Citation Nr: 0003974 Decision Date: 02/15/00 Archive Date: 02/23/00 DOCKET NO. 98-19 593 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Boise, Idaho THE ISSUES 1. Entitlement to service connection for a right wrist disorder. 2. Entitlement to service connection for post-traumatic stress disorder (PTSD). REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD G. A. Wasik, Associate Counsel INTRODUCTION The veteran served on active duty from November 1969 to March 1977. This matter is before the Board of Veterans' Appeals (Board) on appeal of an August 1998 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Boise, Idaho. The RO denied entitlement to service connection for PTSD and for a right wrist disorder. FINDINGS OF FACT 1. The claim of entitlement to service connection for a right wrist disorder is not supported by cognizable evidence showing that the claim is plausible or capable of substantiation. 2. The record does not establish that the veteran engaged in combat in service. 3. There is no competent evidence of stressor corroboration to support a diagnosis of PTSD resulting from military service. 4. The medical evidence does not establish a diagnosis of PTSD based on a verified stressor. CONCLUSIONS OF LAW 1. The claim for service connection for a right wrist disorder is not well-grounded. 38 U.S.C.A. § 5107(a) (West 1991). 2. PTSD was not incurred in or aggravated by active military service. 38 U.S.C.A. §§ 1110, 1131, 1154(b), 5107(b) (West 1991); 38 C.F.R. §§ 3.303, 3.304(f) (1999). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS I. Entitlement to service connection for a right wrist disorder. Factual Background The veteran's service medical records are unavailable. Searches of alternative treatment records failed to evidence any complaints of, diagnosis of or treatment for a right wrist disorder. Private treatment records from Bannock Memorial Hospital have been associated with the claims file. The records evidence the fact that the veteran sought treatment for an injury to his right wrist which occurred on the job in June 1979. X- rays dated in April 1981 revealed a diagnosis of fracture of the right navicular. On a clinical record dated in April 1981, it was noted the veteran reported he had injured his right wrist in an industrial accident in June 1979 when the he was struck by a steel beam. The impression was chronic nonunion of the right dominant navicular, secondary to fracture sustained in June 1979. It was reported that the veteran denied any injuries to the right wrist prior to the June 1979 accident. VA outpatient treatment and hospitalization records have been associated with the claims file. The records evidence intermittent complaints of, diagnosis of and treatment for a right wrist injury. On a hospitalization record dated in September 1989, it was noted the veteran reported that in 1970 he sustained a gunshot wound to the right leg and that during the same incident he fractured his right hand. He complained of occasional discomfort in the right hand. In August 1998, it was noted the veteran had re-injured his right wrist in an industrial accident. An X-ray did not reveal any acute fracture. A November 1998 clinical record included the notation that the veteran had re-injured his right hand. The veteran reported he had had prior wrist surgery in Vietnam. Right wrist fusion was a discharge diagnosis in December 1998. A letter dated in May 1999 from CSS, M.D. has been associated with the claims file. The physician reported that the veteran had a history of injury to the right wrist in the 1970's which was treated at that time with some sort of surgery. The veteran submitted a statement in July 1999 wherein he reported that in 1971 a vehicle he was riding in detonated a land mine which blew him out of the vehicle. He reported that he broke his right wrist and was knocked unconscious by the explosion. At the time of the incident, he was stationed in An Loc with the 3rd Amtrack Battalion. Criteria The threshold question that must be resolved is whether the veteran has presented evidence of a well-grounded claim. See 38 U.S.C.A. § 5107(a) (West 1991); Murphy v. Derwinski, 1 Vet. App. 78, 81 (1990). A well-grounded claim is a plausible claim that is meritorious on its own or capable of substantiation. See Murphy, 1 Vet. App. at 81. If a claim is not well grounded there is no duty to assist the veteran with the development of that claim, and it must be denied. Morton v. West, 12 Vet. App. 477 (1999). An allegation of a disorder that is service connected is not sufficient; the veteran must submit evidence in support of a claim that would "justify a belief by a fair and impartial individual that the claim is plausible." See 38 U.S.C.A. § 5107(a); Tirpak v. Derwinski, 2 Vet. App. 609, 611 (1992). The quality and quantity of the evidence required to meet this statutory burden of necessity will depend upon the issue presented by the claim. Grottveit v. Brown, 5 Vet. App. 91, 92-93 (1993). In determining whether a claim is well grounded, the claimant's evidentiary assertions are presumed true unless inherently incredible or when the fact asserted is beyond the competence of the person making the assertion. King v. Brown, 5 Vet. App. 19, 21 (1993). In order for a claim to be well grounded, there must be competent evidence of a current disability (a medical diagnosis); of incurrence or aggravation of a disease or injury in service (lay or medical evidence); and of a nexus between the in-service injury or disease and the current disability (medical evidence). Caluza v. Brown, 7 Vet. App. 498 (1995). In order to obtain service connection, there must be both evidence of a disease or injury that was incurred in or aggravated by service, and a present disability which is attributable to such disease or injury. 