although the veteran has reported having flashbacks, the descriptions of those events and the clinical evidence evaluating them shows that the veteran has not and does not have flashbacks of past events as described in the DSM-III-R. Although the veteran testified and reported during earlier examinations that the fellow service member who attempted to extort sex from her during service was from another platoon, she said he was actually assigned to her own platoon during the November 1994 VA examination. In discussing the incident of AWOL during service in the statement submitted in association with her initial claim, the veteran said she went AWOL after hearing that a fellow service member had died after injecting tainted drugs and that she was not adjusting well to military life. During the October 1993 VA psychiatric examination, the veteran described adversely reacting to weapons training and reported that she went AWOL secondary to feeling unsafe. However, the documented AWOL was several months after basic military training and occurred before the purported incident of attempted rape. Additionally, the veteran told the November 1994 VA examiner she departed Fort Hood in a leave status on March 31, 1976 for a preplanned visit to a relative and that her failure to return on time resulted in her AWOL However, the record of nonjudicial punishment from service found the veteran responsible for a seven day AWOL which commenced on March 31, 1976; i.e. she was AWOL from the moment she departed Fort Hood. The October 1993 VA examiner reported, that the veteran's psychological testing "might suggest some severe pathologic endorsement of PTSD scale items" and the report of examination suggested a lack of credibility in other areas as well. Clearly based upon the veterans reported history, the November 1994 VA examiner opined that "it sounds like her symptomatology became worse" during service such that the veteran "required psychiatric care and hospitalization" but the veteran did not have such care or hospitalization for many years after service, and then it was for nonservice related dysthymia. Finally, in her VA Form 1-9, the veteran stated that a psychiatric disorder kept her from completing her tour of duty. The evidence on file shows no psychiatric disorder was found during service and that the veteran was administratively separated after a normal mental status examination because of general unsuitability for military service and substandard performance. To summarize, the clinical evidence of record does not show that the veteran manifested a chronic acquired psychiatric disorder, other than PTSD, during service or a psychosis within one year after service. Dysthymia was first diagnosed nine years after service and is clearly shown to be unrelated to any incident of service. PTSD clearly existed prior to service and was not aggravated during service because there is no credible evidence showing that PTSD underwent a permanent increase in severity during service or for many years after service. The stressful incidents alleged to have occurred during service are not credible or verified. Based upon these findings and following a full review of the record, we conclude that a preponderance of the evidence is against entitlement to service connection for an acquired psychiatric disorder to include PTSD. Because there is not an approximate balance of positive or negative evidence regarding the merits of an issue material to the determination of this case, the veteran is not entitled to the favorable application of 38 U.S.C.A. § 5107(b) (1993). ORDER Service connection for a psychiatric disorder, including PTSD, is denied. THOMAS J. DANNAHER 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.