Citation Nr: 0005990 Decision Date: 03/06/00 Archive Date: 03/14/00 DOCKET NO. 97-17 167A ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Los Angeles, California THE ISSUE Entitlement to service connection for schizophrenia. REPRESENTATION Appellant represented by: AMVETS WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD T. L. Douglas, Associate Counsel INTRODUCTION The veteran served on active duty from September 1979 to March 1981. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 1997 rating decision by the Los Angeles, California, Regional Office (RO) of the Department of Veterans Affairs (VA). In August 1998 the veteran testified at a personal hearing before the undersigned Board Member. A copy of the transcript of that hearing is of record. In January 1999 the Board remanded the case to the RO for additional development. FINDINGS OF FACT 1. All available relevant evidence necessary for an equitable disposition of this appeal has been obtained. 2. The evidence undeniably demonstrates that schizophrenia existed prior to service. 3. The evidence of record does not demonstrate that the veteran's schizophrenia permanently increased in severity during active service. CONCLUSION OF LAW The presumption of soundness at entry has been rebutted by clear and unmistakable evidence that schizophrenia pre- existed service; schizophrenia was not aggravated during active service. 38 U.S.C.A. §§ 1111, 1131, 1153, 5107(a) (West 1991); 38 C.F.R. §§ 3.303, 3.304, 3.306 (1999). REASONS AND BASES FOR FINDINGS AND CONCLUSION Initially, the Board notes that the veteran's service medical records are not included in the record on appeal and that an original VA claims file could not be located. The United States Court of Appeals for Veterans Claims (Court) has held that there is a heightened duty to assist in cases where service medical records are presumed destroyed. Cuevas v. Principi, 3 Vet. App. 542, 548 (1992). In this case, the record reflects that in October 1996 the RO requested additional information from the veteran to facilitate a search for his service medical records. Service department correspondence dated in November 1996 indicated a search for alternative medical records at the Madigan Army Medical Center revealed no records and that medical records may have been retired to the National Personnel Records Center (NPRC). A January 1997 NPRC report indicated records were sent to VA in October 1982 and that no other medical records were available. A March 1998 report of contact indicated an additional NPRC search under alternative identification numbers provided by the veteran revealed no available service medical records. An April 1999 report of contact indicated a search of VA records revealed no additional claims file under an alternative identification number. A July 1999 report of contact indicated a search of VA records revealed no additional VA medical records or claims files under alternative identification numbers. Although the veteran testified his private physician and a VA physician told him his schizophrenia was service connected, there is no evidence that these opinions were reported in the veteran's medical record. In fact, a review of the records associated with the veteran's recent VA treatment include no opinion as to etiology and the private physician's statements of record include no opinion indicating schizophrenia is service related. Therefore, the Board finds the RO provided adequate assistance in the development of this claim and that all available relevant evidence necessary for an equitable disposition of this appeal has been obtained. Background Service records include the veteran's DD 214 which indicates discharge from service in March 1981 under the separation authority of Chapter 5, AR 635-40. The narrative reason for separation was physical disability, EPTS, medical board. A March 1981 VA medical record progress note reported the veteran was released from service with a Chapter 5 discharge approximately 4 days earlier, and that benefits had been denied because of a prior neuropsychiatric hospitalization. It was noted the veteran had a copy of his medical board finding with him at the interview. A March 1981 Long Beach VA Medical Center admission summary and staff evaluation noted the veteran had been recently discharged from service following a 3 month period of hospitalization for schizophrenia, paranoid type, and that he was reportedly not eligible for benefits because of a prior neuropsychiatric hospitalization at age 19. It was also noted that the veteran reported he received brief outpatient treatment after his first hospitalization but that he had discontinued psychiatric visits and medication against medical advice. The diagnosis was schizophrenia, paranoid type. VA medical records dated from September 1994 to November 1996 show treatment for schizophrenia and depression. The records are negative for opinion as to etiology. An August 1996 private medical report noted the veteran's present diagnosis was schizophrenia, residual type. It was noted the veteran had been a client of the Mental Health Service since March 1992. In an October 1996 statement the veteran reported he was hospitalized and treated for schizophrenia from approximately January 1981 to March 1981 at the Madigan Army Medical Center. He also stated that after discharge he received day treatment at the Long Beach VA Medical Center for approximately 6 months, and that he received treatment at a hospital in Detroit, Michigan, from March to June 1983. An October 1996 private medical report noted the veteran had been diagnosed with schizophrenia, paranoid type, in 1981. It was also noted that he had been hospitalized in 1981, 1983, and in 1985. In his June 1997 substantive appeal the veteran claimed he was treated for schizophrenia in December 1980 during active service. He stated he only wanted partial disability since he had been diagnosed with schizophrenia in 1977 with a full recovery in early 1979. He noted he had been required to obtain a doctor's permission to join the service. In correspondence to his congressional representative dated in June 1997 the veteran stated, in essence, that his preexisting