Citation Nr: 0002324 Decision Date: 01/28/00 Archive Date: 02/02/00 DOCKET NO. 95-14 531 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Lincoln, Nebraska THE ISSUE Entitlement to service connection for post-traumatic stress disorder (PTSD). REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD Thomas H. O'Shay, Associate Counsel INTRODUCTION The veteran had active military service from May 1978 to April 1981. This matter comes before the Board of Veterans' Appeals (Board) from a May 1994 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Lincoln, Nebraska. This case was remanded by the Board in December 1997 for further development; it was returned to the Board in August 1999. FINDINGS OF FACT 1. All available evidence necessary for an equitable disposition of the veteran's appeal has been obtained. 2. There has been no demonstration of PTSD in service, nor has there been demonstration of a causal relationship between the veteran's PTSD and any event in service. CONCLUSION OF LAW PTSD was not incurred in or aggravated by service. 38 U.S.C.A. §§ 1131, 5107(a) (West 1991); 38 C.F.R. §§ 3.303, 3.304(f) (1999). REASONS AND BASES FOR FINDINGS AND CONCLUSION Initially, the Board notes that the veteran's claim is well grounded within the meaning of 38 U.S.C.A. § 5107(a). Further, the Board is satisfied that all relevant facts have been properly developed and that no further assistance to the veteran is required to comply with 38 U.S.C.A. § 5107(a). Service connection may be granted for disability resulting from disease or injury incurred or aggravated during active service. 38 U.S.C.A. § 1131 (West 1991); 38 C.F.R. § 3.303 (1999). Entitlement to service connection for PTSD requires 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. 38 C.F.R. § 3.304(f) (1998). During the pendency of this appeal, § 3.304(f) was amended, effective March 7, 1997. As amended, § 3.304(f) (1999) provides: Service connection for post-traumatic stress disorder requires medical evidence diagnosing the condition in accordance with § 4.125(a) of this chapter; 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. 64 Fed. Reg. 32807-32808 (1999). Service medical records show that the veteran reported, at his enlistment examination, a history of nervous dermatitis. Service medical records are otherwise negative for any complaints, finding or diagnosis of psychiatric disability. Service personnel records show that the veteran was stationed at the Grand Forks Air Force Base in North Dakota in September 1980 as a security specialist. The personnel records show that the veteran was recommended for discharge based on an apathetic and defective attitude toward military rules and regulations displayed throughout service. The veteran filed the instant claim in November 1993. On file are records from the Social Security Administration (SSA), as well as private medical records for the period from September 1989 to November 1997. Private treatment notes from Paulo Bahr, M.D., for July 1990 to August 1994, in particular document that when the veteran initially presented in July 1990 for evaluation, he reported developing symptoms of PTSD following a recent motor vehicle accident (MVA) in February 1989. Subsequent treatment notes and statements by Dr. Bahr from 1990 until May 1994 record in detail the veteran's complaints of, inter alia, nightmares, intrusive recollections and feelings of guilt associated with the MVA, and document that Dr. Bahr diagnosed the veteran with PTSD which, he concluded on numerous occasions, was secondary to the February 1989 MVA; none of Dr. Bahr's treatment records prior to June 1994 refer to the veteran's period of service. In June 1994, the veteran reported to Dr. Bahr that his PTSD had resulted from a February 1980 incident in service in which he was exposed to an unusual situation involving burning fumes from aircraft. The veteran indicated that he wanted this information to be available in connection with his application for VA benefits; subsequent treatment records from Dr. Bahr are negative for any further reference to the veteran's period of service. Private medical records on file from other providers and SSA records do not reference the veteran's period of service or address the etiology of the veteran's PTSD, other than to indicate that the content of the veteran's psychiatric symptoms consistently involved the February 1989 MVA. At a November 1997 SSA psychological evaluation, the report of which is on file, the veteran referred to his February 1989 MVA in describing his psychiatric symptoms, but notably did not report serving in the military; the examiner concluded that the veteran had a history of PTSD marked by nightmares, flashbacks and other symptoms. On file is a statement, dated in January 1994, from R.G. The author indicated that he had represented the veteran in a lawsuit to recover damages for injuries received in a February 1989 MVA. He indicated that the case had been settled and that the settlement proceeds would be disbursed to the veteran effective the date of the letter. Of record is a January 1994 statement by Dr. Bahr, in which he reported treating the veteran for PTSD and other mental disorders since July 1990. In a March 1994 statement, Dr. Bahr, in response to correspondence from the RO, clarified that the veteran had developed PTSD following an MVA in February 1989. In a June 1994 statement, however, Dr. Bahr averred that the veteran was a good informant, and stated that the veteran had recently reported a February 1980 incident to him in which the veteran was involved in a sensitive or classified project during which time he was exposed to burning fuel related to an aircraft accident. Dr. Bahr indicated that the event was an unusual and overwhelming experience for the veteran that lead to the development of PTSD. The veteran was afforded a VA examination in January 1994, at which time he reported serving as a military policeman in service. He described witnessing an incident