MAJOR DEPRESSIVE DISORDER

ERIC S. LEBOFF · 2026 · Case ID: 26000704

MIXED

Summary

The veteran served in the Army from November 1966 to August 1970. He appealed the denial of service connection for an acquired psychiatric disorder, including depression and anxiety, and for an alcohol use disorder, both claimed as secondary to service-connected PTSD. The Board denied these claims, finding that the symptoms of depression and anxiety were subsumed by the existing PTSD diagnosis, precluding separate compensation under the anti-pyramiding rule. Additionally, a VA examination found no current alcohol use disorder, and even if one existed, it would also be precluded by pyramiding. The Board noted that dementia was mentioned as an issue but was never formally claimed or appealed by the veteran. The case also involved appeals for asthma, diabetes mellitus, and hypertension, claimed as secondary to PTSD. These claims were remanded for further development. Specifically, the Board required a review of potential herbicide exposure at Kadena Air Force Base in Okinawa, considering a historical Army report, and requested VA examination opinions to determine if the asthma, diabetes, and hypertension were at least as likely as not related to, caused by, or aggravated by the service-connected PTSD.

Rationale

Symptoms subsumed by PTSD diagnosis; Anti-pyramiding rule (38 C.F.R. § 4.14); No distinct symptoms shown

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

13-04 220

Full Decision Text

Citation Nr: 26000704
Decision Date: 01/20/26 Archive Date: 01/20/26

DOCKET NO. 13-04 220
DATE: January 20, 2026

ORDER

Entitlement to service connection for an acquired psychiatric disorder, to include one manifested by depression and anxiety to include as secondary to service-connected posttraumatic stress disorder (PTSD) is denied.

Entitlement to service connection for an alcohol use disorder to include as secondary to service-connected PTSD is denied.

REMANDED

Entitlement to service connection for asthma to include as secondary to service-connected PTSD is remanded.

Entitlement to service connection for diabetes mellitus to include as secondary to service-connected PTSD is remanded.

Entitlement to service connection for hypertension to include as secondary to service-connected PTSD is remanded.

FINDINGS OF FACT

1. The symptoms and impairment caused by the claimed acquired psychiatric disorder, to include one manifested by depression and anxiety, have been fully contemplated by the award of service connection for PTSD; there are no distinct symptoms that could be separately compensated.

2. The symptoms and impairment caused by the claimed alcohol use disorder have been fully contemplated by the award of service connection for PTSD.

CONCLUSIONS OF LAW

1. The criteria for an award of service connection for a claimed acquired psychiatric disorder, to include one manifested by depression and anxiety have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 4.14.

2. The criteria for an award of service connection for an alcohol use disorder have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303, 4.14.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from November 1966 to August 1970. This matter is before the Board on appeal from June 2010 and August 2014 rating decisions. In January 2017, the Veteran testified at a Board videoconference hearing before a different Veterans Law Judge.

In September 2025 the Veteran passed away. Appellant is the Veteran's widow who was formally recognized as the substitute claimant by the VA in September 2025. Appellant testified before the undersigned Veterans Law Judge in September 2025.

Finally, The Board notes that one of the issues certified was characterized as an issue of entitlement to service connection for dementia and was described as such at the September 2025 hearing. The Board notes that at no time during the pendency of this appeal was dementia ever claimed or appealed by the Veteran. However, he appealed entitlement to service connection for a psychiatric disorder or disorders to include PTSD (since granted), depression, anxiety, and alcoholism. The Board notes that the issue internally listed as on appeal in the claims folder is described as dementia due to other neurologic or general medical conditions, or substance- induced. Thus, the Board is classifying the issue on appeal as service connection for an alcohol use disorder, as separate from the other remaining issue of entitlement to service connection for a psychiatric disorder to include one manifested by depression and anxiety.

Service Connection

1. Entitlement to service connection for an acquired psychiatric disorder, to include one manifested by depression and anxiety to include as secondary to service-connected posttraumatic stress disorder (PTSD) is denied.

2. Entitlement to service connection for an alcohol use disorder to include as secondary to service-connected PTSD is denied.

Following the May 2024 remand, service connection for PTSD effective August 19, 2024, was granted in a November 2024 rating. Later, a January 2025 rating granted an effective date of July 10, 2009, encompassing the entire appeal period.

VA opinions were obtained in August 2024 in which it was found that the depression and anxiety symptoms were subsumed by the PTSD diagnosis. In this regard, under the anti-pyramiding provision of 38 C.F.R. § 4.14, the evaluation of the "same disability" or the "same manifestation" under various diagnoses is to be avoided. Here, the symptoms contemplated in evaluating the Veteran's PTSD are duplicative of the symptoms associated with the claimed psychiatric disorder manifested by depression and anxiety. See Esteban v. Brown, 6?Vet. App.?259, 261-62 (1994). Accordingly, a separate rating is not warranted and the claim is denied. Moreover, an August 2024 VA examination found that no alcohol use disorder currently existed. Moreover, even if current disability had been shown, this claim would also
regard, under the anti-pyramiding provision of 38 C.F.R. § 4.14, the evaluation of the "same disability" or the "same manifestation" under various diagnoses is to be avoided. Here, the symptoms contemplated in evaluating the Veteran's PTSD are duplicative of the symptoms associated with the claimed psychiatric disorder manifested by depression and anxiety. See Esteban v. Brown, 6?Vet. App.?259, 261-62 (1994). Accordingly, a separate rating is not warranted and the claim is denied. Moreover, an August 2024 VA examination found that no alcohol use disorder currently existed. Moreover, even if current disability had been shown, this claim would also be precluded on the basis of impermissible pyramiding. Again, there is no showing of distinct symptoms apart from those already contemplated by the PTSD rating.

