Citation Nr: 0007048 Decision Date: 03/15/00 Archive Date: 03/23/00 DOCKET NO. 97-22 777 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Manchester, New Hampshire THE ISSUES 1. Entitlement to service connection for residuals of hepatitis. 2. Entitlement to service connection for post-traumatic stress disorder. REPRESENTATION Appellant represented by: The American Legion WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD A. P. Simpson, Associate Counsel INTRODUCTION The appellant served on active duty from July 1969 to February 1972 and from May 1980 to September 1980. This case comes before the Board of Veterans' Appeals (the Board) on appeal from a July 1996 rating decision of the Manchester, New Hampshire, Department of Veterans Affairs (VA) Regional Office (RO). In that decision, the RO denied service connection for residuals of hepatitis and for post- traumatic stress disorder. The Board remanded these claims in March 1998. The requested development has been accomplished, and the case has been returned to the Board for further appellate review. FINDINGS OF FACT 1. Hepatitis B was incurred in service as a result of IV drug use. 2. The claim for service connection for post-traumatic stress disorder is plausible. 3. The appellant does not have post-traumatic stress disorder based upon an inservice stressor. CONCLUSIONS OF LAW 1. The appellant's hepatitis B carrier status is the result of drug abuse and cannot be considered to have been incurred in the line of duty. 38 U.S.C.A. §§ 105(a), 1110, 5107(a) (West 1991); 38 C.F.R. §§ 3.301(a), (d) (1999). 2. Post-traumatic stress disorder was not incurred in or aggravated by active service. 38 U.S.C.A. §§ 1110, 1154, 5107 (West 1991); 38 C.F.R. §§ 3.303, 3.304(f) (1999). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS I. Hepatitis The Board notes that the appellant filed his claim for service connection for hepatitis in 1996. Under Section 8052 of the Omnibus Budget Reconciliation Act of 1990 (OBRA 1990), Pub. L. No. 101-508, § 8052, 104 Stat. 1388, 1388-351, the former 38 U.S.C. §§ 310 and 331 (now designated §§ 1110 and 1131) were amended to prohibit, effective for claims filed after October 31, 1990, payment of compensation for any disability that is "a result of the veteran's own . . . abuse of alcohol or drugs." (Emphasis added). Section 8052 also amended 38 U.S.C. § 105(a) to provide that, with respect to claims filed after October 31, 1990, an injury or disease incurred during active service will not be deemed to have been incurred in line of duty if the injury or disease was a result of the person's own abuse of alcohol or drugs. 38 U.S.C.A. § 105(a) (West 1991). Governing regulations now provide that direct service connection may be granted only when a disability or cause of death was incurred or aggravated in line of duty, and not the result of the veteran's own willful misconduct or, for claims filed after October 31, 1990, the result of his or her abuse of alcohol or drugs. 38 C.F.R. § 3.301(a) (1999). The definition of drug abuse is the use of illegal drugs, the intentional use of prescription or nonprescription drugs for a purpose other than the medically intended use, or the use of substances other than alcohol to enjoy their intoxicating effects. Id. at (d) (1999). Here, the service medical records reveal that in September 1971, the appellant contracted hepatitis. In a September 13, 1971, treatment report, the appellant was diagnosed with hepatitis. The examiner noted that the appellant reported having had used heroin in Vietnam. He was hospitalized at that time. In the hospitalization report, the examiner stated that the appellant admitted to using intravenous heroin while in Vietnam, and had done so as recently as May 1971, but denied any use since that time. At the time of discharge from the hospitalization, in November 1971, it was noted that the appellant's hepatitis was resolving. A treatment report revealed that by January 1972, there was no evidence of hepatitis. In a November 1984 private medical record, Dr. Robert I. Milstein stated that the appellant reported having used drugs while in Vietnam and that the appellant reported having used more alcohol in the past few months. Dr. Milstein stated that the appellant was seen by Dr. Noble, who had found a tender, enlarged liver below the xiphoid below the right costal margin, which was consistent with alcoholic hepatitis. The diagnosis was hepatitis, secondary to alcoholism. The appellant has repeatedly denied in written statements and testimony that he did not use any IV drugs while in Vietnam and claims that such statement in his service medical records is false. The appellant underwent a VA examination in February 1999. The VA examiner stated that review of the service medical records revealed that the appellant had "definite hepatitis." He noted that the appellant denied ever using IV drugs and ever having a blood transfusion. The appellant reported that he had had a tattoo done in 1969. The VA examiner noted that a June 1996 test was positive for hepatitis B core antigen and that the anti-B titer