Yes!

[clw4514]

I'm still working on getting all my stuff together to file my claim. My therapist told me it would be great if i could get documentation of treatment rcvd outside of the VA. well, seeing how i have been pushing the issue aside for 20 years, i never kept records. just out of curiosity, i called the insurance company i had with fedex at one point. they had a record of a referral from 2000. wooohoooo! now if i could just remember who fedex used in the mid 90s....it just made my day to hear them say they had that pc of paper. after all these years, i may get some long over due relief. its almost as if my pain has been validated.

[clw4514]

Do you have a documented stressor while you were in the service?

Just trying to help buddy. The more information we know the more we can help you.

Jay

yeah - i was an sp, raped by fellow sp, reported to my group and afosi. fully and thoroughly documented. even though nothing was done about it, it was documented

[clw4514]

Is your PTSD documented in your SMRs? If so, that's a HUGE help. If not.........eek.

With the lack of continuity in your medical/mental health care for PTSD it will likely pose a problem.

Do you have your SMRs? If not, you need to get them....first thing to do.

i know, purple. u and i have already discussed this. i am still waiting on my smr's and since it was 19 yrs ago, mst/ptsd wasnt a hot button issue so that part is not documented.

[purple]

Then you know you have a fight on your hands....proving this to the VA will be extremely difficult.

[Wings]

x

x

x

This is a non-combat PTSD claim. Hang in there, the more you post, the more information we have to help you! ~Wings

Service connection may be granted for a disability resulting from an injury suffered or disease contracted while in active duty or for aggravation of a preexisting injury suffered or disease contracted in the line of duty, 38 USC Sections 1110, 1131; 38 CFR Section 3.303 (2002). Service connection may also be granted for any disease diagnosed after discharge when all the evidence, including that pertinent to service, establishes that the disease was incurred in service, 38 CFR Sec. 3.303(d) (2002)]

[sharon]

http://www.va.gov/vetapp07/files3/0724223.txtCitation Nr: 0724223

Decision Date: 08/06/07 Archive Date: 08/20/07

DOCKET NO. 06-07 397 ) DATE

)

)

On appeal from the

Department of Veterans Affairs (VA) Regional Office (RO) in

Fort Harrison, Montana

THE ISSUE

Entitlement to service connection for post-traumatic stress

disorder (PTSD), claimed as due to military sexual trauma

(MST).

REPRESENTATION

Veteran represented by: Disabled American Veterans

WITNESS AT HEARING ON APPEAL

Appellant

ATTORNEY FOR THE BOARD

S. M. Marcus, Associate Counsel

INTRODUCTION

The appellant is a veteran who served on active duty from

October 1966 to October 1967.

This matter is before the Board of Veterans' Appeals (Board)

on appeal from a January 2005 rating decision of the

Department of Veterans Affairs (VA) Regional Office (RO) in

Ft. Harrison, Montana. The veteran had a hearing before the

Board in May 2006 and the transcript is of record.

FINDING OF FACT

The veteran's PTSD has been medically attributed to an in-

service stressful incident.

CONCLUSION OF LAW

The veteran's PTSD was incurred in active service.

38 U.S.C.A. §§ 1110, 1154(B), 5102, 5103, 5103A, and 5107

(West 2002 & Supp. 2007); 38 C.F.R. §§ 3.102, 3.159, 3.303,

3.304 (2006).

REASONS AND BASES FOR FINDING AND CONCLUSION

The Board has thoroughly reviewed all the evidence in the

veteran's claims folder. Although the Board has an obligation

to provide reasons and bases supporting this decision, there

is no need to discuss, in detail, the extensive evidence

submitted by the veteran or on his behalf. See Gonzales v.

West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) (the Board must

review the entire record, but does not have to discuss each

piece of evidence). The analysis below focuses on the most

salient and relevant evidence and on what this evidence

shows, or fails to show, on the claim. The veteran must not

assume that the Board has overlooked pieces of evidence that

are not explicitly discussed herein. See Timberlake v.

Gober, 14 Vet. App. 122 (2000) (the law requires only that

the Board address its reasons for rejecting evidence

favorable to the veteran).