in service in which a bomber, possibly carrying nuclear weapons, caught fire. He stated that while no deaths resulted from the incident, several persons sustained injuries. He informed the examiner that he considered the incident particularly frightening because he was responsible for ensuring, by force if necessary, that other flight crews removed their aircraft from the area during the incident. He informed the examiner that he thereafter began to misbehave in service because of this incident. He also reported a history of intermittent employment following service until his MVA in February 1989. With respect to current complaints, the veteran reported experiencing frequent nightmares and recollections of the fire; he did not indicate that those recollections were interfering with his ability to work. After mental status examination, the examiner concluded that while the veteran met criteria A and B for a diagnosis of PTSD, he did not fully meet criterion C or D. A diagnosis of PTSD was therefore not rendered. On file are several statements by the veteran in which he describes an incident in service in which a bomber, possibly carrying nuclear weapons, caught fire. He asserted that he was ordered at that time to ensure that flight crews evacuated other planes from the area, and he stated that he was ordered to kill those crewmembers who failed to comply with those instructions. The veteran complained that he was never debriefed after the incident or provided support, and that he still had recollections of the incident. The veteran's representative argued, in essence, that the veteran's experiences in service resulted in PTSD, and that the February 1989 MVA merely aggravated that condition. Of record are undated newspaper articles which essentially describe an incident occurring at the Grand Forks Air Force Base in which a B-52 bomber caught fire. The articles indicate that the type of weapons carried onboard the aircraft were not known. On file is a January 1997 letter from the U.S. Armed Services Center for Research of Unit Records (USASCRUR) (formerly the U.S. Army & Joint Services Environmental Support Group), which include an historical abstract describing an incident which occurred on September 15, 1980. The abstract indicates that the engine of a B-52H bomber stationed at Grand Forks Air Force Base caught fire, that three firemen were treated for minor injuries and released, and that one crewman and one fireman were hospitalized. Service medical records are negative for any psychiatric complaints or treatment and there is no medical evidence of a diagnosis of PTSD either in service or for more than 7 years after service. PTSD was first diagnosed in July 1990, following a February 1989 MVA, and from 1990 to January 1994, the veteran consistently reported that his nightmares, flashbacks and other symptoms associated with his PTSD only involved the postservice MVA. While the veteran nevertheless now contends that his experiences in service caused his PTSD, the record reflects that he first reported experiencing symptoms related to those events at VA examination in January 1994, immediately after filing his claim for VA compensation for PTSD and shortly before receiving the settlement proceeds from the lawsuit filed in connection with the February 1989 MVA. Moreover, although the veteran attributed his PTSD to service on VA examination in January 1994 and on one occasion in June 1994 with Dr. Bahr, he did not again mention his period of service or any incidents experienced therein when examined or treated at various times thereafter. Indeed, at his November 1997 SSA psychological examination, the veteran did not even report serving in the military, but instead discussed his February 1989 MVA and his psychiatric symptoms in relation thereto. Under the circumstances, the Board concludes that the veteran's statements to the effect that his reported experiences in service distressed him and that he experienced nightmares, flashbacks and other psychiatric symptoms whose content reflected his experiences in service are not credible in light of contemporary medical records which consistently document through 1993, and from July 1994 onward, that the content of the veteran's psychiatric symptoms revolved exclusively around his February 1989 MVA, without any reference to service, and that he was repeatedly diagnosed with PTSD based on symptoms associated with the MVA. Although Dr. Bahr concluded in June 1994 that the veteran developed PTSD from his service experiences, this conclusion was based solely on the veteran's account of the content of his symptoms on that one occasion which, as noted above, is not considered credible. Moreover, the Board notes that Dr. Bahr's June 1994 statement is inconsistent with his prior statements in which he repeatedly noted that the veteran's PTSD symptomatology was exclusively associated with the MVA. In addition, the January 1994 VA examiner concluded, after review of the reported service stressors and mental status evaluation, that the veteran did not fulfill the criteria for a diagnosis of PTSD in that he did not exhibit sufficient symptoms associated with his claimed stressors. In essence, the one medical opinion supporting the veteran's claim is based on statements of the veteran which the Board has found to be not credible. It clearly provides no basis for the Board to conclude that it is at least as likely as not that PTSD was incurred in or aggravated by service. The Board therefore finds that application of the evidentiary equipoise rule, which mandates that where the evidence is balanced and a reasonable doubt exists as to a material issue, the benefit of the doubt shall be given to the claimant, is not required in this case. See 38 U.S.C.A. § 5107 (West 1991); 38 C.F.R. § 3.102 (1999); Gilbert v. Derwinski, 1 Vet. App. 49, 54 (1990). 38 U.S.C.A. § 5107. ORDER Entitlement to service connection for PTSD is denied. SHANE A. DURKIN Member, Board of Veterans' Appeals