was also positive. He stated that the hepatitis B surface antigen was negative. The VA examiner stated that the appellant reported that he had not been tested for hepatitis A or hepatitis C. The appellant reported feeling tired and weak for the last 20 years. The VA examiner stated that the appellant's liver was not palpable and that there was no tenderness, spasms, or masses felt. The diagnosis was positive hepatitis studies for hepatitis B, hepatitis C not active at present, and hepatitis 1971, type undetermined, but more than likely due to hepatitis A. The VA examiner stated that studies were being checked with routine liver studies and undergoing studies for hepatitis A, B, and C. In an April 1999 addendum, the VA examiner stated that following the February 1999 examination and further review of the claims file, he concluded that the 1971 viral hepatitis studies were not done to differentiate viral hepatitis A or B. He stated that due to the documented history of IV drug use, that it was as likely as not that this was hepatitis B. The VA examiner stated that there was no evidence of active liver disease at present, as the bilirubin and enzymes were normal. He stated that the hepatitis screen showed AbcAb reactive and HBSAG negative and that, therefore, the veteran was a carrier of the hepatitis B virus due to IV drug use. The diagnosis was hepatitis B (carrier). The Board finds that service connection for hepatitis is not warranted. In a November 1996 opinion, the Office of General Counsel determined that Section 8052 of the Omnibus Budget Reconciliation Act of 1990, Pub. L. No. 101-508, § 8052, 104 Stat. 1388, 1388-351, which is applicable to claims filed after October 31, 1990, precluded an injury or disease that is a result of a person's own abuse of alcohol or drugs from being considered incurred in line of duty and, consequently, precluded resulting disability or death from being considered service connected. VAOPGCPREC 11-96 (Nov. 15, 1996); see also 38 C.F.R. §§ 3.301(a), (d). The Board notes that it is bound by precedent opinions of the General Counsel of the Department of Veterans Affairs. 38 U.S.C.A. § 7104(c) (West 1991); 38 C.F.R. §§ 19.5, 20.101 (1999). Here, the medical evidence establishes that the appellant incurred hepatitis B in service due to IV drug use. Based on the April 1999 medical opinion, the Board finds that the hepatitis the appellant had in service was hepatitis B and, further, that it was a result of IV drug use. The Board has considered the appellant's numerous arguments that he did not use IV drugs while in service; however, the Board finds his statements made at the time the medical record was created and prior to the filing of monetary benefits that he had engaged in IV drug use are more probative and credible than his current statements that he never used IV drugs. Thus, the appellant is a hepatitis B carrier as a result of IV drug use, and service connection cannot be granted for such. 38 U.S.C.A. §§ 105(a), 1110, (West 1991); 38 C.F.R. § 3.301(a), (d) (1999); see also VAOPGCPREC 11-96. II. Post-traumatic stress disorder Service connection for post-traumatic stress disorder requires: (1) medical evidence diagnosing the condition in accordance with DSM-IV; (2) credible supporting evidence that the claimed inservice stressor actually occurred; and (3) medical evidence of a causal nexus between current symptomatology and the specific claimed inservice stressor. 38 C.F.R. § 3.304(f) (1999); see Cohen v. Brown, 10 Vet. App. 128, 138 (1997). The appellant has submitted evidence of a current medical diagnosis of post-traumatic stress disorder, reported inservice stressors alleged to have caused the post-traumatic stress disorder, and submitted medical evidence which establishes a relationship between the diagnosis of post- traumatic stress disorder and the inservice stressors. In a June 1996 VA psychiatric evaluation report, the VA examiner entered a diagnosis of post-traumatic stress disorder based upon stressors that the appellant had described had occurred while he was in Vietnam. When determining whether a claim is well grounded, the evidence submitted in support of the claim must be accepted as true; however, once well-groundedness is established, the weight and credibility of the evidence must be assessed. Robinette v. Brown, 8 Vet. App. 69, 75-76 (1995). The Board finds that the June 1996 diagnosis of post-traumatic stress disorder based upon inservice stressors is sufficient to establish a well-grounded claim for service connection for post-traumatic stress disorder. Cohen, 10 Vet. App. at 137. However, there is another standard that must be addressed; the benefit of the doubt. When all the evidence is assembled, the Secretary, 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 reaching the merits determination, truthfulness and credibility are no longer assumed. The relevant evidence of record follows. Review of the service records reveal that the appellant served in Vietnam from May 1970 to May 1971. His military occupational specialty was an aircraft mechanic. He was awarded the