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carl1124

Men And Mst

Question

Up till about a 2 week ago I have never talk about this, but it has affected my life with ever thing I do. I was 20 I was station in Diego Garcia. I was sitting on the beach when I was Sexual assault by two men. After that I started drinking hard and end up in Rehab for 6 weeks. I still did not talk about then I was a fearfully that I would get kick out of the Navy for being nuts or homosexual, "Please remember that was 1986 and the Military was on the hunt for any one that might be gay". I am unable to hold a job for 2 years at time and now take Citalopram for depression. At times my depression is so bad I think it would be easier if I just ended it all. I have all kinds problems when it comes to men. I don't trust many people and sit in my computer room most days. I feel safest when no one is around me and God help anyone that sneaks up on me. I have real bad mood swings . Last week I went to the V.A. and told them what happen and the meds. I take. Who did I get for a Doctor was retired Navy Capt. that did not know what to say or act. He looked at me like I was some kind of freak. I know that I need help with this I can not do by myself any more. It has taken 20 years to talk about it, and taken so much of my life away from me. There is so much help out there for women, but I am finding very little help for men. :(

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Up till about a 2 week ago I have never talk about this, but it has affected my life with ever thing I do. I was 20 I was station in Diego Garcia. I was sitting on the beach when I was Sexual assault by two men. After that I started drinking hard and end up in Rehab for 6 weeks. I still did not talk about then I was a fearfully that I would get kick out of the Navy for being nuts or homosexual, "Please remember that was 1986 and the Military was on the hunt for any one that might be gay". I am unable to hold a job for 2 years at time and now take Citalopram for depression. At times my depression is so bad I think it would be easier if I just ended it all. I have all kinds problems when it comes to men. I don't trust many people and sit in my computer room most days. I feel safest when no one is around me and God help anyone that sneaks up on me. I have real bad mood swings . Last week I went to the V.A. and told them what happen and the meds. I take. Who did I get for a Doctor was retired Navy Capt. that did not know what to say or act. He looked at me like I was some kind of freak. I know that I need help with this I can not do by myself any more. It has taken 20 years to talk about it, and taken so much of my life away from me. There is so much help out there for women, but I am finding very little help for men. :(

welcome to hadit.com. u will find many knowledgeable and supportive folks on here. it took me 20 yrs, too before i got help. just started last year. has the va offered to let u speak with a social worker for the mst? that person will do an evaluation for ptsd due to mst and get things started for treatment. i would think that there is a group for male mst survivors at ur va. have u checked into that? and if u do not feel comfy with a male doctor, can u not request a female? or maybe just have a female present during visits? are u married? maybe ur wife could sit in ur regular appts with u, obviously not the mst appts. best of luck to u. hang in there and all the answers will come to u.

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The same regulations for MST service-connection apply to both male and female veterans alike. The first thing you will need, in order to file a claim for VA Compensation --is a medical diagnosis. If you find the VA is not supportive of your claim, then I strongly suggest seeing a civilian provider. See below. ~Wings

http://www.va.gov/vetapp08/files3/0818664.txt

Citation Nr: 0818664

Decision Date: 06/05/08

Archive Date: 06/12/08

DOCKET NO. 05-02 449

FINDING OF FACT

According to the medical and other evidence of record, it is

just as likely as not the veteran has PTSD partly due to a

sexual assault while in the military, irrespective of her

other claimed combat-related stressors.

CONCLUSION OF LAW

Resolving all reasonable doubt in her favor, the veteran's

PTSD was incurred in service. 38 U.S.C.A. §§ 1110, 1131,

5107 (West 2002 and Supp. 2007); 38 C.F.R. §§ 3.102, 3.303,

3.304 (2007).

Analysis

The establishment of service connection for PTSD

requires:

(1) medical evidence diagnosing the condition in

accordance with 38 C.F.R. § 4.125(a)(2007)(i.e., DSM-IV);

(2) credible supporting evidence that the claimed in-service

stressor actually occurred; and

(3) medical evidence of a link between current symptomatology

and the claimed in-service stressor. 38 C.F.R. § 3.304(f)(2007).

See also Cohen v. Brown, 10 Vet. App. 128 (1997).

The evidence necessary to establish the occurrence of a

recognizable stressor during service to support a diagnosis

of PTSD will vary depending upon whether the veteran

engaged in "combat with the enemy," as established by

recognized military combat citations or other official

records. See e.g., Hayes v. Brown, 5 Vet. App. 60, 66

(1993); Cohen v. Brown, 10 Vet. App. 128 (1997).

If VA determines the veteran engaged in combat with the enemy and

her alleged stressor is combat-related, then her lay

testimony or statement is accepted as conclusive evidence of

the stressor's occurrence and no further development or

corroborative evidence is required provided her testimony

is found to be "satisfactory," i.e., credible,

and "consistent with the circumstances, conditions, or

hardships of service." See 38 C.F.R. § 3.304(f)(1). See

also 38 U.S.C.A. § 1154(b);; 38 C.F.R. § 3.304(d); Zarycki v.