38 U.S.C.A. §§ 1110, 1131; 38 C.F.R. § 3.303. A claim for service-connection for a disability must be accompanied by evidence which establishes that the claimant currently has the claimed disability. See Rabideau v. Derwinski, 2 Vet. App. 141, 144 (1992); see also Brammer v. Derwinski, 3 .Vet. App. 223, 225 (1992) (absent proof of a present disability there can be no valid claim). Where the determinant issue involves a question of medical diagnosis or medical causation, competent medical evidence to the effect that the claim is plausible or possible is required to establish a well-grounded claim. Grottveit v. Brown, 5 Vet. App. 91, 93 (1993). Lay assertions of medical causation cannot constitute evidence to render a claim well grounded under 38 U.S.C.A. § 5107(a) (West 1991); if no cognizable evidence is submitted to support a claim, the claim cannot be well grounded. Id. The United States Court of Appeals for Veterans Claims (hereinafter, "the Court")" has held in Savage v. Gober, 10 Vet. App. 488 (1997), that the "continuity of symptomatology" provision of 38 C.F.R. § 3.303(b) may obviate the need for medical evidence of a nexus between present disability and service. See Savage, 10 Vet. App. at 497. The only proviso is that there be medical evidence on file demonstrating a relationship between the veteran's current disability and post-service symptomatology, unless such a relationship is one to which a lay person's observation is competent. Where a veteran served continuously for 90 days or more during a period of war and arthritis becomes manifest to a degree of 10 percent within one year from the date of termination of such service, such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. 38 U.S.C.A. §§ 1101, 1112, 1113, 1137 (West 1991 & Supp. 1999); 38 C.F.R. §§ 3.307, 3.309 (1999). When a disability is not initially manifested during service or within an applicable presumptive period, "direct" service connection may nevertheless be established by evidence demonstrating the disability was in fact incurred or aggravated during the veteran's service. See 38 U.S.C.A. § 1113(b) (West 1991 & Supp. 1999); 38 C.F.R. § 3.303(d). In a case where the veteran's service medical records are presumed destroyed, the Board's obligation to explain its findings and conclusions and to consider carefully the benefit-of-the-doubt rule is heightened. O'Hare v. Derwinski, 1 Vet. App. 365 (1991). When all the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the appellant prevailing in either event, or whether a preponderance of the evidence is against a claim, in which case, the claim is denied. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). When, after consideration of all of the evidence and material of record in an appropriate case before VA, there is an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving such issue shall be given to the claimant. 38 U.S.C.A. § 5107(b) (West 1991); 38 C.F.R. §§ 3.102, 4.3 (1999). Analysis Initially, the Board notes the veteran's service medical records have not been associated with the claims file. An August 1998 Memorandum for File demonstrates that the RO made several attempts to obtain the service medical records without success. The RO also attempted to locate any pertinent medical records through alternative sources but searches of these records failed to reveal any treatment records for the veteran. The Board finds the RO has made a diligent effort to obtain the veteran's service medical records without success. A remand for further attempts at locating the records is not warranted. The Board finds the claim of entitlement to service connection for a right wrist disorder to be not well- grounded. The Board has placed reduced probative value on the veteran's allegations of in-service injuries he received due to the conflicting evidence of record. The evidence of record demonstrates the veteran has reported that he injured his right wrist in 1970 after being shot in the leg or that he injured the right wrist as a result of a land mine explosion in 1971. Despite the apparent conflicting reports as to the date and etiology of injury, the Board finds the veteran's evidentiary assertions are presumed true as they are not inherently incredible. Additionally, the veteran's allegations that he injured his right hand during active