Service connection means that the facts establish that a

particular injury or disease resulting in disability was

incurred in the line of duty in the active military service

or, if pre-existing such service, was aggravated during

service. 38 U.S.C.A. § 1110; 38 C.F.R. § 3.303(a). This may

be shown by affirmative evidence showing inception or

aggravation during service or through statutory presumptions.

Id. When a disease is first diagnosed after service, service

connection can still be granted for that condition if the

evidence shows it was incurred in service. 38 C.F.R.

§ 3.303(d).

Service connection for PTSD requires medical evidence

diagnosing the condition in accordance with 38 C.F.R. §

4.125(a); 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. 38 C.F.R. § 3.304(f) and 38 C.F.R. § 4.125 (2006)

(requiring PTSD diagnoses to conform to the criteria in the

DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDERS (4th

ed. 1994) (DSM-IV)).

The veteran alleges that his PTSD is a result of being

sexually assaulted by his commanding sergeant for a three

month period from April 1967 to June 1967. Specifically, the

veteran alleges that the commanding sergeant would routinely

force himself on him in the shower and threatened to

physically injure him if the matter was ever reported. The

veteran further testified he never reported the incident, but

attempted to escape the base in various different ways, to

include requesting a formal transfer, proposing to a woman he

knew for one day, stealing a military vehicle, and suicide.

The Board acknowledges that the veteran is competent to give

evidence about what he experienced; for example, he is

competent to discuss his current pain and other experienced

symptoms. See, e.g., Layno v. Brown, 6 Vet. App. 465 (1994).

He is not, however, competent to diagnose any medical

disorder or render an opinion as to the cause or etiology of

any current disorder because he does not have the requisite

medical knowledge or training. See Rucker v. Brown, 10 Vet.

App. 67, 74 (1997) (stating that competency must be

distinguished from weight and credibility, which are factual

determinations going to the probative value of the evidence).

The veteran admits that he never formally reported the MST

and, in fact, never admitted the MST to a health care

provider until 2004, nearly forty years after service.

Accordingly, there is no objective verification of the

assault. If a PTSD claim is based on Military Sexual Trauma

(MST) or personal assault in service, evidence from sources

other than the veteran's records may corroborate the

veteran's account of the stressor incident. Examples of such

evidence include, but are not limited to: records from law

enforcement authorities, rape crisis centers, mental health

counseling centers, hospitals or physicians; pregnancy tests

or tests for sexually transmitted diseases; and statements

from family members, roommates, fellow service members, or

clergy. 38 C.F.R. § 3.304(f)(3).

Additionally, evidence of behavior changes following the

claimed assault is relevant evidence that may be found in the

mentioned sources. Examples of behavior changes that may

constitute credible evidence of a stressor include, but are

not limited to: a request for a transfer to another military

duty assignment; deterioration in work performance; substance

abuse; episodes of depression, panic attacks, or anxiety

without an identifiable cause; or unexplained economic or

social behavior changes. Id.

In this case, the veteran's service medical and personnel

records do show some of the above listed types of evidence.

That is, in May 2007 the veteran volunteered for an

assignment requiring transport in a military vehicle. Prior

to receiving clearance, however, the veteran fled in the

vehicle with his girlfriend and got into a serious motor

vehicle accident. The veteran, during his May 2006 Board

hearing, alleged he was attempting to escape the military

base away from the sergeant who was sexually abusing him.

Upon his return, also in May 1967, the veteran was

hospitalized for attempted suicide after taking a large

amount of aspirin. Although he left a suicide note, the

veteran denied he was trying to kill himself, but rather said

the whole thing was a "joke." During his May 2006 Board

hearing, the veteran explained that he was afraid and ashamed

to admit the truth at that time. The psychiatrist at the

time attributed the suicide attempt to girlfriend troubles

and an emotionally unstable personality disorder.

Thereafter, in July 1967, the veteran formally requested a

transfer off the base citing "familial problems" and a

desire to be closer to home. The request was not formally

processed because two days later he requested permission to

marry a seventeen year old girl he had known for only 30

hours. The veteran testified at his May 2006 Board hearing

that he was trying anything he could think of to find a way

off the base. There is also an August 1967 notation in his

record that the veteran admitted to trying to get the girl

pregnant in order to obtain permission to marry her.