3. For the foregoing reasons, the claims of service connection for an acquired psychiatric disorder, to include one manifested by depression and anxiety, and for an alcohol use disorder are denied. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303.

REASONS FOR REMAND

The Board previously remanded the appeal in April 2017. Following the April 2017 remand, the issue of entitlement to nonservice-connected pension benefits was granted by way of an October 2023 rating decision. Thus, that issue is no longer on appeal.

The appeal was remanded a second time in May 2024 for additional development. Following the May 2024 remand, service connection for PTSD effective August 19, 2024, was granted in a November 2024 rating. Later, a January 2025 rating granted an effective date of July 10, 2009, for entitlement to service connection for PTSD. The remaining issues are returned to the Board for further consideration.

1. Entitlement to service connection for asthma to include as secondary to service-connected PTSD is remanded.

2. Entitlement to service connection for diabetes mellitus to include as secondary to service-connected PTSD is remanded.

3. Entitlement to service connection for hypertension to include as secondary to service-connected PTSD is remanded.

Unfortunately, as to the asthma, diabetes, and hypertension claims, the Board finds that another remand is necessary to ensure adequate development and appellate review. Regarding participation in toxic exposure risk activity (TERA), specifically claimed as Agent Orange exposure, it was determined that despite his confirmed assignment to Kadena, Air Force Base in Okinawa, as well as a temporary assignment at Taegu AB in South Korea, there was no such participation per a TERA memorandum in April 2025 (reversing an earlier favorable TERA memorandum). However, additional development remains necessary. First, as pointed out by the Veteran's Representative at the September 2025 hearing, the Veteran's duty in Korea was from March 7, 1968, to May 29, 1968. This is verified in the personnel records. However, in the research response to determine whether the Veteran had service at the Korean DMZ, the dates searched were from January 27, 1968, to March 28, 1968, not covering his entire time in Korea on temporary duty as part of the 20th Weather Squadron.

At the September 2025 hearing the Appellant's attorney cited a 1971 U.S. Army report titled Historical, Logistical, Political, and Technical Aspects of the Herbicide Defoliant Program, 1961 to 1971, which reference herbicide stockpiles in the Pacific Command Area, including Okinawa, and specifically at Kadena Air Force Base where the Veteran was stationed. The attorney pointed specifically to page 29 of the report which noted that the environmental statements should consider herbicide stockpiles elsewhere in PACOM, U.S. government restricted materials Thailand, and Okinawa, especially Kadena Air Force Base. Hearing Transcript 9/18/25 at pg. 4. It is noted that the negative TERA memo issued in April 2025 found against any exposures based on a lack of service in Vietnam and a lack of indication of exposure based on the Veteran's temporary duty in Korea. However, there was no consideration of potential exposure at Kadena AFB. Given the contentions raised at hearing, a formal finding should be issued as to whether the Veteran's service at Kadena AFB involved TERA.

Also, since this matter was last remanded in September 2024, service connection was granted for PTSD per a November 2024 rating. The Board notes that the Veteran in essence claimed entitlement to service connection for all issues to include as secondary to PTSD in a statement within a July 2014 NOD per the following statement: "Also the Veteran's PTSD, depression and related mental issues could certainly be part of the cause if not the entire cause of one or more of the conditions." Elsewhere in the appeal he asserted that his asthma and hypertension were secondary to PTSD, per another NOD in November 2015 which also asserted alcoholism as connected to his PTSD. Additionally, at the September 2025 hearing, the Appellant's representative contended that asthma could be related to PTSD, and that depression and the alcohol use disorder were also associated with PTSD. Although it was pointed out that a grant of service connection for depression (and dementia) would not result in a separately evaluated service-connected psychiatric disability from the PTSD, the depression issue was not withdrawn and remains on appeal. Hearing Transcript 9/18/25 at pg. 2- 4. The alcohol use disorder likewise is shown to remain on appeal although it was not listed in the September 2025 hearing.

In view of the foregoing, the Board finds it is necessary to obtain VA examination opinions addressing whether all the claimed disorders were caused by or aggravated beyond natural progression by his service-connected PTSD.

The matters are REMANDED for the following action:

1. Through appropriate channels, the AOJ should initiate another research request encompassing the timeframe from March 29, 1968 to May 29, 1968, to determine whether personnel from Detachment 8, 20th Weather Squadron assigned to Weather Team 3 conducted any duties at the Korean Demilitarized Zone.

2. The AOJ should obtain an additional TERA memo addressing contentions raised in the September 2025 hearing as to herbicide exposure during the Veteran's time at Kadena Air Force Base. The 1971 U.S. Army report titled Historical, Logistical, Political, and Technical Aspects of the Herbicide Defoliant Program, 1961 to 1971 at page 29 should be considered.

3. The AOJ should obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's hypertension, diabetes, and/or asthma was at least as likely as not (likelihood nearly equally balanced or greater) related to service-connected PTSD, due to service-connected PTSD and/or aggravated by service-connected PTSD. The examiner is advised that aggravation can include temporary worsening or flare-ups.? If aggravation is found, the examiner should also state, to the extent possible, the baseline level of disability prior to aggravation. This may be ascertained by the medical evidence of record and by the Veteran's statements as to the nature, severity, and frequency of his observable symptoms over time.

The examiner should review the evidence in the claims file. All opinions should be accompanied by adequate rationale.

4. Thereafter, readjudicate the claims.

Eric S. Leboff

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Eckart, C.

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.

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