duty are not beyond the competence of the person making the assertion. Thus, for the purposes of determining if the veteran submitted a well- grounded claim, the Board finds the veteran's allegations are sufficient to demonstrate that there was an in-service injury to the right wrist. Associated with the claims file is competent evidence of the current existence of residuals of a right wrist injury in the form of the VA outpatient treatment and hospitalization records as well as private treatment records. Thus the Board finds there is evidence of record of an in-service injury to the right wrist and there is also competent evidence of the current existence of residuals of a right wrist injury. The veteran's claim, however, is determined to be not well- grounded as there is no competent evidence of record linking the current residuals of a right wrist injury to active duty. None of the medical evidence associated with the claims file includes opinions linking residuals of a right wrist injury to active duty. The veteran has not alleged he has had continuity of symptomatology for the right wrist from active duty to the present which would permit application of Savage v. Gober. The only evidence of record which links a right wrist disorder to active duty is the veteran's own allegations. The veteran has not reported that he has specialized medical training and is thus considered a lay person. A lay person is not competent to make a medical diagnosis or to relate a medical disorder to a specific cause. See Espiritu v. Derwinski, 2 Vet. App. 492, 494 (1992). The veteran's claim that he has residuals of a right wrist injury as a result of active duty is predicated upon his own unsubstantiated opinion. As it is the province of trained health care professionals to enter conclusions which require medical opinions as to causation, Grivois, the veteran's lay opinion is an insufficient basis upon which to find this claim well grounded. Espiritu, King. Accordingly, as a well grounded claim must be supported by evidence, not merely allegations, Tirpak, the veteran's claim for service connection for a right wrist disorder must be denied as not well grounded. The Board finds that the RO advised the appellant of the evidence necessary to establish a well grounded claim, and the appellant has not indicated the existence of any post service medical evidence that has not already been obtained that would well ground his claim. 38 U.S.C.A. § 5103(a) (West 1991); McKnight v. Gober, 131 F.3d 1483 (Fed. Cir. 1997); Epps v. Gober, 126 F. 3d. 1464 (Fed. Cir. 1997). As the veteran has not submitted a well grounded claim for service connection for a right wrist disorder, the doctrine of reasonable doubt has no application. The Court has held that if the appellant fails to submit a well grounded claim, VA is under no duty to assist in any further development of the claim. 38 U.S.C.A. § 5107(a); Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990); Grottveit v. Brown, 5 Vet. App. 91, 93 (1993); 38 C.F.R. § 3.159(a) (1999). The appellant's representative contends that subsequent to the Court's decisions pertaining to this issue, VA expanded its duty to assist the appellant in developing evidence to include the situation in which the appellant has not submitted a well grounded claim. Veterans Benefits Administration Manual M21-1, Part III, Chapter I, 1.03(a), and Part VI, Chapter 2, 2.10(f) (1996). The appellant's representative further contends that the M21- 1 provisions indicate that the claim must be fully developed prior to determining whether the claim is well grounded, and that this requirement is binding on the Board. The Board, however, is required to follow the precedent opinions of the Court. 38 U.S.C.A. § 7269 (West 1991); Tobler v. Derwinski, 2 Vet. App. 8, 14 (1991). Subsequent to the revisions to the M21-1 Manual, in Meyer v. Brown, 9 Vet. App. 425 (1996), the Court held that the Board is not required to remand a claim for additional development, in accordance with 38 C.F.R. § 19.9 (1999), prior to determining that a claim is not well grounded. The Board is not bound by an administrative issuance that is in conflict with binding judicial decisions, and the Court's holdings on the issue of VA's duty to assist in connection with the well grounded claim determination are quite clear. Bernard v. Brown, 4 Vet. App. 384, 394 (1993); 38 C.F.R. § 19.5 (1999). In Morton v. West, 12 Vet App 477 (1999), the Court held that the Manual M21-1 provisions pertaining to the development of claims prior to a finding of well groundedness are interpretative, in that they do not relate to whether a benefit will be allowed or denied, nor do they impinge on a benefit or right provided by statute or regulation. The Court found that the Manual M21-1 provisions constituted "administrative directions to the field containing guidance as to the procedures to be used in the adjudication process," and that the policy declarations did not create enforceable rights. The Court also found that interpretative provisions that are contrary to statutes