An August 1967 medical board determination ultimately found

the veteran unfit for active duty due to an emotionally

unstable personality disorder and he was separated from the

military in October 1967.

The first pertinent inquiry is whether a chronic psychiatric

condition, to include PTSD, is shown in service. The Board

concludes it is not. The veteran's September 1966 enlistment

examination indicates the veteran exhibited "substantial

anxiety at one time, recurring." Such behavior is noted

throughout the veteran's military service, particularly in

May 1967. The veteran, at that time, was diagnosed with a

personality disorder, but personality disorders are

considered congenital or developmental defects and not a

"disability" for compensation purposes. See VAOPGCPREC 82-

90, 55 Fed. Reg. 45,711 (1990) [a reissue of General Counsel

Opinion 01-85 (March 5, 1985)]; see also Carpenter v. Brown,

8 Vet. App. 240, 245 (1995); Monroe v. Brown, 4 Vet. App.

513, 514- 15 (1993). The Board notes, however, that

personality disorders may be service-connected if they are

shown to have been permanently aggravated beyond the natural

progression of the disorder due to some incident of service.

Id.

In this case, the veteran alleges he has PTSD as a result of

MST. The veteran was not diagnosed with this condition or

any other chronic psychiatric condition in service. Even if

a chronic condition was not shown during service, service

connection may be established under 38 C.F.R. § 3.303( by

evidence of continuity of symptomatology or under 38 C.F.R.

§ 3.303(d) if the evidence shows a disease first diagnosed

after service was incurred in service.

After service, the medical records indicate treatment for

various psychiatric conditions as early as 1998, over twenty

years after service. At that time, the veteran was diagnosed

with bipolar disorder, depression, alcohol dependence and

anxiety disorder. He also diagnosed with PTSD due to

childhood trauma in April 2000. The veteran's treatment

records indicate his father physically abused him and his

siblings as children and indeed, he reported his father

killed his sister and then himself in one of these abusive

episodes.

The veteran first reported MST in a July 2004 VA psychiatric

consultation. At that time, he was diagnosed with PTSD, due

to the MST. Since that time, the veteran has been diagnosed

with PTSD attributed to MST by various VA psychiatrists at

various times.

The veteran was afforded a VA examination in March 2005 where

the examiner diagnosed the veteran with PTSD due to MST

specifically opining as follows:

It is felt that a diagnosis of posttraumatic stress

disorder is warranted. It is felt that his PTSD is

caused by, or is the result of trauma experienced while

in the military. I would note that while his sexual

trauma is not well documented prior to his admission to

Fort Meade VA, his presentation was consistent with

PTSD. [The veteran] did describe significant behavioral

changes after the sexual assault. He reported that he

frequently would go to sick bay in order to avoid

contact with the offender. He also received an early

out from the Air Force following a suicide attempt.

Accordingly, the veteran has a competent medical diagnosis of

PTSD linked to the alleged in-service stressful incident.

The crucial inquiry, then, is whether the alleged incident

can be verified. Resolving all reasonable doubt in favor of

the veteran, the Board concludes it can.

Again, there is no objective evidence confirming the MST.

However, the veteran's service and personnel records confirm

the veteran's frequent visits to sick bay, especially during

the months of April, May and June 1967. The records confirm

the veteran got in a car accident in May 1967 after taking a

military vehicle without proper clearance and the subsequent

suicide attempt. The veteran's request for a transfer and

attempt to marry are also well documented all within or

slightly after the timeframe of the alleged MST.

It is clear, however, that the veteran has a history of

personal trauma unrelated to the alleged MST. His family

history of child abuse, for example, is well documented in

his medical records as is his anxiety, noted on his 1966

entrance examination. The veteran was diagnosed with a wide

range of psychiatric conditions prior to PTSD and his PTSD

was previously associated with childhood trauma, not MST.

