BVA9507186 DOCKET NO. 93-11 232 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUE Entitlement to service connection for post traumatic stress disorder (PTSD). WITNESSES AT HEARING ON APPEAL Appellant and his wife REPRESENTATION Appellant represented by: Vietnam Veterans of America ATTORNEY FOR THE BOARD L. M. Barnard, Counsel INTRODUCTION The veteran served on active duty from January 1970 to February 1972. This appeal arises from a March 1992 rating decision of the St. Petersburg, Florida, Department of Veterans Affairs (VA), Regional Office (RO), which denied entitlement to service connection for PTSD. This decision was confirmed and continued by a rating action issued in July 1992. The veteran and his wife testified at a personal hearing in November 1992; the hearing officer continued the denial of the benefit sought in a decision issued in December 1992. A rating action confirming the denial was issued in January 1993. A review of the record indicates that the veteran appears to be raising a claim that he is unemployable because of his PTSD. In light of the following decision, the RO should review the record and determine whether the veteran has been rendered unemployable by his now service-connected PTSD. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends, in essence, that he is entitled to service connection for PTSD. He asserts that he was exposed to combat in Vietnam when he served as a helicopter doorgunner. He states that, during this period of duty, he witnessed the deaths of numerous service-men, and participated in attacks upon enemy villages, where civilians, including children, were killed. He asserts that he currently suffers from depression, nightmares concerning his time as a doorgunner, flashbacks and anger. Therefore, he believes that service connection for PTSD should be granted. 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. 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 evidence supports a finding of entitlement to service connection for PTSD. FINDINGS OF FACT PTSD has been verified by the evidence of record. CONCLUSION OF LAW PTSD was incurred in service. 38 U.S.C.A. §§ 1110. 5107(a) (West 1991); 38 C.F.R. 3.304(f) (1994). REASONS AND BASES FOR FINDINGS AND CONCLUSION The veteran's claim is well grounded within the meaning of 38 U.S.C.A. § 5107(a). That is, we find that he has presented a claim which is plausible. We are also satisfied that all relevant facts have been properly developed. The record is devoid of any indication that there are other records available which should be obtained. Therefore, no further development is required in order to comply with the duty to assist mandated by 38 U.S.C.A. § 5107(a). Under the applicable criteria, service connection may be granted for a disability the result of disease or injury incurred in or aggravated by service. 38 U.S.C.A. § 1110 (West 1991). In order to establish entitlement to service connection for PTSD, there must be medical evidence establishing a clear diagnosis of the condition, credible supporting evidence that the claimed inservice stressor actually occurred, and a link, established by medical evidence, between current symptomatology and the claimed inservice stressor. If the claimed stressor is related to combat, service department evidence that the veteran engaged in combat or that the veteran was awarded the Purple Heart, Combat Infantryman Badge, or similar combat citation will be accepted, in the absence of evidence to the contrary, as conclusive evidence of the claimed inservice stressor. 38 C.F.R. § 3.304(f) (1994). According to the United States Court of Veterans Appeals (Court) in Zarycki v. Brown, 6 Vet.App. 91 (1993): ...the evidence necessary to establish the occurrence of a recognizable stressor during service to support a claim of entitlement to service connection for PTSD will vary depending on whether or not the veteran was 'engaged in combat with the enemy.' (cites omitted). Where it is determined, through recognized military citations or other supportive evidence, that the veteran was engaged in combat with the enemy and the claimed stressors are related to such combat, the veteran's lay testimony regarding claimed stressors must be accepted as conclusive as to their actual occurrence and no further development for 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.' (cites omitted). In the instant case, the veteran's DD-214 indicates that he received the Vietnam Service Medal with two Bronze Service Stars and the Vietnam Campaign Medal. This document indicated that his primary military occupation was helicopter repairman. Subsequent documentation revealed that he also received an Air Medal, for meritorious achievement while participating in aerial flight in Vietnam. These records also show that he received hazardous duty pay. The record noted that he served as a doorgunner, whose instructions included regular and frequent participation in aerial flight as a crew member in connection with duty as a doorgunner. A review of the service medical records reveals that the veteran was psychiatrically normal upon entrance onto active duty in January 1970. The December 1971 separation examination revealed that he was psychiatrically normal, although he did complain of frequent trouble sleeping. However, there is no evidence that he complained of or was treated for a psychiatric disability while on active duty. A VA examination was performed in September 1991. During this examination, the veteran admitted to past drug abuse, which he said had ended five years before. He also admitted to a drinking problem. He then stated that he had been a doorgunner while in Vietnam and that, as such, he had witnessed many traumatic events, the worst of which was seeing a dead 10 year old boy with bugs crawling on him. He stated that he had nightmares about being shot down, captured and tortured by Vietcong. He also recounted