are not entitled to deference, and that in the absence of a well grounded claim, VA could not undertake to assist a veteran in developing the facts pertinent to the claim. The Board has determined, therefore, in the absence of a well grounded claim for service connection for a right wrist disorder, VA has no duty to assist the veteran in developing his case. II. Entitlement to service connection for PTSD. Factual Background The veteran's service medical records are unavailable. Searches of alternative treatment records failed to evidence any complaints of, diagnosis of or treatment for a psychiatric disorder. Review of the service personnel records demonstrates that the veteran served in Vietnam as demonstrated by his receipt of the Vietnam Service Medal. He had overseas and/or foreign service for eleven months and twenty two days. He did not receive any awards or decorations indicative of participation in combat. His primary specialty title was AmTrac Crewman. A letter dated in November 1989 from RH, a counselor, has been associated with the claims file. The author reported the veteran sought help in January 1989 for marital dysfunction and legal difficulties. It was noted the veteran reported experiencing distressing dreams of combat-related events. The veteran informed the author that he was assigned to the "101st" when he was sent to Vietnam where he was stationed in the northern highlands. He further informed the author that he served in Vietnam for eighteen months which included a six month extension of duty. The clinical impression was delayed chronic PTSD. On a VA Form 21-526 which was received at the RO in February 1990, the veteran indicated he received a bullet wound and was treated for it in 1971 while he was serving with the "1/9 1st Mar Div" in Da Nang. He also indicated he fractured his right leg in 1975. VA outpatient treatment and hospitalization records have been associated with the claims file. The records evidence the veteran was diagnosed with and treated for mental disorders beginning in May 1989. On a hospitalization record dated in September 1989, it was noted the veteran was seeking treatment for depression which he attributed, in part, to his wife's illness and his experiences in Vietnam. The veteran reported that in 1970 he sustained a gunshot wound to the right leg and at the same time fractured the right leg and ankle while he was serving in Vietnam. He further reported that during the same incident he fractured his right hand. The impression at that time was depression. A separate hospitalization record dated in September 1989 included diagnoses of PTSD and depressive disorder. The only stressor reported was "combat experiences." On a record dated in December 1997, it was noted the veteran reported he had made a mistake in combat which resulted in the deaths of two friends and that he had served two tours of duty in Vietnam with a United States Marine Corps reconnaissance team. The impression at that time was rule out PTSD. On a clinical record dated in May 1998 it was noted the veteran was a Vietnam combat veteran. The veteran alleged that he was a "LERRPS" infantryman while in Vietnam where he felt he made mistakes which cost two friends their lives. The Axis I diagnoses were PTSD, alcohol dependence and intermittent explosive disorder. The veteran submitted a statement in July 1999 wherein he reported that in 1971 a vehicle he was riding in detonated a land mine which blew him out of the vehicle. He reported that he broke his right wrist and was knocked unconscious by the explosion. At the time of the incident, he was stationed in An Loc with the 3rd Amtrack Battalion. Criteria Generally, for service connection to be granted, it is required that the evidence establish that a particular injury or disease resulting in chronic disability was incurred in service, or, if pre-existing service, was aggravated therein. 38 U.S.C.A. § 1110, 38 C.F.R. § 3.303. When a disability is not initially manifested during service or within an applicable presumptive period, "direct" service connection may nevertheless be established by evidence demonstrating the disability was in fact incurred or aggravated during the veteran's service. See 38 U.S.C.A. § 1113(b) (West 1991 & Supp. 1999); 38 C.F.R. § 3.303(d). Adjudication of a well-grounded claim of service connection for PTSD requires the evaluation of the evidence in light of the places, types, and circumstances of service, as evidenced by service records, the official history of each organization in which the veteran served, the veteran's military records, and all pertinent medical and lay evidence. 