Citation Nr: 0000612 Decision Date: 01/07/00 Archive Date: 01/11/00 DOCKET NO. 94 - 43 739 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in St. Paul, Minnesota THE ISSUE Whether the claim of entitlement to service connection for an acquired psychiatric disability, to include paranoid schizophrenia, is well-grounded. REPRESENTATION Appellant represented by: Veterans of Foreign Wars of the United States WITNESS AT HEARINGS ON APPEAL Appellant ATTORNEY FOR THE BOARD Frank L. Christian, Counsel INTRODUCTION The veteran served on active duty from January to November 1980. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a rating decision of September 1992 from the Department of Veterans Affairs (VA) Regional Office (RO) in St. Paul, Minnesota. The veteran's prior claims of entitlement to service connection for an acquired psychiatric disability, including paranoid schizophrenia, were previously denied by rating decisions of January 1982, June 1983, and April 1987, and those decisions were not appealed. In September 1992, the RO determined that new and material evidence had not been submitted to reopen the veteran's claim, and the veteran initiated and perfected an appeal of that decision. The RO subsequently determined that evidence received in February 1997 was both new and material to the issue of entitlement to service connection for an acquired psychiatric disability, including paranoid schizophrenia, and reopened that claim. However, on de novo review, the RO determined that service connection for an acquired psychiatric disability, including paranoid schizophrenia, was not warranted and issued a Supplemental Statement of the Case to the veteran addressing that issue. This case was previously before the Board in February 1998, and was Remanded to the RO for additional development of the evidence, to include review of the medical evidence by a board certified psychiatrist and an opinion as to whether an increase in the veteran's psychiatric disability occurred during active service and, if so, whether the increase in psychiatric disability was due to the natural progress of the disease. The requested actions have been satisfactorily completed, and the case is now before the Board for further appellate consideration. FINDING OF FACT The claim of entitlement to service connection for an acquired psychiatric disability, including paranoid schizophrenia, is not plausible because no competent medical evidence demonstrates that such disability was incurred in or aggravated by active service, or is otherwise linked or related to active service. CONCLUSION OF LAW The claim of entitlement to service connection for an acquired psychiatric disability, including paranoid schizophrenia, is not well grounded because the record contains no competent medical evidence showing that such disability originated during active service or was aggravated therein, and no nexus between such disability and active service has been demonstrated. 38 U.S.C.A. §§ 1131, 5107(a) (West 1991); Caluza v. Brown, 7 Vet. App. 498 (1995), affirmed per curiam, 78 F.3d 604 (Fed. Cir. 1996). REASONS AND BASES FOR FINDING AND CONCLUSION As a preliminary matter, the Board must determine whether the veteran has submitted evidence of a well-grounded claim of entitlement to service connection for an acquired psychiatric disability, including paranoid schizophrenia. If he has not, his appeal must fail, and VA is not obligated to assist him in the development of the claim. 38 U.S.C.A. § 5107(a) (West 1991). The United States Court of Appeals for Veterans Claims (Court) has defined a well-grounded claim as a plausible claim, one which is meritorious on its own or capable of substantiation. Murphy v. Derwinski, 1 Vet. App. 78, 81 (1990). It has also held that where a determinative issue involves a medical diagnosis or medical causation, competent medical evidence to the effect that the claim is plausible is required. Grottveit v. Brown, 5 Vet. App. 91, 93 (1993). For the reasons set forth below, the Board finds that the veteran has not met his burden of submitting evidence to support a belief that his claim of entitlement to service connection for an acquired psychiatric disability, including paranoid schizophrenia, is well grounded. 38 U.S.C.A. § 5107(a) (West 1991); see Grottveit, at 93; Tirpak v. Derwinski, 2 Vet. App. 609 (1992); Murphy, at 80 In order to establish a well-grounded claim, there must be (1) competent evidence of a current disability in the form of a medical diagnosis; as well as (2) evidence of incurrence or aggravation of a disease or injury in service in the form of competent lay or medical evidence; together with (3) evidence of a nexus between the inservice injury or disease and the current disability in the form of medical evidence. Caluza v. Brown, 7 Vet. App. 498 (1995), affirmed per curiam, 78 F.3d 604 (Fed. Cir. 1996). In this case, the requirement of item (1) is satisfied as to the claim for service connection for an acquired psychiatric disability, including paranoid schizophrenia, because the record contains clear diagnoses of acquired psychiatric disability, including paranoid schizophrenia, beginning in May 1975 and continuing through the present. The requirement of item (2), above, that evidence be submitted of incurrence or aggravation of a disease or injury in service in the form of lay or medical evidence is not met because there is no competent medical evidence that the veteran's acquired psychiatric disability, including paranoid schizophrenia, originated or was incurred during active service. Rather, the medical evidence of record shows that the veteran was admitted by Court order to Golden Valley Health Center in December 1974, and that he was again hospitalized and diagnosed with paranoid schizophrenia at Golden Valley Health Center in May 1975, approximately five years prior to service entry. Further, additional medical records from that facility, from Azoka State Hospital, and from Brainerd State Hospital show that the veteran was hospitalized at those facilities in June 1975, and at Metropolitan Medical Center in 1977 and 1979, for treatment of an acquired psychiatric disability, diagnosed as paranoid schizophrenia, and that the veteran was being treated with Navane, an anti-psychotic, at the time of service entry and subsequently. Such documented medical evidence is credible, and establishes that the veteran's paranoid schizophrenia was not incurred during active service, but clearly and unmistakably preexisted service entry. Finally, at his