BVA9504893 DOCKET NO. 92-09 483 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Nashville, Tennessee THE ISSUE Entitlement to service connection for an acquired psychiatric disorder. WITNESS AT HEARING ON APPEAL The appellant ATTORNEY FOR THE BOARD Raymond F. Ferner, Counsel INTRODUCTION This matter comes before the Board of Veterans' Appeals (BVA or Board) on appeal from a February 1991 rating decision of the Department of Veterans Affairs (VA) Regional Office in Nashville, Tennessee, (RO) which denied the benefit sought on appeal. The veteran, who had active service from April 1967 to May 1968, appealed that decision to the BVA, and the case was initially received at the Board on this matter in June 1992. A BVA decision dated in May 1993 remanded this case to the RO for further development, and the case was returned to the Board in October 1994. CONTENTIONS OF APPELLANT ON APPEAL The veteran essentially contends that the RO was incorrect in not granting the benefit sought on appeal. The veteran maintains, in substance, that he had the onset of an acquired psychiatric disorder during his period of military service, or in the alternative, that a preexisting acquired psychiatric disorder chronically worsened during service. The veteran noted that prior to his entry onto active duty he was diagnosed as having chronic brain syndrome, and that he was subsequently discharged from service due to a psychiatric disability. Reference is made to the evidence of record as supporting these contentions. Therefore, a favorable determination has been requested. DECISION OF THE BOARD The Board, in accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991), has reviewed all of the evidence of record. Based on a review of the evidence in this matter, and for the following reasons and bases, it is the decision of the Board that the preponderance of the evidence is against the claim for service connection for an acquired psychiatric disorder. FINDINGS OF FACT 1. All relevant evidence necessary for an equitable disposition of the veteran's appeal has been obtained by the RO. 2. Preservice private medical records dated in March 1966 contained a diagnosis of chronic brain syndrome, but a subsequent neurology consultation performed later that month concluded that the veteran had no organic disturbance of either the central or peripheral nervous system. 3. The report of the veteran's service entrance examination performed in November 1966 contains no evidence of chronic brain syndrome, or any other psychiatric disorder. 4. Service medical records contain no evidence of complaints, treatment, or diagnosis of an acquired psychiatric disorder. 5. The reports of the veteran's separation physical examination and a mental health consultation performed in connection with that examination contain diagnoses of an inadequate personality disorder. 6. Schizophrenia was not manifested within one year of the veteran's separation from service. CONCLUSION OF LAW An acquired psychiatric disorder was not incurred in or aggravated by active service, nor may a psychosis be presumed to have been so incurred. 38 U.S.C.A. §§ 1101, 1110, 1111, 1112, 1113, 5107 (West 1991); 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309 (1994). REASONS AND BASES FOR FINDINGS AND CONCLUSION As a preliminary matter, the Board finds that the veteran's claim is "well grounded" within the meaning of 38 U.S.C.A. § 5107(a) (West 1991). See Murphy v. Derwinski, 1 Vet.App. 78, 81 (1990); Gilbert v. Derwinski, 1 Vet.App. 49, 55 (1990). That is, the Board finds that the veteran has presented a claim which is not implausible when his contentions and the evidence of record are viewed in the light most favorable to that claim. The Board is also satisfied that all relevant facts have been properly and sufficiently developed. Medical records dated prior to the veteran's entry into service disclose that the veteran was hospitalized for six days in early March 1966 following an altercation while participating in a Job Corps program. Following that hospitalization the final diagnosis was chronic brain syndrome. Further treatment as an outpatient was recommended. A neurological examination performed later in March 1966 by Robert F. Goodwin, M.D., concluded with an impression that the veteran had no organic disturbance of either the central or peripheral nervous systems. In November 1966 the veteran underwent a physical examination in connection with his entry into service. At the time of that examination the veteran denied experiencing any pertinent complaints or symptomatology on the Report of Medical History portion of the examination, and the Report of Medical Examination indicates that neurologic and psychiatric clinical evaluations were normal. The veteran's service medical records are devoid of any psychiatric complaints, clinical findings, treatment or diagnosis, with the exception of a mental hygiene consultation performed in March 1968 at the request of the veteran's commanding officer. That consultation indicated that the mental status examination disclosed the veteran showed no signs of organic, neurotic