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

[john999]

Ridiculous claim in my opinion. If that is the standard every vet who rode from Airport to the replacement center in Vietnam was in fear of death since grenades had been thrown in bus windows which is why they were covered with screen.

[Papa]

Agree John. When my plane was landing at Cam Rahn the VC were shooting rockets at us, about cra**ed in my pants. Based on this, you are rioght, their will be alot of new PTSD claims, if this is the standard.

Papa

[DuRock]

Agree John. When my plane was landing at Cam Rahn the VC were shooting rockets at us, about cra**ed in my pants. Based on this, you are rioght, their will be alot of new PTSD claims, if this is the standard.

Papa

Papa, I heard this a lot from the guy's I served with at Cam Rahn, same thing happened to me, it was like they saw our plane coming in and knew it was full of cheery boy's. We didn't even get half way off the tarmac when the rockets started coming in, we ran for sand bags and the one image that has stuck in my mind from that night all this time is an APC rolling by us as we were taking cover, some guy was standing up holding his M16 up hollering welcome to Viet Nam Mother#$%@*#. I am not ashamed to say I had a load in my britches as well, what a wake up call. I just had my first C & P for PTSD last month, put it off way to many years but finally did something about it. If this guy got it then there should be no doubt about me getting it with the experience's I had in NAM.

Vietnam Vets Forever

DuRock

[billy2]

They should just grant comp for PTSD to everyone so we don't have to listen to all this BULL SHIT

[chr49]

Very strange one.

Edited September 27, 2010 by chr49

[carlie]

I will not judge the person in this article.

I will not judge the decision maker that granted this claim.

I do not know all of the details.

I have read my own DRO and BVA written transcripts

where I know positively and personally, some things that were

discussed at hearings,were not shown to be record within the written transcripts.

Another person, especially another veteran, has no business even trying

to pass judgement on me or any service connected disability that has caused

me to suffer in any way.

This is between the VBA and the claimant.

If it turns out to be a fraudulent claim, burn their butts -

but still, that is between the claimant and the goobermint .