having experienced two recent flashbacks. The mental status examination revealed that he was depressed and became increasingly emotional as he spoke of Vietnam. The impression was mild PTSD. The examiner opined that this disorder had flared up due to the veteran's unemployment and the Desert Storm conflict. Lay statements submitted by the veteran's mother, sister and wife between October and November 1991 attested to how the veteran's behavior had changed since returning from Vietnam. It was noted that he had become withdrawn, suspicious, hostile and aggressive. His wife stated that he suffered from recurrent war-related nightmares. In December 1991, in response to a request by the RO, the veteran was re-examined by the doctor who examined him in September of that year. The veteran recounted that he had flown missions in Cambodia and that he had seen a temple that was full of corpses, some headless. He stated that the odor was overpowering. He also saw a body of a boy in a village that he had helped attack the day before. The examiner stated that this additional evidence was enough to justify the diagnosis of PTSD. In February 1992, the veteran was re-examined by VA. This noted that he had volunteered to be a doorgunner, where he said he had felt some control over his fate. This examination noted that he met several PTSD criteria: beginning on his first night in Vietnam, he was exposed to dead bodies and witnessed the deaths of numerous soldiers; he re-experienced being in a helicopter with tracer rounds flying by; he avoided Vietnam stimuli; he felt estranged, lacked interest and was unable to express love; and he had nightmares and startled easily. The impression was PTSD. In February 1992 and between March and April 1992, the veteran was hospitalized by VA, with complaints of nightmares, flashbacks and sleeplessness. Each hospitalization diagnosed PTSD. These also noted his continuing polysubstance abuse. VA outpatient treatment records developed between May and October 1992 reflected continuing treatment for PTSD. In November 1992, the veteran and his wife testified at a personal hearing. He stated that, despite a military speciality as a helicopter repairman, he never worked in this capacity. Instead, he volunteered almost immediately to fly as a doorgunner. He said he felt safer off the ground. The missions that he flew revolved around the insertion and retrieval of troops. As part of this duty, they were subjected to a great deal of enemy fire, to include one rocket that missed. During one mission, they dropped grenades in a village to stop incoming mortar fire, and he thinks that he killed a boy, a possibility that has haunted him ever since. No one on the helicopter was killed, but many of the men they dropped or picked up were wounded. After he returned from the war, he stated that his parents made him move from their home; he believed that they were afraid of him. He then lived in his car in the woods for about two years. He eventually married, although he described his marriage as "disintegrating." He said that he now sleeps in another room because of his violent nightmares, a statement that his wife confirmed. Both noted that he had been unable to keep a job for more than a few months. He no longer socialized and felt depressed. A November to December 1992 VA hospital report indicated that his mood was depressed and his affect was flat. The diagnosis included PTSD. In December 1992, the Environmental Support Group noted the veteran's MOS of helicopter repairman. It was then noted that they were unable to document that he was assigned as a doorgunner. In March 1993, the Department of the Army stated that there was no evidence that the veteran had received the Silver Star. After a careful review of the evidence of record, it is the conclusion of the undersigned that entitlement to service connection for PTSD has been established. Initially, it is noted that the record supports a finding that the veteran was engaged in combat. While his military speciality was helicopter repairman, objective evidence supports his claim that he served as a doorgunner. There is evidence that he received hazardous duty pay because of his participation in frequent flights as a doorgunner. Furthermore, he was awarded the Air Medal for meritorious achievement in aerial flight in Vietnam. Finally, he received the Vietnam Service Medal with two Bronze Service Stars. Clearly, the veteran was exposed to combat. Furthermore, the veteran's claimed stressors are directly linked to his time as a doorgunner. He recounted, during his November 1992 personal hearing, the rigors of this type of service. He then noted that he had recurrent nightmares of being in the helicopter and being shot. Clearly, his testimony was consistent with the hardships of service in this capacity. See Zarycki, id. Therefore, the evidence supports a finding that the claimed in-service stressors actually occurred. Further review of the record indicates substantial objective evidence of the diagnosis of PTSD. This disorder has been repeatedly diagnosed in VA hospital reports, VA outpatient treatment records, and in VA examinations. Moreover, there is a direct link between the current symptomatology, which includes nightmares, flashbacks, isolation, emotional numbing, and a startle response, and the in-service stressors. This link is most notably demonstrated by the content of the veteran's nightmares, which revolve around his service as a doorgunner, and the young boy that he believes that he killed. In conclusion, the undersigned finds that the veteran suffers from PTSD which is directly related to his exposure to combat while on active duty in Vietnam. Therefore, the preponderance of the evidence supports a finding of entitlement to service connection for PTSD. ORDER Service connection for PTSD is granted. C. P. RUSSELL 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.