National Defense Service Medal, Vietnam Service Medal; two Overseas bars, Army Commendation Medal with Oak Leaf Cluster; and Vietnam Campaign Medical with 60 device. The service records do not indicate that the appellant received any awards or decorations that would establish that he engaged in combat. In a May 1985 private medical record, Dr. John Vorenberg entered a diagnosis of post Vietnam stress syndrome. He stated that the appellant had been admitted in an extremely agitated state. He stated that the appellant had post-stress syndrome, chronic alcoholism, and was depressed. Dr. Vorenberg stated that the appellant was at war with his boss, whom he felt was a bureaucrat and made his life harder, rather than easier. Additionally, he stated that the appellant was at war with his wife because he was bothered that she was hanging out with a woman who was known for being unfaithful to her husband. In a May 1996 VA Form 21-4138, Statement in Support of Claim, the appellant stated that he took care of the helicopters and had to fly on many combat missions to make sure that the helicopter got off the ground. He stated that they would open fire on villages and any zone where there were no Americans and called it "instant death." The appellant stated that he was too young to go into service on his own. He stated that he robbed a store post service after seeing a movie on Vietnam and had gone to jail because of post- traumatic stress disorder. The appellant underwent a VA examination in June 1996. The appellant stated that upon arriving in Vietnam, he was immediately hit by the heat and the stench. He reported that rockets had come into the area where he had been assigned and that he was often too fearful to go out to the latrine. He stated that he would go up in the helicopter with his buddies and at times they would open fire at everything they saw on the ground. The appellant reported having seeing a group of soldiers who had hung and then shot a Vietnamese person after they found out he was passing information. He stated that while he was in Vietnam, he had the increasing sense that life was meaningless and lost all respect for human life. The VA examiner stated that the appellant appeared to be unable to describe specific events related to his war time service secondary to increasing agitation and affective distress. The VA examiner noted that review of the appellant's claims folder indicated that the appellant had not shown up for some post-traumatic stress disorder examinations and that the appellant reported that it was due to his difficulty with talking about Vietnam. Additionally, the VA examiner noted that 1988 medical records revealed that the appellant had not had any depression prior to going to service in Vietnam, but that he had developed it following his return. The VA examiner entered a diagnosis of post-traumatic stress disorder. He stated that such diagnosis was entered using the DSM III diagnostic criteria. It was the VA examiner's determination that the appellant had experienced events that were outside the range of usual human experience and that would be markedly distressing to almost anyone. The VA examiner stated that such events consisted of the appellant having serious threat to his life or physical integrity, as well as sudden destruction of home or community. He stated that these events also included seeing another person who had recently been or was being seriously injured and killed as a result of physical violence. In an October 1996 private medical record, Dr. F. Howard Buss, entered a diagnosis of post-traumatic stress disorder. He stated that the appellant reported having served in Vietnam and although he was not physically hurt, he had been "mentally wounded." The appellant reported that he experienced flashbacks from his experiences in Vietnam. The appellant had a hearing before this Board Member in January 1998. He stated that he was being treated for post- traumatic stress disorder at the VA Medical Center. He testified that they had taken North Vietnam sympathizers and put them up on a pole and had opened fire on them. He stated that they would then take the person down from the pole and throw them into the ocean. The appellant stated that while he was up in a helicopter, they would open fire on villagers. He stated that the first day he arrived in Vietnam, they were attacked with incoming rockets and mortars and that there were numerous attacks during his service in Vietnam. The appellant stated that he had almost gotten killed. He stated that two fellow soldiers were killed but that he could not remember their names. In June 1998 and December 1998 letters, Dr. Herbert I. Rothfarb stated that the he had treated the appellant in 1971 as a result of emotional difficulties that the appellant had experienced while serving in Vietnam and that the appellant had been treated for post-traumatic stress disorder with associated battle fatigue and confusion at that time. In a December 1998 VA Form 21-4138, the appellant reported that upon arriving in Chu Lai, he was attacked and bombarded by enemy rocket