38 U.S.C.A. § 1154(a). Under the provisions for direct service connection for PTSD, 60 Fed. Reg. 32807-32808 (1999) (codified at 38 C.F.R. § 3.304(f)), service connection for PTSD requires medical evidence diagnosing the condition in accordance with 38 C.F.R. § 4.125 (diagnosis of mental disorder); a link, established by medical evidence, between current symptoms and an in-service stressor; and credible supporting evidence that the claimed in-service stressor occurred. If the evidence establishes that the veteran engaged in combat with the enemy and the claimed stressor is related to this combat, in the absence of clear and convincing evidence to the contrary, and provided that the claimed stressor is consistent with the circumstances, conditions, or hardships of the veteran's service, the veteran's lay testimony alone may establish the occurrence of the claimed in-service stressor. See Moreau v. Brown, 9 Vet. App. 389, 394 (1996). The VA regulation was changed in June 1999 to conform to the Court's determination in Cohen v. Brown, 10 Vet. App. 128 (1997). As the Cohen determination was in effect when the RO reviewed this case, the Board finds no prejudice to the veteran in proceeding with this case at this time. See Bernard v. Brown, 4 Vet. App. 384 (1993). The award of service connection for PTSD, therefore, requires the presence of three elements: (1) a medical diagnosis of PTSD diagnosing the condition in accordance with 38 C.F.R. § 4.125; (2) credible supporting evidence that the claimed in-service stressor actually occurred; and, (3) medical evidence of a link between current symptomatology and the specified claimed in-service stressor. The claims file contains diagnoses of PTSD as evidenced by the VA outpatient treatment and hospitalization records. The reported stressors included in these records were alleged to have occurred during the veteran's tour of duty while stationed in Vietnam. The Board finds that the health care professionals who promulgated the diagnoses of PTSD have linked the disorder to events the veteran reportedly experienced while on active duty in Vietnam. Thus, the Board finds the record establishes the first and third elements set out above. 38 C.F.R. § 3.304(f). Therefore, the claim for service connection for PTSD in this appeal must be decided based upon the question of whether the in-service stressor(s) reported by the veteran and relied upon by the competent medical professionals diagnosing PTSD occurred, as substantiated by competent corroborating evidence. That question involves both consideration of the facts as presented and the credibility of the evidence contained in the instant record. The Court has held that, "[i]t is the duty of the BVA as the fact finder to determine credibility of the testimony and other lay evidence." Culver v. Derwinski, 3 Vet. App. 292, 297 (1992). The Court in Zarycki v. Brown, 6 Vet. App. 91 (1993), set forth the foundation for the framework now established by the case law for establishing the presence of a recognizable stressor, which is the essential prerequisite to support the diagnosis of PTSD. The Court noted that the evidence necessary to establish the existence of the recognizable stressor during service will vary depending on whether or not the veteran was "engaged in combat with the enemy" under 38 U.S.C.A. § 1154(b) (West 1991) and 38 C.F.R. § 3.304 (1999), as determined through recognized military citations or other service department evidence. In other words, a veteran's bare assertions that he "engaged in combat with the enemy" are not sufficient, by themselves, to establish this fact. If the determination of combat status is affirmative, then (and only then), a second step requires that the veteran's lay testimony regarding claimed stressors must be accepted as conclusive as to their actual occurrence and no further development or corroborative evidence will be required, provided that the veteran's testimony is found to be "satisfactory," e.g., credible, and "consistent with the circumstances, conditions, or hardships of such service." Zarycki at 98 (emphasis added). The Court, in Moreau v. Brown, 9 Vet. App. 389 (1996), citing the MANUAL M21-1 Part VA, 7.46.c (Oct. 11, 1995) held that "credible supporting evidence" of a non-combat stressor "may be obtained from" service records or "other sources." The Court further held that while the MANUAL M21-1 provisions did not expressly state whether the veteran's testimony standing alone could constitute credible evidence of the actual occurrence of a non-combat stressor, the Court's holding in Dizoglio v. Brown, 9 Vet. App. 163, 166 (1996), established, as a matter of law, that "if the claimed stressor is not combat-related, [the] appellant's lay testimony regarding the in-service stressors is insufficient to establish the occurrence of the stressor." Further, the Court held in Moreau, the fact that a medical opinion was provided relating PTSD to events the veteran described in service could not constitute "credible supporting evidence" of the existence of the claimed non- combat stressor. Id. In Cohen v. Brown, 10 Vet. App. 128 (1997), the Court noted that VA had adopted a final rule in October 1996, effective November 7, 1996, revising 38 C.F.R. §§ 4.125 and 4.126 (1996). The effect of these revisions was to change the diagnostic criteria for mental disorders from the Diagnostic and Statistical Manual for Mental Disorders (DSM), third edition and the third edition, revised, to the fourth edition (DSM-IV). The