Citation Nr: 0003831 Decision Date: 02/14/00 Archive Date: 02/15/00 DOCKET NO. 98-10 657A ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Atlanta, Georgia THE ISSUE Entitlement to service connection for an acquired psychiatric disorder, to include post-traumatic stress disorder (PTSD). REPRESENTATION Appellant represented by: Georgia Department of Veterans Service WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD M. L. Kane, Associate Counsel INTRODUCTION The appellant had active military service from July 1992 to August 1995. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a May 1998 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Atlanta, Georgia, which denied the above claim. The appellant requested a hearing before a Member of the Board at the RO, and a videoconference hearing was scheduled in December 1999. However, the appellant failed to report for that hearing. FINDINGS OF FACT 1. The appellant's claim is plausible, and the RO has obtained sufficient evidence for correct disposition of this claim. 2. The appellant was diagnosed with an adjustment disorder during service, and she has continued to receive treatment for psychiatric disorders since service, which the medical evidence establishes are as likely as not related to her military service. CONCLUSIONS OF LAW 1. The appellant has presented a well-grounded claim for service connection for an acquired psychiatric disorder, and VA has satisfied its statutory duty to assist her in developing facts pertinent to this claim. 38 U.S.C.A. § 5107(a) (West 1991); 38 C.F.R. § 3.103 (1999). 2. The appellant acquired a psychiatric disorder, most recently diagnosed as depressive disorder and adjustment disorder, during her military service. 38 U.S.C.A. §§ 1110, 1131, 5107(b) (West 1991); 38 C.F.R. §§ 3.102, 3.303, 3.304 (1999). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS Service connection means that the facts, shown by evidence, establish that a particular injury or disease resulting in disability was incurred in the line of duty in the active military service or, if pre-existing such service, was aggravated during service. 38 U.S.C.A. §§ 1110 and 1131 (West 1991); 38 C.F.R. § 3.303(a) (1999). It is the responsibility of a person seeking entitlement to service connection to present a well-grounded claim. 38 U.S.C.A. § 5107 (West 1991). Generally, a well-grounded claim is a "plausible claim, one which is meritorious on its own or capable of substantiation." Murphy v. Derwinski, 1 Vet. App. 78, 81 (1990). A claim for service connection requires three elements to be well grounded. It requires competent (medical) evidence of a current disability; competent (lay or medical) evidence of incurrence or aggravation of disease or injury in service; and competent (medical) evidence of a nexus between the in-service injury or disease and the current disability. Epps v. Gober, 126 F.3d 1464, 1468 (Fed. Cir. 1997); Caluza v. Brown, 7 Vet. App. 498, 506 (1995); aff'd 78 F.3d 604 (Fed.Cir. 1996) (table). Truthfulness of the evidence is presumed in determining whether a claim is well grounded. Caluza at 504. The appellant's claim is well grounded. Her service medical records show treatment for an acquired psychiatric disorder, diagnosed as adjustment disorder, on several occasions between 1993 and 1995. A diagnosis of adjustment disorder was rendered just prior to her discharge from service. Moreover, on both an outpatient basis and upon VA examination, each within a year of the appellant's discharge from service, a diagnosis of adjustment disorder was also rendered. The fact that she continued to receive treatment for the same psychiatric disorder as that diagnosed during service is sufficient to provide a link between the post- service adjustment disorder and her period of service. Cf. Hampton v. Gober, 10 Vet. App. 481 (1997) (where veteran filed disability claim one month after service, diagnosis of a disorder during the separation examination provides evidence of both a current condition and a relationship to service). The appellant has continuously received treatment for psychiatric disorders since her discharge from service, providing continuity of symptomatology. Although no medical professional has expressly rendered a nexus opinion, there is certainly enough evidence to render this claim plausible, and it is therefore well grounded. The appellant having stated a well-grounded claim, the Department had a duty to assist her in the development of facts relating to the claim. 38 U.S.C.A. § 5107(a) (West 1991). In this case, the appellant was provided appropriate VA examinations, and a personal hearing was scheduled in accordance with her request. Sufficient evidence is of record to decide the claim favorably. Therefore, no further assistance is required. As to the merits of the claim, the Board finds that the evidence supports the claim for the following reasons. The appellant's service medical records showed treatment for a psychiatric disorder on numerous occasions over a sufficiently extensive length of time (i.e., November 1993 to August 1995) from which a conclusion could be made that the inservice psychiatric disorder was chronic. This conclusion is bolstered by the fact that the same disorder for which she was treated during service was also diagnosed by more than one medical examiner within the year after her discharge from service. Although an adjustment disorder is not subject to presumptive service connection, see 38 C.F.R. §§ 3.307 and 3.309 (1999), this fact supports the finding that the inservice psychiatric disorder was chronic. The appellant has continued to receive psychiatric treatment ever since her discharge from service. The diagnosis has primarily remained adjustment disorder, although depressive disorder has also been diagnosed. There is some indication in the recent medical evidence that the appellant is malingering (exaggerating or falsifying the presence of psychiatric symptoms, perhaps for the purpose of financial gain), and the VA examiner in 1998 pointed out many inconsistencies in the appellant's reported history. However, the nature of the inconsistencies does not appear to the Board to cast doubt upon the diagnosis of a chronic psychiatric disorder. For example, one of the inconsistencies noted was that on one occasion the appellant reported crying spells on a daily basis whereas, upon later questioning, she reported crying spells for two or three days once a month. Another discrepancy involved the exact nature of the sexual "abuse" she claimed to have experienced as a child, e.g., whether a certain uncle "fondled" her or whether the "abuse" involved was "just kissing." These discrepancies, in the Board's judgment, do not render the diagnosis of a psychiatric disorder invalid. The evidence is, at the very least, in equipoise regarding the appellant's claim since it indicates that she was diagnosed with an acquired psychiatric disorder during service, and she has continued to receive treatment for the same disability since her discharge from service. Accordingly, she is entitled to the application of the benefit of the doubt, see 38 U.S.C.A. § 5107(b), and the Board finds that she incurred an acquired psychiatric disorder, a chronic adjustment disorder, during her military service. 38 U.S.C.A. §§ 1110 and 1131 (West 1991); 38 C.F.R. §§ 3.102, 3.303 and 3.304 (1999). The Board notes that the appellant has also claimed entitlement to service connection for PTSD. In order for a claim for service connection for PTSD to be successful there must be (1) medical evidence diagnosing the condition in accordance with 38 C.F.R. § 4.125(a); (2) credible supporting evidence that the claimed inservice stressor actually occurred; and (3) a link, established by medical evidence, between the current symptoms and the claimed inservice stressor. 38 C.F.R. § 3.304(f) (1999); see also Cohen v. Brown, 10 Vet. App 128 (1997). Her VA outpatient records show treatment for PTSD secondary to sexual harassment while in the military, and evidence from the Department of the Army indicates that there is some substantiation for her allegations of sexual harassment. It would be difficult if not impossible to separate the effects of the PTSD on her social and occupational functioning from that resulting from the acquired psychiatric disorder for which she is being awarded service connection. Therefore, this claim is moot, in that she is being granted service connection for an acquired psychiatric disorder in this decision, and she could not receive a separate rating for any disability resulting from PTSD. See 38 C.F.R. § 4.14 (1999). ORDER Entitlement to service connection for an acquired psychiatric disorder, most recently diagnosed as depressive disorder and adjustment disorder, is granted. BETTINA S. CALLAWAY Member, Board of Veterans' Appeals