fire, which had caused a lot of casualties. He stated that it was horrifying. Additionally, he stated that in November or December of 1970, while he was at a hospital, he and others took hits from rocket fire and that body parts were all over the place. He told of the incident where they tied a Vietnamese man to a pole and opened fire on him and threw his body into the ocean. The appellant stated that the most stressful times were when the Vietcong would try to attack their compound. He stated that in May 1971, he was at the orderly room getting paperwork completed when one of their own guys snapped and tried to kill the commanding officer of their company by shooting rounds into the orderly room, almost killing him. Finally, he stated that as he got ready to go home, they came under heavy rocket attacks. In a January 1999 letter, Dr. Bernard S. Yudowitz stated that he had seen the appellant in June 1991 for battle fatigue and confusion, which was now known as post-traumatic stress disorder. The appellant's stressors were submitted to the U.S. Armed Services Center for Research of Unit Records (USASCRUR) for verification. In an April 1999 letter, the USASCRUR stated that records substantiated that an armed soldier had held several personnel at bay while waiting for the commanding officer in order to kill him, but that the only time the weapon was discharged was when a fellow soldier wrested the perpetrator to the floor. It stated that report indicated that no one was injured. USASCRUR stated that it was unable to verify the May 1971 attack, but that Chu Lai had received enemy rocket fire in June 1970 and November 1970. The appellant underwent a VA psychiatric evaluation in May 1999. The VA examiner stated that he had had an opportunity to review "thoroughly" the appellant's claims files, including the treatment notes, and the opportunity to examine the appellant. The appellant reported that as soon as he got to Vietnam, he had been welcomed by a barrage of enemy rocket attacks. He stated that he had participated in convoy rides, at which time he had been in danger of being killed. He stated that he had witnessed a Vietnamese collaborator who was put to death by being placed on a pole and fired at by his fellow soldiers. The appellant stated that he participated in helicopter flying missions, during which time they shot at anything in sight and that he could hear people screaming. The VA examiner stated the following as to the appellant's stressors: 1. In his 1/13/98 hearing report, page 8, it states that they used to take North Vietnamese sympathizers and put them on a pole and used to open fire on them. [The appellant] reported in this interview that he had never killed nor was in active combat per se. 2. In the same document on page 13[,] he makes reference to Walter Reed Hospital being directly hit and nothing left but people's intestines. When asked about this incident[,] he stated that he was some 15 yards from it and it was caused by a rocket. This examiner found no references to such incident on the record. 3. Lastly, pertaining to orderly room incident in Vietnam dated 5/26/71, he reported that the soldier in question was on a hill and firing all over the place; the [D]epartment of Navy's report dated 4/22/99 indicates that this soldier held enemy personnel at bay, however, not firing his weapon. 4. Pertaining to enemy rocket attack on Chu Lai on 3/16/71, the report confirms such attacks. The VA examiner noted that the appellant had difficulty describing events critical to rendering an appropriate psychiatric diagnosis. He stated that the appellant's memories of the events in service were not only fragmented but inconsistent. He added that the appellant did not provide a coherent picture of the events in service nor had there been any signs of distress related to such experiences. The examiner observed flat affective reactivity; accompanying emotions were missing . It was also observed that his cognitive response style yielded no signs of physiological arousal. His verbalized stressors were not only unproductive, but contradictory. There was no fear detected to his own reaction to traumatic memories. The VA examiner noted that the appellant refused to undergo two diagnostic tests. He entered a diagnosis of generalized anxiety disorder with symptoms of dysthymia/mood swings, which were of post service origin. He stated that the appellant's description of his subjectively experienced symptoms coupled with the thorough review of the clinical record did not meet the criteria of a diagnosis of post- traumatic stress disorder. In a June 1999 letter, a VA examiner stated that the appellant had been treated regularly at the VA Medical Center for symptoms if anxiety, depression, social isolation, withdrawal, and recurrent flashbacks and intrusive thoughts, which were all a result of his chronic and severe post- traumatic stress disorder. The VA examiner added that the appellant's post-traumatic stress disorder had affected most areas of his life, including employment, interpersonal relationships, and social interactions. VA medical