Court found that DSM-IV altered the criteria for assessing the adequacy of the stressor from an objective to a subjective basis. The Court further found that where there was "undisputed, unequivocal" diagnoses of PTSD of record, and the Board did not make a finding that the reports were incomplete, the adequacy of the stressor had to be presumed as a matter of law. (The concurring opinion goes further and states that the case also holds that where there is an "unequivocal" diagnosis of PTSD, the adequacy of the symptoms to support the diagnosis, as well as the sufficiency of the stressor, are presumed. Id. at 153). In West v. Brown, 7 Vet. App. 70 (1994), the Court held that the sufficiency of the stressor is a medical determination, and therefore adjudicators may not render a determination on this point in the absence of independent medical evidence. When all the evidence is assembled, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the appellant prevailing in either event, or whether a preponderance of the evidence is against a claim, in which case, the claim is denied. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). When, after consideration of all of the evidence and material of record in an appropriate case before VA, there is an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C.A. § 5107(b) (West 1991); 38 C.F.R. §§ 3.102, 4.3 (1999). Analysis The Board must initially address the question of whether the claimant has presented evidence of a well grounded claim. 38 U.S.C.A. § 5107(a); Murphy v. Derwinski, 1 Vet. App. 78 (1990). The evidence, in brief, shows that the veteran served in Vietnam during active duty, that he reported he was exposed to stressors during such service, and that PTSD has been diagnosed by VA medical professionals based on the reported stressors. In view of these findings, the Board has concluded that the veteran's claim is not implausible; therefore, the Board must determine if VA has a further obligation to assist him, more than it already has, in the development of the claim. The veteran has not identified any additional, relevant evidence that has not been requested or obtained. The Board thus finds that all relevant evidence necessary for an equitable disposition of the appeal has been obtained to the extent possible, and no further assistance is required to comply with the duty to assist mandated by 38 U.S.C.A. § 5107. The Board finds that, upon review of the relevant criteria and case law, it is clear that the question of the existence and character of an event claimed as a recognizable stressor is a matter solely within the province of adjudicatory personnel. That is the issue addressed herein. The Board, insofar as it finds below that there is no recognizable stressor, does not reach questions of whether the events claimed by the veteran were sufficient to constitute a stressor for the purpose of causing PTSD, or whether the remaining elements required to support the diagnosis of PTSD have been met, both matters that require competent medical opinions and expertise. In the instant case, the Board concludes that the veteran did not engage in combat with the enemy and is thus not entitled to the presumptions under 38 U.S.C.A. § 1154(b); 38 C.F.R. § 3.304(f). He did not receive any awards or decorations denoting participation in combat. His military occupational specialty was Armored Tractor Crewman. The Board has placed significantly reduced probative value on the veteran's allegations of in-service stressors as he has provided conflicting accounts as to the incidents and as to his service. He informed RH that he was assigned to the "101st" while in Vietnam and that he served in Vietnam for eighteen months. However, review of the service personnel records demonstrates that the veteran served with the United States Marine Corps and only had overseas and/or foreign service for a period of eleven months and twenty two days. It is a well known fact that the "101st" is an airborne Army division. The veteran informed one VA health care professional that he fractured his right hand after sustaining a gunshot wound to the right leg in 1970. This is in contrast to his allegation included in a July 1999 statement wherein he reported he fractured his right wrist in 1971 as a result of a mine explosion. These two allegations are contradicted by private medical records which reveal that the veteran injured his right wrist in an industrial accident in June 1979. The private treatment records further evidence the fact that the veteran denied any injuries to his right wrist prior to June 1979. The veteran alleged he was shot in the right leg in 1970 and has also alleged that he received an unspecified gunshot wound in 1971. The veteran's service medical records are unavailable. The RO, however, initiated searches of alternative medical records but was unable to document any medical treatment the veteran received during active duty. As the Board has placed significantly reduced probative value on the veteran's allegations and as there is no other evidence of treatment