ptsd For Those Who Were Diagnosed With Ptsd After (Post) Service

[pacmanx1]

Citation Nr: 1001376

Decision Date: 01/08/10 Archive Date: 01/15/10

DOCKET NO. 07-27 131 ) DATE

)

)

On appeal from the

Department of Veterans Affairs Regional Office in St.

Petersburg, Florida

THE ISSUE

Entitlement to service connection for posttraumatic stress

disorder (PTSD).

REPRESENTATION

Appellant represented by: Florida Department of Veterans

Affairs

WITNESS AT HEARING ON APPEAL

Appellant

ATTORNEY FOR THE BOARD

D. Van Wambeke, Counsel

INTRODUCTION

The Veteran served on active duty from June 1966 to November

1986.

This matter comes to the Board of Veterans' Appeals (Board)

on appeal from a March 2007 rating decision of the Department

of Veterans Affairs (VA) Regional Office (RO) in St.

Petersburg, Florida, which denied the claim.

The Veteran presented testimony before the undersigned

Veterans Law Judge in June 2008. A transcript of the hearing

is of record.

The issue was remanded by the Board in December 2008 for

additional development and to address due process concerns.

The actions directed by the Board have been accomplished and

the matter returned for appellate review.

FINDING OF FACT

The Board resolves reasonable doubt by finding that the

Veteran has been diagnosed with PTSD as a result of active

service.

CONCLUSION OF LAW

The criteria for service connection for PTSD have been met.

38 U.S.C.A.

§§ 1110, 1131 (West 2002); 38 C.F.R. §§ 3.102, 3.303, 3.304

(2009).

REASONS AND BASES FOR FINDING AND CONCLUSION

Service connection for PTSD requires (1) medical evidence

diagnosing the condition in accordance with the Diagnostic

and Statistical Manual of Mental Disorders, 4th ed., 1994

(DSM-IV), see 38 C.F.R. § 4.125(a) (2009); (2) a link,

established by medical evidence, between current symptoms and

an in-service stressor; and (3) credible supporting evidence

that the claimed in-service stressor occurred. 38 C.F.R. §

3.304(f) (2009); Cohen v. Brown, 10 Vet. App. 128 (1997).

The Veteran contends that he has PTSD as a result of an

incident that took place on June 25, 1979 while he was

assigned as a driver at the Supreme Headquarters Allied

Powers Europe (SHAPE) in Belgium. He reports that he was the

driver for General J.R.A. who was the Chief of Staff of SHAPE

and for General A.H. The Veteran asserts that on the morning

of June 25, 1979, he was driving General J.R.A. to SHAPE

headquarters and had planned to use a regular route. He

reports that he decided to take another route when he saw

there was a truck that he did not want to get stuck behind.

The Veteran asserts that he later found out there had been an

attempt to blow up the car General A.H. was in, which had

taken the route the Veteran normally did. He contends that

he could have been killed had the car he was driving taken

the normal route, though he acknowledges that no one was

killed as a result of the bomb. The Veteran also asserts

that he drove under the fear of being bombed and attacked

every day that he drove for the Chief of Staff for two years

after the attempted assassination on General A.H. He further

contends that he suffers real aspects of the events and

replays the fear of driving in his everyday activities. See

August 2006 VA Form 21-0781; June 2007 VA Form 21-4138;

August 2007 VA Form 9; June 2008 hearing transcript.

The Veteran's service personnel records reveal that he was a

driver for the Supreme Allied Commander, Europe (SACEUR) VIP

Platoon for SHAPE in Belgium between July 1978 and November

1978 and a VIP driver for SHAPE between November 1978 and

August 1981. See Chronology of Service Assignments;

Department of Defense Joint Service Commendation Medal.

The Veteran has submitted a November 1993 New York Times

article related to the 1979 bomb attack on former NATO

commander A.H.'s car on June 25, 1979, as well as an

unidentified report entitled the "Haig Assassination

Attempt."

The Board finds that the Veteran's service personnel records

and the articles he has submitted provide corroboration that

the claimed in-service stressor did occur while the Veteran

was working in the capacity of a SHAPE driver.

The Veteran acknowledges that he did not seek any treatment

while in service. See June 2008 hearing transcript. As

such, it is not necessary to discuss the findings in his

service treatment records. The Veteran also acknowledges

that his first post-service treatment was not until

approximately 2005. See id. Treatment records from the VA

Medical Center (VAMC) in Bay Pines have been obtained and

reveal that the Veteran has been diagnosed with PTSD in

conjunction with a report of his alleged stressor. See e.g.,

May 2007 STP progress note. They also reveal that the

Veteran has received group therapy for PTSD, depressive

disorder, not otherwise specified (NOS), and alcohol

dependence.

At noted in the Board's previous decision, it is unclear

whether the diagnosis provided in VA treatment records was

made in accordance with the DSM-IV criteria, as required by

38 C.F.R. § 3.304(f). It was for this reason that the Board

remanded the claim in order for the Veteran to be afforded an

examination.