records confirm that the appellant has been treated for post- traumatic stress disorder at the VA Medical Center for many years. The appellant underwent diagnostic testing in July 1999. The VA examiner who conducted the May 1999 psychiatric evaluation stated that the Minnesota Multiphasic Personality Inventory results were invalid because of symptom exaggeration and that the Milton Clinical Multiaxial Inventory II results were suggestive of an individual with traits that fell into schizoid, passive aggressive, aggressive, avoidant, anxiety, and dysthymia. He stated that the results of the diagnostic testing supported the diagnosis he had entered in the May 1999 evaluation report. The appellant and his wife have submitted numerous statements as to why service connection for post-traumatic stress disorder is warranted. As stated above, the diagnosis of post-traumatic stress disorder entered by the VA examiner in the June 1996 psychiatric evaluation establishes a well-grounded claim for service connection for post-traumatic stress disorder. However, meeting the provisions of 38 C.F.R. § 3.304(f) does not require a grant of service connection; rather, 38 C.F.R. § 3.304(f) provides the framework or minimal requirements for consideration of a grant of service connection for post- traumatic stress disorder. Meeting the provisions of 38 C.F.R. § 3.304(f) establishes all the elements needed for a well-grounded claim. Once the elements are met, the Board must then review all the evidence and assess the weight and credibility. Case law from the United States Court of Appeals for Veterans Claims (the Court) has not established that VA must accept any diagnosis when the validity of the diagnosis is in doubt. See Colvin v. Derwinski, 1 Vet. App. 171, 175 (1991). The Board notes that the May 1985 private medical record from Dr. Vorenberg, the October 1996 private medical record from Dr. Buss, the June 1998 and December 1998 letters from Dr. Rothfarb, the January 1999 letter from Dr. Yudowitz, the June 1999 letter from a VA examiner, and the VA medical records showing treatment for post-traumatic stress disorder do not assist the appellant in his claim for service connection for post-traumatic stress disorder. In none of the records, letters, or treatment reports, do the examiners report inservice stressors. The private medical examiners enter diagnoses of post-traumatic stress disorder without ever discussing an inservice stressor or relating the diagnosis of post-traumatic stress disorder to an inservice stressor. See 38 C.F.R. § 3.304(f). The same analysis applies to the VA examiner's June 1999 letter, wherein he stated only that the appellant was being treated for post-traumatic stress disorder. He did not report any inservice stressors upon which the diagnosis of post-traumatic stress disorder was based. See id. Additionally, the treatment reports show diagnosis after diagnosis of post-traumatic stress disorder; however, there is no report of an inservice stressor or a medical opinion offering a nexus between the diagnosis of post-traumatic stress disorder and an inservice stressor. See id. Thus, none of the records listed above do not assist the appellant in establishing service connection for post- traumatic stress disorder. The evidence that supports the appellant's claim for service connection for post-traumatic stress disorder is the June 1996 psychiatric evaluation report. There, the VA examiner stated that he had an opportunity to review the evidence of record and examine the appellant. The VA examiner stated that the diagnosis of post-traumatic stress disorder was based upon events that were outside the range of usual human experience, such as having a serious threat to his life or physical integrity, as well as sudden destruction of home or community. The VA examiner further stated that these events also included seeing another person who had recently been or was being seriously injured and killed as a result of physical violence. In this regard, the Board notes that one of the stressors that the appellant reported to this VA examiner, having been subjected to rocket fire attacks, has been verified. The evidence against the appellant's claim for service connection for post-traumatic stress disorder are the May 1999 psychiatric evaluation report, in conjunction with the July 1999 diagnostic testing results report. In the May 1999 psychiatric evaluation report, the VA examiner reviewed the evidence of record "thoroughly", reported the inservice stressors that the appellant had described and noted which one had been verified by the USASCRUR. The Board notes that the examiner stated that the rocket attack in March 1971 had been confirmed. However, the April 1999 letter from USASCRUR states that the dates of rocket fore were in June 1970 and November 1970. Regardless, the evidence establishes that the appellant was exposed to rocket attacks. It was the VA examiner's determination that based upon his review of the record and examination of the appellant that the evidence did not support a diagnosis of post-traumatic stress disorder. Instead, the