The RO sought clarification from the March 2005 examiner on

whether the stressor could be verified given the evidence in

the record. The examiner opined as follows in a December

2005 statement:

[The veteran] carries a diagnosis of post-traumatic

stress disorder as made by several sources. Again, he

reported to various sources that he had been sexually

abused but confirmed that he did not report this while

in the military. Records indicate that [the veteran]

likely had psychological difficulties in the form of a

personality disorder prior to entering the military. It

was his personality disorder that significantly impacted

his ability to remain in the military. He entered the

military at age 17 and was discharged at age 18.

Records do not confirm that [the veteran's] allegation

that he had been sexually assaulted can be supported

through record review. Thus there is no supporting

evidence apart from the veteran's own statement which

would confirm that there was a sexual assault that

occurred while in the military. I could find no

evidence in the records that [the veteran's] behavior

changed significantly after the alleged sexual assault.

It would appear he had adjustment difficulties while in

the military throughout his military career. Thus, it

must be concluded that records do not support that a

sexual assault occurred. I would comment that this does

not mean that [the veteran's] self report of being

sexually assaulted by a sergeant while in the military

is not true but only that this could not be verified

through documentation reviewed. (Emphasis added).

The examiner correctly indicates that, regrettably, there

simply is no objective evidence of the veteran's alleged

sexual assault. The examiner correctly indicated the veteran

entered the military with adjustment difficulties and

exhibited those difficulties throughout his military service.

There is also evidence the veteran suffered through pre-

military childhood trauma as well as post-service loss of his

son and wife.

The Board finds compelling, however, the various chain of

events confirmed in the veteran's service and personnel

records all occurring in the spring of 1967 or shortly

thereafter, the timeframe of the alleged sexual assault. The

veteran's testimony, moreover, is consistent with the

veteran's service and personnel records indicating the

veteran's frequent trips to sick bay, the May 1967 automobile

accident and reprimand, the May 1967 suicide attempt, a

subsequent request for a transfer and an attempt to marry.

In short, there is some objective evidence that the veteran

was trying to escape his Air Force base in various ways on

and around May 1967. The only evidence, however, that the

alleged stressful incident occurred is his statement.

The veteran's testimony appears to be credible and consistent

with the record. The veteran alleges, for example, that he

began abusing alcohol as a means of medicating himself. The

veteran's post-service medical records show hospitalizations

and treatment for alcohol abuse as early as 1998. Again,

while the veteran may have entered the military with

"anxiety" problems, his only reprimands and other formal

action noted in his personnel records are all around the May

1967 timeframe.

Although there is a lack of objective verification of the in-

service stressful incident, the Board finds the evidence to

be at the very least in equipoise. Thus, the veteran is

entitled to the benefit of the doubt. This is especially

true in light of the PTSD medical diagnosis linking his

condition to service made by various treating psychiatrists

at various times, the objective evidence indicating the

veteran's car accident, suicide attempt, request to be

transferred of the base and marriage proposal all on or

around May 1967 and his consistent statements regarding the

in-service MST. Even the VA examiner acknowledged in his

December 2005 statement that the MST may be true despite

objective verification given the diagnosis rendered by

various physicians at various times. The Board, therefore,

concludes that service connection is warranted for PTSD.

As this decision represents a complete allowance of the

benefit sought on appeal, it is not necessary for the Board

to discuss the Veterans Claims Assistance Act of 2000 and

whether the duties to notify and assist have been properly

discharged by VA. Upon return of this case to the RO, it

will be making a decision regarding disability rating and

effective date. If the veteran disagrees with either as

assigned by the RO, he may file a notice of disagreement and

appeal the determination(s). The veteran is not prejudiced

by the Board's decision on the merits of this appeal.

ORDER

Entitlement to service connection for post-traumatic stress

disorder (PTSD) is granted.

____________________________________________

K. PARAKKAL

Veterans Law Judge, Board of Veterans' Appeals

Department of Veterans Affairs

[Pete53]

Less than 21 years after separation I apploed for VA Disability I gfot Social Security in about 4 months from date I appled and VA took 5 years but I got it.

You will need to show the stressor whie you were in Service and the things you did to alleviate it. Believe it or not frugs and alcohol abuse, failed marriages, trouble keeping a job, moving a lot are things that help. You really have to be willing to spill your guts to win.

Good Luck