BVA9505117 DOCKET NO. 92-02 890 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Nashville, Tennessee THE ISSUE Entitlement to service connection for a psychiatric disorder, characterized as depression. REPRESENTATION Appellant represented by: The American Legion WITNESSES AT HEARING ON APPEAL Appellant; [redacted] ATTORNEY FOR THE BOARD Julia M. Kurtz, Associate Counsel INTRODUCTION The veteran served on active duty from June 1943 to April 1946 and July 1948 to June 1965. This appeal arises from a November 1991 rating decision of the Nashville, Tennessee, Regional Office (RO) which denied entitlement to service connection for depression. The veteran testified before a hearing officer at the RO in August 1992. In April 1993, the Board remanded this case by letter. In March 1994, the Board remanded the case for further development. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends that he is entitled to service connection for depression. He contends that he was confined to quarters, suffered cruel and inhumane treatment in service, and was denied retirement, which rendered him depressed. He asserts that he was unable to function outside his home for several months following discharge and has suffered from depression since discharge from service. 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(s). 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 preponderance of the evidence is against the veteran's claim for entitlement to service connection for a psychiatric disorder characterized as depression. FINDINGS OF FACT 1. All relevant evidence necessary for an equitable disposition of the veteran's appeal has been obtained by the RO. 2. A psychiatric disorder was not present during service, not clinically documented for many years following service, and any current psychiatric disorder is not shown to be of service origin. CONCLUSION OF LAW An acquired psychiatric disorder, including a psychosis, was not incurred in or aggravated by the veteran's active service, nor may be presumed to have been incurred therein. 38 U.S.C.A. §§ 1101, 1110, 1112, 1131, 1137,5107 (West 1991); 38 C.F.R. §§ 3.303, 3.307, 3.309 (1993). REASONS AND BASES FOR FINDINGS AND CONCLUSION Initially, it is necessary to determine if the veteran has submitted a well-grounded claim within the meaning of 38 U.S.C.A. § 5107(a) (West 1991), and if so, whether the Department of Veterans Affairs (VA) has properly assisted him in the development of his claim. A "well-grounded" claim is one which is not implausible. Our review of the record indicates that the veteran's claim is plausible and that all relevant facts have been properly developed. Pursuant to the Board's March 1994 remand, private medical records have been obtained. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C.A. §§ 1110, 1131 (West 1991). Service connection for a psychosis may be granted if manifested to a compensable degree within one year following service if the veteran had served for a minimum of ninety (90) days. 38 U.S.C.A. §§ 1101, 1112 (West 1991). The veteran's service medical records are negative for complaints or findings of a psychiatric disorder. At his separation examination in June 1965, the veteran complained of headache on the right side and twitching of the right hand. A neurology consultation was within normal limits. The examiner indicated that the veteran had been under considerable pressure for the last 6 months finishing up work. He suggested that the veteran be worked up for a spinal disorder. The veteran's personnel records are not contained within the claims file. A medical statement dated in May 1991 from William M. Petrie, M.D., indicates that he interviewed the veteran for a major depressive disorder. He stated that the veteran had, in part, reacted to traumatic episodes which occurred in the Navy over 19 years ago for which the veteran was denied retirement and kept on house arrest, that the veteran has ruminated about the issue which has resulted in ongoing depressive symptoms. He also indicated that the veteran was receiving individual psychotherapy treatment through Ms. Dorothy Stockard. At a VA psychiatric examination in October 1991, the veteran gave a history of being discharged after 19 years, 11 1/2 months of service. He believed that he became the "whipping boy" for his superior officer, and was ultimately given unsatisfactory fitness reports. While serving in Alaska, he picked up some spare parts from an enlisted man and was given a special Courts Martial for association with an enlisted man. He was subsequently transferred back to California but that a letter from the Chief of Naval Personnel had preceded him, telling of his background. He was then forced to retire short of the time necessary to qualify for retirement benefits. Since that time, he has felt it necessary to excel in everything to make it up to his family. He stated that he has been depressed since service, will come home from work early and just lie down and has difficulty concentrating. His first treatment for depression was 8 months earlier. He and his wife owned a floral shop. His outside work has included church work, civic clubs, social organizations, and he was elected County Commissioner several times. Upon examination, the veteran did not show evidence of disturbance of mood, sensorium, or affect. His spontaneous speech was relevant, logical, coherent, and did not show indication of hallucinations, delusions, paranoid thinking or thought disorder. He did not show restlessness, tension, or anxiety. He gave a precise and detailed history for past and recent events. The impression was major depression by history, not evident at this time. The veteran and his wife testified before a hearing officer at the RO in August 1992. He testified that: approximately four years prior to retirement, he became the whipping boy of his superior officer; he volunteered for Vietnam but was assigned to Alaska under one of his superior officer's friends where the harassment continued; he was charged in a special courts-martial for several offenses; he was convicted of nefarious dealings with an enlisted man for buying an auto part for the man; he was transferred back to California under another friend of his superior officer's; he then received unfit fitness reports despite a commendation from the admiral of the base; and was discharged from service approximately 40 days short of obtaining his retirement; his nervous disorder developed due to the intentional destruction of his career by his superior officer; for the first six months following service, he could not help his wife run the floral shop they own due to his fear of crowds; he constantly thought about the destruction of his career, including dreaming at night about it; he could not talk about the destruction of his career for 28 years until he saw Dr. Petrie; and that while being held for courts-martial, he could not look left or right while eating his meals. His wife testified that ; she met the veteran while working in the Army Hospital; the veteran never talked about his superior officer, but she sensed something was wrong; her