Brown, 6 Vet. App. 91, 98 (1993).

If, on the other hand, VA determines either that the veteran

did not engage in combat with the enemy or that she did

engage in combat, but that the alleged stressor is not combat

related, then her lay testimony, by itself, is insufficient

to establish the occurrence of the alleged stressor.

Instead, the record must contain credible supporting evidence

that corroborates her testimony or statements. Cohen v.

Brown, 10 Vet. App. at 147; Moreau v. Brown, 9 Vet. App. 389, 395 (1996).

The Board is not required to accept an appellant's

uncorroborated account of his or her active service

experiences. See Swann v. Brown, 5 Vet. App. 229, 233 (1993)

and Wood v. Derwinski, 1 Vet. App. 190, 192 (1991).

Moreover, after-the-fact medical nexus evidence cannot be the

sole evidence of the occurrence of the claimed stressor.

Moreau, 9 Vet. App. at 396.

Corroboration does not require, however, "that there be

corroboration of every detail including the appellant's

personal participation in the identifying process." Suozzi v. Brown,

10 Vet. App. 307, 311 (1997).

Rather, an appellant only needs to offer independent

evidence of a stressful event that is sufficient to imply his

or her personal exposure. For example, in Pentecost v.

Principi, 16 Vet. App. 124 (2002), the Court held that a

veteran need not corroborate his actual physical proximity to

(or firsthand experience with), and personal participation

in, rocket attacks while stationed in Vietnam.

Furthermore, medical opinions in cases of personal assault

for PTSD are exceptions to the general rule discussed in

Moreau that an opinion by a medical professional based on a

post-service examination cannot be used to establish the

occurrence of a stressor. See Patton v. West, 12 Vet. App.

272, 277 (1999). See also 38 C.F.R. § 3.304(f)(3); VA

Adjudication Procedure Manual, M21-1MR, Part III, Subpart iv,

Chapter 4, Section H, part 30(b),©,(e)(Aug. 1 ,2006).

Because personal assault is an extremely personal and

sensitive issue, many incidents are not officially reported,

which creates a proof problem with respect to the occurrence

of the claimed stressor. In these situations, it is not

unusual for there to be an absence of service records

documenting the events the veteran has alleged.

The victims of this type of trauma may not necessarily report the full

circumstances of it for many years after it occurred. Thus,

when a PTSD claim is based on a personal assault in service,

evidence from sources other than the veteran's service

records may corroborate the veteran's account of the stressor

incident. 38 C.F.R. § 3.304(f)(3); see also Patton, 12

Vet. App. at 277.

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).

Evidence of behavior changes following the claimed assault is

one type of relevant evidence that may be found in these

sources. Examples of behavior changes that may constitute

credible evidence of the 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.

The Court has set a relatively low bar for interpreting a

claim for PTSD as one involving a personal assault stressor

for which the provisions of 38 C.F.R. § 3.304(f)(3) are

applicable. See, e.g., Bradford v. Nicholson, 20 Vet. App.

200 (2006) (veteran alleged that his sergeant kicked him down

a set of stairs).

The Court advised that the portions of the VA Adjudication

Procedure Manual M21-1, Part III, paragraph 5.14c, provide

"guidance on the types of evidence that may serve as

'credible supporting evidence' for establishing service

connection of PTSD which allegedly was precipitated by a

personal assault during military service." Patton, 12 Vet.

App. at 277.

The Court held that the provisions in M21-1,

Part III, 5.14©, which address PTSD claims based on

personal assault, are substantive rules that are the

equivalent of VA regulations [indeed, this is now codified at

38 C.F.R. § 3.304(f)(3)], and therefore, they bind VA

decisions. YR v. West, 11 Vet. App. 393, 398-99 (1998);

Patton, 12 Vet. App. at 272.

Moreover, VA itself has defined personal assault very broadly

to include an event of human design that threatens or

inflicts harm. Examples of personal assault include rape,

physical assault, domestic battery, robbery, mugging,

stalking, and harassment. See VA Adjudication Procedure

Manual M21-1MR, Part III, Subpart iv., Ch. 4, Section H, part

30(a)(Aug. 1, 2006); VA Adjudication Procedure Manual M21-

1MR, Part IV, Subpart ii., Ch. 1, Section D, part 17(a),©

(Dec. 13, 2005).

As a consequence, it is important to address and consider the

applicability, or at least the potential applicability, of

38 C.F.R. § 3.304(f)(3) in claims of entitlement to service

connection for PTSD where the appellant describes any type of

action or occurrence that could generally be described as

constituting an "assault" or "harassment" during service,

even if it is unclear whether the appellant is actually

claiming PTSD based on that alleged assault or harassment.

