ADJUSTMENT DISORDER

Summary

The Veteran, an Army Veteran who served from January 1974 to January 1977, appeals the denial of service connection for an acquired psychiatric disorder. The Veteran claims the disorder is related to in-service stressors, including racial abuse from superior officers due to a shaving profile and racially motivated threats following an arrest. The Veteran submitted psychological evaluations from Dr. A.S. in July 2018 and August 2022, diagnosing adjustment disorder and other specified trauma disorder. Dr. A.S. opined that the adjustment disorder was as likely as not related to service, citing harassment and racial abuse corroborated by service records. A VA examiner in May 2021 provided a negative nexus opinion, stating the adjustment issues were less likely than not related to service, but acknowledged the Veteran's account of racially motivated trauma was likely credible. The Board found both opinions probative, noting the VA examiner's rationale supported Dr. A.S.'s conclusion regarding the credible reports of trauma. The Board determined the probative medical evidence on etiology was in equipoise, resolving doubt in the Veteran's favor. Service connection for an acquired psychiatric disorder was granted.

Rationale

Dr. A.S. opined adjustment disorder as likely as not related to service.; Dr. A.S. cited harassment and racial abuse corroborated by service records.; VA examiner provided negative nexus but acknowledged credible reports of trauma.; Board found evidence in equipoise, resolving doubt in Veteran's favor.

Full Decision Text

Citation Nr: 23015635
Decision Date: 03/15/23	Archive Date: 03/15/23

DOCKET NO. 16-42 772
DATE: March 15, 2023

ORDER

Service connection for an acquired psychiatric disorder, to include adjustment disorder, is granted.

FINDING OF FACT

Resolving all reasonable doubt in his favor, the Veteran's an acquired psychiatric disorder, to include adjustment disorder, is related to his military service.

CONCLUSION OF LAW

The criteria for service connection for an acquired psychiatric disorder, to include adjustment disorder, have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty in the United States Army from January 1974 to January 1977.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a rating decision issued in January 2014 by the Department of Veterans Affairs (VA) Regional Office in Winston Salem, North Carolina.

This appeal was previously before the Board in October 2018, at which time it was denied. The Veteran appealed that denial to the United States Court of Appeals for Veterans Claims (Court). In an August 2019 Joint Motion for Partial Remand (JMPR), the parties agreed that a remand was warranted for the Board to provide adequate reasons and bases as to whether a VA psychological examination and medical opinion were necessary to decide the claim.

In October 2020, the Board again denied entitlement to service connection for an acquired psychiatric disability. The Veteran appealed the matter to the Court. In July 2021 Joint Motion for Remand, the parties agreed that a remand was warranted for the Board to provide adequate reasons and bases regarding the Veteran's behavioral changes in service discussed in a positive nexus opinion provided by the Veteran. It now returns to the Board.

In June 2018, the Veteran testified at a Board videoconference hearing before a Veterans Law Judge. In April 2022, the Veteran testified at a second Board videoconference hearing before the undersigned Acting Veterans Law Judge. Transcripts of both hearings are of record. As the Veteran's claim is being granted in full herein, the Board finds there is no prejudice in not offering the Veteran the opportunity for a third Board hearing. See Arneson v. Shinseki, 24 Vet. App. 379 (2011).

Service Connection

Service connection will be granted if the evidence demonstrates a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303 (a). Establishing service connection generally requires (1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the present disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

The Veteran asserts he has an acquired psychiatric disorder related to stressors he experienced during service. Specifically, the Veteran states he was harassed and subjected to racial abuse by his superior officers due to his shaving profile, and he was subjected to racially motivated threats by the police when he was arrested in service.

The Veteran underwent psychological evaluations by a Dr. A.S. in July 2018 and August 2022. Dr. A.S. rendered diagnoses of adjustment disorder and other specified trauma disorder, explaining that the Veteran's adjustment disorder was as likely as not related to his service, whereas his other specified trauma disorder is related to the events of the September 11, 2001. 

Dr. A.S. explained that the Veteran was seen numerous times in service for pseudofolliculitis secondary to shaving. As the Veteran reported, he was put on profile which limited his service duties, and was subsequently harassed by his duty commander and accused of being lazy and subjected to racial abuse. The precipitant for this abuse is corroborated by service records. Dr. A.S. noted that the described incidents in service where he was called racial epithets is a clear circumstance that would cause difficulties with adjustment and mood. The Board notes that Dr. A.S.'s opinion is consistent with the evidence of record.

On the contrary, a May 2021 VA examiner opined that the Veteran's acquired psychiatric disorder was less likely than not related to service. The May 2021 VA examiner stated that the Veteran reported experiencing significant racially motivated personal trauma, reports which were believable, and which could
 he was put on profile which limited his service duties, and was subsequently harassed by his duty commander and accused of being lazy and subjected to racial abuse. The precipitant for this abuse is corroborated by service records. Dr. A.S. noted that the described incidents in service where he was called racial epithets is a clear circumstance that would cause difficulties with adjustment and mood. The Board notes that Dr. A.S.'s opinion is consistent with the evidence of record.

On the contrary, a May 2021 VA examiner opined that the Veteran's acquired psychiatric disorder was less likely than not related to service. The May 2021 VA examiner stated that the Veteran reported experiencing significant racially motivated personal trauma, reports which were believable, and which could have caused depression, anxiety or posttraumatic stress disorder. While the examiner noted that the Veteran's adjustment issues could not be reliably connected to in-service experiences, she conceded that the Veteran's account of racially motivated personal trauma in service was likely credible. The Board finds that although the May 2021 examiner provided a negative nexus opinion, her rationale is supportive of Dr. A.S.'s opinion linking the Veteran's adjustment disorder to his credible reports of racially motivated personal trauma.

The Board finds the probative medical evidence is at least in equipoise concerning whether the Veteran's acquired psychiatric condition is related to service. In this regard, the examination reports authored by Dr. A.S. and the VA examiner reflect consideration of the entirety of the record and provide a complete rationale supported by the evidence of record. Furthermore, the opinions offer clear conclusions with supporting data as well as a reasoned medical explanation connecting the two. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) ("[A]medical opinion... must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions"). Accordingly, the Board finds both opinions highly probative.

Thus, as the probative medical evidence on the question of etiology is at least in equipoise, the Board resolves all doubt in favor of the Veteran and finds that service connection an acquired psychiatric disorder is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F. 4th 776 (Fed. Cir. 2021)(only when the evidence persuasively favors one side or another is the benefit of the doubt doctrine not for application). The claim is granted. 

 

 

JEREMY J. OLSEN

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	A. St. Laurent, Associate Counsel

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.