or psychotic disease, and the diagnosis following the examination was of an inadequate personality manifested by an inability to perform routine military tasks. The veteran was recommended for separation from service. Following service the veteran has been diagnosed with several psychiatric disorders, the earliest diagnosis being recorded following the hospitalization in June 1978 when the veteran was diagnosed as having an adjustment reaction of adult life. Subsequent diagnoses include a diagnosis of schizophrenia following a psychiatric evaluation performed in May 1982 by George L. Gee, Jr., M.D. Under laws and regulations pertaining to service connection the veteran is presumed "to have been in sound condition when examined, accepted, and enrolled for service, except as to defects, infirmities, or disorders noted at the time of the examination, acceptance, and enrollment, or where clear and unmistakable evidence demonstrates that the injury or disease existed before acceptance and enrollment and was not aggravated by such service." 38 U.S.C.A. § 1111 (West 1991). In this case, no psychiatric defects, abnormalities or disorders were noted on the veteran's entrance physical examination, and he is, therefore, presumed to have been in sound condition upon his entry into service. While there was evidence that reflects that the veteran had been diagnosed as having a chronic brain syndrome prior to service, given the neurological examination performed following the hospitalization which diagnosed the veteran as having that disorder, and which failed to diagnose the veteran as having any psychiatric or neurological disorder, the Board finds that there is not clear and unmistakable evidence which demonstrates that any psychiatric or neurological disorder preexisted the veteran's entry into service. The veteran's service medical records do not demonstrate that the veteran was treated or diagnosed as having an acquired psychiatric disorder during service. Rather, a mental health consultation concluded with a diagnosis that the veteran had a personality disorder, a disorder which is not within "the meaning of applicable legislation for disability compensation purposes." 38 C.F.R. § 4.9 (1994). See also, 38 C.F.R. §§ 3.303(c), 4.127 (1994). As such, the veteran is not shown to have manifested an acquired psychiatric disorder during his period of military service. Following service, the record reflects a plethora of psychiatric diagnoses, including a diagnosis of schizophrenia made in 1982, more than one year following the veteran's separation from service. While a diagnosis of a psychosis more than one year following the veteran's separation from service would appear to preclude a grant of service connection on a presumptive basis, 38 C.F.R. §§ 1101, 1112, 1113 (West 1991); 38 C.F.R. §§ 3.307, 3.309 (1994), a VA psychiatric examination performed in April 1987 appears to raise a question as to the date of onset of the veteran's schizophrenia. Following that examination, the examiner commented that, "In review of the available information, it would appear that the [veteran] has in most likelihood, been schizophrenic throughout most of his adult life, although this was not noted during his military career. In my opinion, it would have preceeded [sic] his entry into service." It is noteworthy that the examiner does not appear to have had access to all of the medical records in the veteran's claims file, or, at the very least, the examiner did not indicate that he had a benefit of a review of the veteran's claims file. In an attempt to reconcile the various psychiatric diagnoses of record and to determine when the veteran's schizophrenia had its onset, the Board remanded this case in May 1993 to afford the veteran an additional psychiatric examination by a board of two psychiatrists. Following accomplishment of those examinations, in February l994, which included a review of the veteran's claims file and all pertinent medical records contained therein, the examiners concluded that, "In regards to diagnosis, he suffers from schizophrenia, paranoid type, chronic severe degree, dating back to 1981. Also he has an Axis II diagnosis of personality disorder, not otherwise specified, with antisocial, borderline and histrionic traits, which would date back to childhood and adolescence, prior to service and prior to any development of any schizophrenia. His personality disorder has no relationship with his non-service-connected disability." Based on this evidence and the discussion above, the Board concludes that the veteran did not have a psychiatric disorder which clearly and unmistakably existed prior to service, that he did not manifest an acquired psychiatric disorder during service, and that a psychosis was not manifested within the one-year presumptive period following the veteran's separation from service. Consequently, the Board concludes that service connection for an acquired psychiatric disorder is not established. ORDER Service connection for an acquired psychiatric disorder is denied. WARREN W. RICE, JR. 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.