The Veteran underwent a VA compensation and pension (C&P)

initial PTSD examination in April 2009. In pertinent part,

he denied any direct combat exposure but reported

experiencing trauma when he was acting as a driver in

service, at which time he reported the stressor detailed

above. Following psychiatric examination, Axis I diagnoses

of chronic PTSD and depression, NOS, were made. The examiner

reported that the Veteran had symptoms of PTSD but prognosis

was good. The examiner also reported that the Veteran's

depressive symptoms did not meet the criteria for a full

depressive episode as they only last hours and may be part of

his PTSD. It was the examiner's opinion that the diagnosis

of PTSD could be related to the stressor as reported by the

Veteran and that it is as least as likely as not caused by or

a result of the event of the Veteran changing route and later

finding out that the others who had taken the original route

had been bombed, as he felt it could have been him. The

rationale employed by the examiner was that the Veteran

experienced a traumatic event in which there was

threat/injury to others and the Veteran experienced fear and

a sense of helplessness. He has flashbacks, intrusive

thoughts, distressing dreams, avoidance and persistent

arousal symptoms.

The Appeals Management Center (AMC) subsequently requested

another opinion, citing the fact that the April 2009 VA

examiner did not indicate that the Veteran's claims folder

was reviewed at the time of the examination. In June 2009, a

different VA examiner reported that after reviewing the

complete claims folder and electronic medical records from

the Bay Pines VAMC, he fully concurred with the opinion of

the April 2009 VA examiner that it is as likely as not that

the Veteran's established diagnosis of PTSD is due to the

cited stressor of a near-death experience in which the

Veteran and a senior SHAPE general averted a potentially

fatal terrorist attack while traveling on a civilian road in

Belgium in 1979. The examiner's rationale was that since the

Veteran evinced no psychiatric problems prior to enlistment

or prior to the cited stressor, since the stressor has been

verified, and since the Veteran has had continuous symptoms

of PTSD to variable degrees and frequency, then it may be

reasonably clinically concluded that the noted stressor as

likely as not served as the precipitant for a subsequent

anxiety disorder. The examiner further noted that as the

Veteran has continuously experienced key target symptoms of

PTSD, as outlined in the DSM-IV, then the diagnosis

qualifiers are fulfilled. It was also reported that near-

death experiences are frequent causes of PTSD, as cited in

published scientific studies and case reports.

The examiner made some other findings that the Board has

determined are not pertinent to the issue on appeal. The

Board does note, however, that the VA examiner reported that

with regard to the Veteran's additional diagnosis of

depressive disorder, NOS, his symptoms of depression have

evolved in recent years in consort with the sustained

expression of PTSD. Per DSM-IV diagnostic criteria, the

current expression of depressive symptoms is consonant with

the mood disorder diagnosis that has been the focus of

treatment (depressive disorder, NOS) and does not meet the

full criteria for another mood disorder diagnosis. After

reviewing the cited clinical records and interviewing the

Veteran, it was the examiner's opinion that it would be

speculative to estimate the causality of the Veteran's post-

service depression to his PTSD (anxiety disorder), or to

estimate the relative contributions of his depression

symptoms and his anxiety condition to his overall limitations

in psychosocial functioning and quality of life.

In light of the opinions provided by the VA examiners in

April 2009 and June 2009, and in light of 38 U.S.C.A. § 1154

(a) (West 2002), which requires consideration of the places,

types, and circumstances of the Veteran's service as shown by

his service record, the Board resolves all reasonable doubt

in the Veteran's favor by finding that service connection for

PTSD is warranted. 38 C.F.R. §§ 3.102, 3.303, 3.304.

VA's duties to notify and assist claimants in substantiating

a claim for VA benefits are found at 38 U.S.C.A. §§ 5100,

5102, 5103, 5103A, 5107, 5126 (West 2002 & Supp. 2009);

38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326(a) (2009). As the

claim has been granted, the duty to notify and assist has

been met to the extent necessary.

ORDER

Service connection for PTSD is granted.

____________________________________________

P.M. DILORENZO

Veterans Law Judge, Board of Veterans' Appeals

[Notorious Kelly]

I'm with Carlie - save the judging for the folks getting millions and billions without ever putting their butts on the line.

Any service member may have lost their lives or experienced other suffering at any moment; the forklift operator in Kansas who dies unloading pallets is no less respected by me than a combat veteran.

People react to different experiences differently.

I hope no vet hesitates to apply for benefits fearing judgment from fellow veterans.

[pacmanx1]

We should give every veteran the benefit of doubt. The original post could possibly help another veteran provided they file a claim and the evidence or incident can be verified by VA.

[Testvet]

since the Judge didn't grant a percentage and it was sent back to the VARO I get this mental image of an award letter that granted him either 0% or 10% I imagine he is still appealing the low ball award but this is the new standard for fearing for your life in a hazardous duty area the "fear of death" if you think this award was bad I would quit reading future BVA appeals the reads will probably just make you even madder the Judge made the decision what if this was YOUR claim would you want it granted or denied? Like Carlie said we should not be judging we are here to help other vets our opinions just show the bias to veterans reading it and it may prevent them from asking for our help because they might be afraid to be ridiculed

I have seen some wild stuff and I will send private e mails to get the attitude out of me denigrating other vets though does not help anyone does it?

[stillhere]

The mind is a very interesting and intriguing organ. IF this did in fact cause the sensation of or result in his PTSD then he of course should be compensated.

As far as 10% to 100% he will be evaluated as to how it effects him today.

[GDavis9755]

I like the part about the doctor who gave his input ( while never seeing his C-file or medical records ) and the other who did read both and gave the same decision. Make's you wonder why anyone needs to look at your files or medical records at the C&P examine. Hell they know the answers already. Brother

[ranger11bv]

Good God!! This is right up my alley! The only difference is me having physical trauma... WOW!!! This could really help couldnt it???