VA examiner entered a diagnosis of generalized anxiety disorder with symptoms of dysthymia/mood swings and that such diagnosis was not related to service. Additionally, the VA examiner stated that the diagnostic tests that the appellant took were either invalid or did not support a diagnosis of post-traumatic stress disorder, and he reaffirmed his diagnosis of generalized anxiety disorder. After having reviewed the evidence for and against the appellant's claim, the Board finds that the preponderance of the evidence is against the appellant's claim for service connection for post-traumatic stress disorder. The Board finds that May 1999 psychiatric evaluation report, coupled with the July 1999 diagnostic testing results report, are more probative than the June 1996 psychiatric evaluation report for several reasons. Although both VA examiners had an opportunity to review the claims file and examine the appellant, the Board notes that the VA examiner who conducted the May 1999 psychiatric evaluation had an opportunity to review far more evidence, including the June 1996 psychiatric evaluation report and the results of psychological testing. The VA examiner in 1999 also based his diagnosis on analysis of the appellant's subjectively experienced symptoms, especially in connection with the his account of the alleged in- service stressors. The VA examiner in the May 1999 evaluation report noted that the appellant's memories of the events in service were not only inconsistent and fragmented but also contradictory. Further, in describing the stressors, he did not exhibit the symptoms associated with trauma as set forth in DSM IV. Additionally, the examiner stated in the evaluation report that the appellant had admitted at the evaluation that he had not been in active combat "per se." However, at the time of the June 1996 psychiatric evaluation, the appellant gave the VA examiner the impression that he had been in active combat (the VA examiner stated that the appellant reported "that he experience[d] flashbacks of his combat service in Vietnam"). The Board notes that the VA examiner's opinion in the June 1996 evaluation report is based upon the appellant's history only, and that the appellant admitted at the time of the May 1999 evaluation that he had not engaged in combat "per se." Such evidence weighs against the appellant's claim and against the VA examiner's opinion in the June 1996 evaluation report that the appellant had post-traumatic stress disorder based upon inservice stressors, which were combat related. Additionally, the Board notes that when the appellant underwent objective diagnostic testing, the results either were invalid or were not supportive of a diagnosis of post- traumatic stress disorder. This evidence also goes against the appellant's claim for post-traumatic stress disorder. For the above reasons, the Board finds that the June 1996 evaluation report and other evidence supporting the claim is outweighed by the May 1999 evaluation report with the July 1999 diagnostic testing report. As discussed above, the Board has determined that the preponderance of the evidence is against the appellant's claim for service connection for post-traumatic stress disorder. Although the VA examiner entered a diagnosis of post-traumatic stress disorder in the June 1996 evaluation report, the Court has recognized that the Board is not compelled to accept a medical opinion; rather, if the Board reaches a contrary conclusion, it must state its reasons and bases and be able to point to a medical opinion other than the Board's own, unsubstantiated opinion. Colvin, 1 Vet. App. at 175. The Board has based its determination on the May 1999 psychiatric evaluation report and the July 1999 diagnostic testing report. In the May 1999 evaluation report, the VA examiner stated that he had an opportunity to review the appellant's claims files, to include the verified stressors, and made a specific finding that the appellant did not have post-traumatic stress disorder. Additionally, the July 1999 diagnostic testing report revealed that the results were either invalid or not indicative of a diagnosis of post-traumatic stress disorder. Although the appellant and his wife have alleged that he has post-traumatic stress disorder related to his service in Vietnam, they are not competent to make a such a diagnosis, as that requires a medical opinion. Espiritu v. Derwinski, 2 Vet. App. 492, 494 (1992); see also Layno v. Brown, 6 Vet. App. 465 (1994). The Board must point out that the appellant has most recently reported that he did not engage in combat "per se," and thus entitlement to application of 38 U.S.C.A. § 1154(b) (West 1991) is not warranted. For the reasons stated above, the Board finds that the preponderance of evidence is against the appellant's claim for service connection for post-traumatic stress disorder, and there is no doubt to be resolved. 38 U.S.C.A. § 5107(b) (West 1991). ORDER Service connection for hepatitis is denied. Service connection for post-traumatic stress disorder is denied. NANCY I. PHILLIPS Member, Board of Veterans' Appeals