personal hearing held at the RO in July 1999, the veteran affirmatively acknowledged in sworn testimony that he was psychiatrically ill before his entry on active duty. Further, there is no competent lay or medical evidence which shows that the preexisting paranoid schizophrenia, or any other acquired psychiatric disability, worsened during active service as a result of aggravation. To that point, the Board notes that the only individual who has expressed the opinion that the veteran's preservice psychiatric disability might have worsened during active service is the veteran himself, although the service medical records reflect no increase in the severity of his preservice pathology during service. At his personal hearing held in July 1999, the veteran was unable to provide any basis for a belief that an increase in the severity of his psychiatric illness had taken place while on active duty. Further, in November 1998 the RO obtained a complete review of the veteran's medical records and a medical opinion from a VA psychiatrist, who noted documented diagnoses of paranoid schizophrenia in the veteran as early as May 1975. That psychiatrist further expressed the opinion that the medical evidence prior to, during, and following service showed that the veteran had serious mental problems, probably schizophrenia and possibly a bipolar disorder, before he entered service; that the medical records contained no indication of any significant traumatic events during service; and that the veteran's experience in the service had nothing to do with the continuing mental problems he has experienced through the years. The Board finds that such medical opinion is based upon the documented medical record and is credible. Based upon the foregoing, the Board finds that the record contains no competent medical or lay evidence demonstrating incurrence or aggravation of an acquired psychiatric disability, including paranoid schizophrenia, during active service. To the contrary, the documented medical record is replete with instances as early as December 1974 in which the veteran was institutionalized under Court order due to florid psychosis; that paranoid schizophrenia was competently diagnosed in May 1975 and subsequently; that such instances of hospitalization and treatment for psychosis continued during the years prior to service entry; that he was found to have Navane in his possession during a locker search in basic training; and that he was maintained on that or similar anti-psychotics throughout his brief period of active service until his discharge after ten months. The Board further finds that the presumption of soundness at entry has been overwhelmingly rebutted by clear and unmistakable medical evidence to the contrary. Accordingly, the requirements of item (2) that evidence be submitted of incurrence or aggravation of a disease or injury in service in the form of competent lay or medical evidence are not met. The Board further finds that the requirements of item (3) are not met in that the veteran has not presented any competent medical evidence of a nexus between his current acquired psychiatric disability, including paranoid schizophrenia, and his period of active service. Specifically, there is no competent medical evidence which attributes any current psychiatric pathology to incurrence or aggravation during active service, and there is competent and informed medical evidence to the contrary which states that the veteran's psychiatric disability preexisted service entry by a number of years, and was neither incurred in nor aggravated by his brief period of active duty. That evidence, in the form of a medical opinion, states unequivocally that the medical evidence prior to, during, and following service demonstrates that the veteran had serious mental problems, probably schizophrenia and possibly a bipolar disorder, before he entered service; that the record contains no indication of any significant traumatic events during service; and that the veteran's experience in the service had nothing to do with the continuing mental problems he has experienced through the years. The Board again finds that opinion to be credible and supported by the documentary record. Further, the record is devoid of any competent evidence to the contrary. Based upon the foregoing, the Board finds that the appellant has not submitted evidence sufficient to justify a belief by a fair and impartial individual that his claim of entitlement to service connection for an acquired psychiatric disability, including paranoid schizophrenia, is well grounded. Accordingly, that claim is denied. The Court has held that VA has no statutory duty to assist a veteran absent evidence of a well-grounded claim, and cautioned VA against volunteering assistance to establish well groundedness. Grivois v. Brown, 6 Vet. App. 136, 140 (1994). However, the Board notes that the veteran may render his claim well grounded by submitting competent medical evidence establishing aggravation of his preservice psychiatric disability, including schizophrenia, during his period of active service, or linking or relating such to trauma or pathology experienced during active service. Robinette v. Brown, 8 Vet. App. 69, 74 (1995). Although the Board has considered and denied the veteran's claims for service connection for an acquired psychiatric disability, including paranoid schizophrenia, on a ground different from that of the RO, that is, on the basis of whether the veteran's claim for service connection for acquired psychiatric disabilities was well grounded rather than whether he is entitled to prevail on the merits, the veteran has not been prejudiced by this decision. In assuming that this particular claim was well grounded, the RO accorded the veteran greater consideration than his claim warranted under the circumstances. Bernard v. Brown, 4 Vet. App. 384, 392-394 (1993). To remand this case to the RO for consideration of the issue of whether the appellant's claim for service connection for an acquired psychiatric disability, including paranoid schizophrenia, is well grounded would be pointless and, in light of the legal authority cited above, would not result in a determination favorable to the appellant. VAOPGCPREC 16-92 (O.G.C. 16-92); 57 Fed. Reg. 49, 747 (1992). ORDER Evidence of a well-grounded claim of entitlement to service connection for an acquired psychiatric disability, including paranoid schizophrenia, not having been submitted, the claim is denied. F. JUDGE FLOWERS Member, Board of Veterans' Appeals