The veteran has received the required DSM-IV diagnosis of

PTSD. Boyer v. West, 210 F.3d 1351, 1353 (Fed. Cir. 2000);

Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992); See also

38 C.F.R. § 3.304(f). Her recent VA treatment records reveal

ongoing therapy for this condition. See, for example, her

January to March 2007 VA treatment records. In addition, a

May 2007 letter from a VA staff psychiatrist reiterates the

veteran has been diagnosed with PTSD and indicates she is

receiving mental health care for disabling symptoms of

"traumatic re-experience, nightmares, flashbacks, chronic

insomnia, hyper vigilance, startled response and social

avoidance," low frustration tolerance, and memory and

concentration problems. See also July and October 2004

Social Security Administration (SSA) examination reports.

The PTSD diagnosis is further supported by Global Assessment

of Functioning (GAF) scores as low as 40. The GAF score,

incidentally, is a scaled rating reflecting the

"psychological, social, and occupational functioning on a

hypothetical continuum of mental health-illness." See

Carpenter v. Brown, 8 Vet. App. 240, 242 (1995); Richard v.

Brown, 9 Vet. App. 266 (1996) (citing the American

Psychiatric Association's DIAGNOSTIC AND STATISTICAL MANUAL

FOR MENTAL DISORDERS (4th Ed.) (DSM-IV), p. 32). GAF scores

ranging from 31 to 40 reflect some impairment in reality

testing or communication (e.g., speech is at times illogical,

obscure, or irrelevant) or major impairment in several areas,

such as work or school, family relations, judgment, thinking,

or mood (e.g., depressed man avoids friends, neglects family,

and unable to work, etc.)

The determinative issue, then, is whether there is sufficient

evidence for concluding that any of the veteran's alleged

stressors in service actually occurred and, if there is,

whether there also is medical evidence linking her PTSD

diagnosis to at least one of the confirmed stressors. See

Watson v. Brown, 4 Vet. App. 309, 314 (1993)

("A determination of service connection requires a finding of

the existence of a current disability and a determination of

a relationship between that disability and an injury or

disease incurred in service."). See, too, Maggitt v. West,

202 F.3d 1370, 1375 (Fed. Cir. 2000); D'Amico v. West, 209

F.3d 1322, 1326 (Fed. Cir. 2000); Hibbard v. West, 13 Vet.

App. 546, 548 (2000); and Collaro v. West, 136 F.3d 1304,

1308 (Fed. Cir. 1998).

The veteran has asserted several stressors occurred during

her military service, some in combat and others related to

military sexual trauma (MST). She says that she observed

missiles flying overhead, witnessed casualties to a jeep in

her convoy from hitting a land mine, and participated in

burying dead enemy Iraqi soldiers. She also reports

observing a decapitated body in a mortuary. Her MST stressor

involves purportedly being gang raped by three white male

assailants when dragged into some nearby woods around her

base.

After attempting to further develop the claim as directed in

the Board's December 2006 remand, including trying to obtain

some corroborating evidence concerning these alleged

stressors, the U. S. Army and Joint Services Records Research

Center (JSRRC) indicated in July 2007 that it was unable to

verify these claimed stressors due to insufficient

information. And the veteran has since indicated in August

2007, on a VA Form 21-4138, that she has no additional

information or evidence to provide to substantiate these

claimed stressors, such as concerning specific names of

casualties and definitely not the names of the soldiers that

assaulted her. So for the most part these incidents remain

unverified and, therefore, an insufficient basis to grant

service connection. 38 C.F.R. § 3.304(f);

Cohen, 10 Vet. App. at 147; Moreau, 9 Vet. App. at 395.

There is, however, sufficient evidence to grant the claim to

the extent it is predicated on MST. As already alluded to,

the veteran claims that she was gang raped by three white

males, just outside a military base in Hanover, Germany.

She says she was grabbed from behind while standing at the

base's gate waiting for a taxi and dragged into a nearby

wooded area, where she was assaulted and then left. See her

July 2005 personal assault questionnaire and January 2007

supporting statement (VA Form 21-4138); see also her

statements in a December 2004 VA treatment record. During

her July 2006 video-conference hearing, she testified that

when she attempted to report the incident to her superiors,

she was harassed and her complaints ignored. As for the date

of the incident, she said the assault occurred between July

1990 and May 1992. See her July 2005 personal assault

questionnaire. Notably, she contends that she cannot narrow

down the assault date to within a three-month time frame

because her PTSD makes it stressful merely to think about the

incident. See her November 2005 and August 2007 supporting

statements on VA Form 21-4138.

Although she has been unable to provide more specific details

concerning this alleged MST, the veteran has provided several

corroborating lay statements. Individually and especially

cumulatively, they provide highly probative evidence

corroborating her changes in behavior since service due to

this MST. See 38 C.F.R. § 3.304(f)(3).