schizophrenia had been aggravated during active service. In an August 1998 affidavit in support of the claim the veteran's sister stated she visited the veteran in the psychiatric ward of the Madigan Army Hospital in February 1981. At his personal hearing the veteran stated service connection was warranted for his psychiatric disorder because he was hospitalized and treated for schizophrenia during active service and because the disorder continued to date. Transcript, p. 4 (August 1998). He stated a VA physician he had seen in the last couple of years told him he was service connected and suggested he apply for benefits. Tr., p. 4. He reported he was presently receiving treatment from a private physician who he believed had indicated the disorder was service related. Tr., pp. 4-5. Analysis Initially, the Board notes that the veteran's claim is found to be well-grounded under 38 U.S.C.A. § 5107(a) (West 1991). That is, based upon VA medical records indicating treatment for schizophrenia during active service, he has presented a claim which is plausible. Murphy v. Derwinski, 1 Vet. App. 78 (1990). Service connection may be granted for a disability resulting from personal injury suffered or disease contracted in line of duty or for aggravation of preexisting injury suffered or disease contracted in line of duty. 38 U.S.C.A. § 1131 (West 1991); 38 C.F.R. § 3.303 (1999). The veteran is considered to have been in sound condition when examined, accepted and enrolled for service, except as to defects, infirmities, or disorders noted at entrance into service, or where clear and unmistakable (obvious or manifest) evidence demonstrates that an injury or disease existed prior thereto. 38 U.S.C.A. § 1111 (West 1991); 38 C.F.R. § 3.304 (1999). A preexisting injury or disease is considered to have been aggravated by active service where there is an increase in disability during 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 (West 1991); 38 C.F.R. § 3.306 (1999). The Court has held that lay assertions of medical causation cannot constitute evidence to establish a claim under 38 U.S.C.A. § 5107(a). See Grottveit v. Brown, 5 Vet. App. 91, 93 (1993); see also Espiritu v. Derwinski, 2 Vet. App. 492, 494 (1992) (Court held that a witness must be competent in order for his statements or testimony to be probative as to the facts under consideration). The United States Court of Appeals for the Federal Circuit has recognized the Board's "authority to discount the weight and probity of evidence in light of its own inherent characteristics and its relationship to other items of evidence." Madden v. Gober, 125 F.3d 1477, 1481 (Fed. Cir. 1997). It is the policy of VA to administer the law under a broad interpretation, consistent with the facts in each case, and that all reasonable doubt be resolved in favor of the claimant. 38 C.F.R. § 3.102 (1999). In this case, the Board finds clear and unmistakable evidence demonstrates the veteran's schizophrenia existed prior to service. VA medical records dated in March 1981 immediately after the veteran's release from active service, as well as the veteran's own statements show he was treated for the disorder prior to service. In fact, in correspondence to his congressional representative the veteran stated he was seeking VA benefits for aggravation of his schizophrenia during service. As to the issue of aggravation of the veteran's preexisting schizophrenia during active service, the Board notes the record includes a March 1981 VA medical report which noted the veteran had been hospitalized and treated for schizophrenia prior to his release from service. The veteran and his sister have also provided credible evidence demonstrating treatment for this disorder during service. The Board notes, however, that available records demonstrate a service medical board made a specific finding that the veteran's disorder existed prior to service and was not aggravated during active service. Although the veteran's service medical records are not available for review, the evidence of record includes a separation report indicating discharge for a physical disability based upon a medical board finding of preexisting disability. The veteran's DD 214 also indicates his discharge was under the separation authority of Chapter 5, AR 635-40, which provides for separation of an enlisted soldier for non-service aggravated preexisting disorders when the soldier requests waiver of a physical evaluation board review. In the absence of any evidence to the contrary, the Board finds the veteran's separation under this specific authority was based upon information provided in the medical board report. In addition, a March 1981 VA medical report noted the veteran had a copy of the service department medical board finding with him at the interview. It was noted the service department found the veteran was industrially impaired and that he had been denied benefits for schizophrenia due to prior neuropsychiatric hospitalization. Based upon the available evidence, the Board finds the veteran's preexisting schizophrenia did not experience an increase in severity during active service beyond the natural progress of the disorder. Although the veteran claimed private and VA physicians had related his present disability to service, these claims are not substantiated by the medical evidence of record. The only evidence of an aggravation of schizophrenia beyond the natural progress of the disorder during active service is the veteran's own opinion. While the veteran is competent to testify as to symptoms he experienced, he is not competent to provide a medical opinion because this requires specialized medical knowledge. Grottveit, 5 Vet. App. at 93; Espiritu, 2 Vet. App. at 494. When all the evidence is assembled VA is then responsible for determining whether the evidence supports the claim or is in relative equipoise, with the veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990). In this case, the Board finds the preponderance of the evidence is against the claim for service connection for schizophrenia. ORDER Entitlement to service connection for schizophrenia is denied. THOMAS J. DANNAHER Member, Board of Veterans' Appeals