for a gunshot wound during active duty, the Board finds this allegation to be without merit. Review of the claims file discloses the veteran reported, at various times, the following stressors: being shot in the right leg in 1970; receiving an unspecified gunshot wound in 1971 in Da Nang while serving with the "1/9 1st Mar Div"; acting in the role of a "LERRPS" at which time he made a mistake which cost the lives of two friends; and riding in an Amtrack which struck a mine in 1971 in An Loc while serving with the 3rd Amtrack Battalion. He provided no other identifying information on the other claimed stressors. The Board finds that the veteran did not provide information sufficient to attempt to verify the claimed in-service stressors. The Board notes that the veteran has not provided sufficient names, places, dates or unit designations by which verification could be attempted. The only dates he provided were the years but not the months when he was allegedly either shot or was in a mine explosion. The Board finds that the veteran's claim of entitlement to service connection for PTSD must be denied as none of the veteran's claimed stressors have been corroborated by credible supporting evidence and the veteran has not provided additional information sufficient to submit to the United States Armed Services Center for Research of Unit Records for an attempt at verification. The Board notes that the veteran was requested in October 1989, March 1998, and June 1999 to provide descriptive information by which his claimed in-service stressors could be verified. The veteran only responded to one request for his stressor information which was a statement received in July 1999. The Court has held that asking a veteran to provide the underlying facts, i.e., the names of individuals involved, the dates, and the places where the claimed events occurred, does not constitute an impossible or onerous task. Wood v. Derwinski, 1 Vet. App. 190 (1991). A review of the available evidence in the claims file reveals no supporting lay statements from the veteran's fellow unit members or others who may have witnessed or participated in the alleged events. In short, the sole supporting evidence that the alleged stressful events occurred are the veteran's own statements and notation of such experiences as recorded by medical professionals in connection with treatment and evaluation. A non-combat veteran's lay testimony regarding in-service stressors is insufficient to establish the occurrence of the stressor and must be corroborated by credible supporting evidence that the claimed stressors actually occurred. Cohen v. Brown, supra at 20 (citing Doran v. Brown, 6 Vet. App. 283, 289 (1994)). The Board also notes that credible supporting evidence of the actual occurrence of an in-service stressor cannot consist solely of after-the-fact medical nexus evidence. See Moreau v. Brown, 9 Vet. App. 389, 396. The evidentiary record in this case clearly shows that a diagnosis of PTSD has not been substantiated, and there is no evidence that the veteran served in combat. Therefore, the pertinent governing criteria do not provide a basis upon which to predicate a grant of entitlement to service connection. Without credible supporting evidence that the claimed in- service stressors actually occurred, the diagnosis of PTSD opined to be causally related to the claimed stressful in- service events, is not supportable. The diagnosis of PTSD was based upon interviews with the veteran and on a history of stressors as related by him. The Board is not bound to accept medical opinions which are based on history supplied by the veteran where that history is unsupported or based on inaccurate factual premises. See Black v. Brown, 5 Vet. App. 177 (1993); Swann v. Brown, 5 Vet. App. 229 (1993); Reonal v. Brown, 5 Vet. App. 458 (1993); Guimond v. Brown, 6 Vet. App. 69 (1993). Moreover, the Board is not required to accept a physician's diagnosis "[j]ust because a physician or other health care professional accepted the appellant's description of his [wartime] experiences as credible and diagnosed the appellant as suffering from PTSD." West v. Brown, 7 Vet. App. 70, 77 (1994) quoting Wilson v. Derwinski, 2 Vet. App. 614, 618 (1992). In conclusion, the Board has determined that there is no credible supporting evidence that any of the claimed in- service stressors actually occurred. See West v. Brown, 7 Vet. App. 70, 79-80 (1994). Thus, there is no diagnosis of PTSD shown to be related to recognized military stressors. In light of the above, there is not an approximate balance of positive and negative evidence to which the benefit-of-the- doubt standard applies; the preponderance of the evidence is against the claim of service connection for PTSD and the veteran's appeal is denied. 38 C.F.R. § 3.304(f). ORDER The veteran not having submitted a well grounded claim of entitlement to service connection for a right wrist disorder, the appeal is denied. Entitlement to service connection for PTSD is denied. RONALD R. BOSCH Member, Board of Veterans' Appeals