First, there is a June 2005 statement from a childhood friend and

co-worker in the military, who the veteran reported the

sexual assault to and whose letter corroborates the claim in

great detail by noting behavioral changes in the form of

emotional withdrawal, reduced energy, apprehensiveness of

crowds and leaving her room, crying spells, and general

anger. Second, a July 2005 statement and an undated

statement from her older sister also account her confiding in

a trusted friend about the sexual assault in Germany by three

men. Her sister noted that, before military service, her

sister was energetic, fun, good spirited, and outgoing, but

after being assaulted, became isolated, depressed, and

suicidal. Third, a July 2006 statement from her long-time

friend and roommate also states that the veteran told her of

the sexual assault by three Caucasian men. This friend added

that the veteran became a "shell of who she once was,"

reluctant to leave her home to do basic tasks such as

shopping for groceries and driving long distances.

Fourth and finally, a July 2006 statement from her father

reaffirms that she became depressed after service, though she

was fun and active when younger. The Board finds these

statements to be credible because of their consistency in

reporting the facts and details of them. Jandreau v.

Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); Barr v.

Nicholson, 21 Vet. App. 303, 310 (2007).

The veteran's service medical records are mostly unremarkable

for indications of a sexual-assault stressor, except for two

potentially highly probative records. In the time frame

alleged for the rape (July 1990 to May 1992), a January 1992

gynecologic cytology record notes a small tear in her vaginal

wall and associated complaints of bleeding after intercourse.

This is suggestive of prior sexual trauma.

There is also a conspicuous stamp on a radiologic

consultation report indicating she denied being pregnant in

March 1992, also contemporaneous to when her MST allegedly

occurred, prompting the question of why she had to make that

declaration unless she had that concern. Resolving this

doubt in her favor, it is possibly the result of a pregnancy

test, providing further probative evidence supporting the

occurrence of MST. 38 C.F.R. § 3.304(f)(3).

And perhaps most significantly, a July 2005 nexus opinion of

record is provided by a VA staff psychologist, who indicated

the veteran has PTSD that is MST related. This same VA

licensed psychologist more recently submitted another

supporting statement in November 2006 reiterating this

opinion. Moreover, a March 2006 VA treatment record by a

staff psychiatrist also provided an assessment of PTSD

arising from MST (rape), indicating as well that the veteran

has a life-long disability resulting from that trauma.

So while, in general, credible evidence of the occurrence of a

claimed stressor cannot consist solely of medical evidence

obtained after the fact (such as a VA physician's opinion

after separation from service), the Court held in Patton that

this general rule in Moreau does not apply to

sexual-assault based cases, especially where, as here, there

is other probative evidence supporting the claim.

Furthermore, there is no specific information suggesting the

alleged incident of MST did not occur. Concerning this, a

stressor need not be corroborated in every detail. Pentecost

v. Principi, 16 Vet. App. 124, 128 (2002) (quoting

Suozzi v. Brown, 10 Vet. App. 307 (1997)). While the

evidence that has been obtained is not necessarily of the

specificity that it would corroborate all details associated

with this incident, there nonetheless is sufficient

corroboration of the veteran's change in behavior and

demeanor, consistent with what she has alleged.

Thus, considered in the aggregate and resolving all

reasonable doubt in her favor, the Board finds that the

evidence supports the veteran's claim of entitlement to

service connection for PTSD - at least to the extent it is

predicated on MST. See 38 C.F.R. §§ 3.102, 3.304(f)(3);

Alemany v. Brown, 9 Vet. App. 518, 519 (1996).

ORDER

Service connection for PTSD is granted.

KEITH W. ALLEN

Veterans Law Judge, Board of Veterans' Appeals

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The VET CENTER is a good place to start. Your records are confidential there and cannot be release to any agency without your permission.

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It has taken 20 years to talk about it, and taken so much of my life away from me. There is so much help out there for women, but I am finding very little help for men. :(

Carl,

In my opinion there is actually more help out there for men who have been raped.

Most of the help offered for MST - sucks to begin with.

Seems to me as rape is viewed as more traumatic for a man than it is for a female.

But rape is rape...period.

The Vet Centers will gladly provide service's to you. If you want to- request

to be seen by a female.

Another place you can go is just call your closest VAMC, press zero for an

operator - when the operator comes on the line ask to be connected to

their Center for Sexual Trauma.

Who ever answers the phone you don't need to blurt everything out to them

just say something happened to you and you need to make an appointment

to be seen and request to be seen by a female.

Third way to access service's is talk to your PCP and ask for a referral.

carlie

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Carl

Just be sure you stay with us until you get the help you need. Don't accept "No" for an answer. If the VA retired Navy Captain can't handle it that is his problem. Where has he been living besides a glass jar.

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