husband has recommended the service to many young men; the veteran did not talk to her about the details of the courts-martial; following discharge, the veteran would watch television late into the night and cursed in his sleep; she thought she was doing something wrong until he told the psychiatrist what was the matter; they've been married for 30 years; and that he gave up his coin and photography collection after the service. In October 1992, affidavits were received from friends of the veteran. [redacted] stated that he has known the veteran for over 30 years, had been stationed with the veteran for a period of time, and was shocked at his appearance and mental state when he next saw him about 5 months after service. He stated that the veteran was greatly depressed and distressed, endeavored to overcome the depression by becoming involved in the community, and always tried to better himself, despite bouts of long depression. He indicated that he believes the reason for the veteran's continued bouts of depression is related to his military service or someone associated with it. [redacted] stated that he has known the veteran since the early 1960's, that his discharge short of retirement was a devastating blow to the veteran, that the veteran was very reserved for many months following discharge, and knows from personal and business associations with the veteran over the past 25 years, that the mistreatment in service has preyed on his mind on a constant basis and has been very depressing to him all those years. [redacted], who has known the veteran since 1961, stated that, after the veteran's unfair and unfortunate separation from service, the veteran lost interest in his florist shop, other interests and hobbies, and was able to function but lost his zest for life. She also stated that as a civilian nurse who worked for the Army, she has seen many such incidents and believes that the veteran's depression is directly attributable to the treatment he received in the Navy. Pursuant to the Board's March 1994 remand, treatment records were requested from Michael C. Reed, M.D., Dorothy Stockard of Centennial Medical Center, William C. Petrie, M.D., and Mark Houston, M.D. Medical records from Michael C. Reed, M.D., dating from August 1992 to February 1993 show treatment for complaints of depression. Dr. Reed indicated that the veteran described a 30 year history of depression related to unfair treatment by a superior officer while in the Navy. The veteran was reportedly seeing a social worker and was placed on Prozac. The impression was major depressive disorder, single episode, and obsessive compulsive personality disorder, probable. A treatment record received in June 1994 from Dr. Petrie, dated in February 1991, states that the veteran was depressed over what happened in the Navy, ruminated about his 3 duty stations, and did not describe a loss of energy. The initial diagnosis was dysthymic disorder. Dr. Houston's medical records dating from July 1991 to March 1993 show treatment for hypertension, hyperlipidemia, diabetes mellitus, back problems and obesity. In July 1992, he noted the veteran was found to be an obsessive compulsive eater and had some severe depression - psychological disorder related probably to his experience in the Navy. He referred the veteran to Dr. Reed for a psychological evaluation. Medical records received from Dorothy Stockard and Centennial Medical Center in June 1994, dated in February 1991, show laboratory test results. The Board has weighed both the probative evidence and the veteran's argument on appeal; however, there is no persuasive evidence that the veteran's psychiatric disorder is of service origin. The veteran's separation examination notes a complaint of headaches and an examiner indicated that the veteran had been under pressure for the last 6 months finishing up work, however, this was related to a possible spinal disorder. The reminder of the veteran's service medical records are negative for complaints or findings of a psychiatric disorder. The Board has considered the testimony by the veteran and his wife on appeal regarding events which occurred in service, including statements by friends of the veteran, including a nurse, regarding the veteran's state of mind during and following service, and opinions that the veteran was depressed due to events which occurred in service. The Board notes that although the veteran may testify to events which occurred in service, he is not qualified to give an opinion as to whether such an event resulted in a medical disability. Espiritu v. Derwinski, 2 Vet.App. 492 (1992). The United States Court of Appeals has held that where the determinative issues involve medical causation or diagnosis, competent medical substantiation is required. Grottveit v. Brown, 5 Vet.App. 91, 93 (1993). Although the veteran, his wife, and friends' testimony is credible, it is of less probative value than medical treatment records from physicians, or psychiatrists. The statement from the nurse is noted to be developed through a health care professional and is accorded some probative value in this regard. Nevertheless, she is not a psychiatrist. Lacking this professional qualification, her expressed opinion is not found to be sufficiently probative as to place the balance of the evidence in equipoise. Pursuant to the Board's remand, treatment records were requested from the veteran's physicians, including psychiatrists; however, the records show that the physicians, including psychiatrists, did not begin treating the veteran until 1991, at the earliest. Although the veteran's physicians indicate that the veteran described a long history of depression, this is based solely on history given by the veteran rather than actual observance of clinical symptomatology. The physicians' opinions, which are based solely on history related by the veteran, are not persuasive in view of the 25 year time period between the events in service as related by the veteran and diagnosis by the physicians, and do not serve to put the evidence in equipoise. The salient factual circumstance in this case is that the objective evidence of record does not show a psychiatric disorder, or psychosis, until 1991, many years after service. Accordingly, service connection for a psychiatric disorder, characterized as depression, is not warranted. The Board notes that the veteran alleges a disturbing scenario during service which ultimately resulted in a psychiatric disorder; however, according to the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Third Edition, the veteran has not alleged any of the serious trauma's listed as would constitute a "stressor", nor has a diagnosis of post-traumatic stress disorder been advanced in this case. As such, the issue currently on appeal does not encompass consideration of whether service connection should be granted for post-traumatic stress disorder. ORDER Service connection for a psychiatric disorder characterized as depression is denied. JEFF MARTIN Member, Board of Veterans' Appeals (CONTINUED ON NEXT PAGE) 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.