MAJOR DEPRESSIVE DISORDER

Summary

The veteran, who served from June 2015 to June 2019, appeals the March 2025 rating decision concerning his depressive disorder. The veteran claims entitlement to service connection for a depressive disorder secondary to his service-connected bilateral knee disability. The Board reviewed evidence submitted by the veteran, including a November 2024 independent medical examination and a November 2024 VA examination. The private psychologist opined that the veteran's depressive disorder was more likely than not secondary to his chronic knee pain, citing persistent emotional distress and adverse impacts on his life. In contrast, the March 2025 VA examiner concluded that the veteran did not meet DSM-5 criteria for a mental health diagnosis and opined that the condition was less likely than not proximately due to or the result of the service-connected knee disability, finding insufficient evidence to support a nexus. The Board found the evidence to be at least evenly balanced between the conflicting opinions. Applying the benefit of the doubt doctrine, the Board granted service connection for the depressive disorder secondary to the service-connected bilateral knee strain.

Rationale

Current diagnosis of depressive disorder with depressive features, melancholic features, and anxious distress.; Conflicting opinions from private psychologist (favorable nexus) and VA examiner (unfavorable nexus).; Evidence found to be at least evenly balanced.

Full Decision Text

Citation Nr: A26028339
Decision Date: 03/30/26	Archive Date: 03/30/26

DOCKET NO. 250707-561717
DATE: March 30, 2026

ORDER

Entitlement to service connection for depressive disorder, with depressive features, melancholic features, and anxious distress, secondary to service-connected bilateral knee strain, on a causation basis, is granted.   

FINDING OF FACT

The evidence is at least evenly balanced as to whether the Veteran's depressive disorder is caused by service-connected bilateral knee strain.

CONCLUSION OF LAW

The criteria for service connection for depressive disorder with depressive features, melancholic features, and anxious distress, secondary to service-connected bilateral knee strain, on a causation basis, have been met.  38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.310.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty from June 2015 to June 2019.

This matter comes to the Board of Veterans' Appeals (Board) on appeal from March 2025 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO).

In the July 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Evidence Submission docket. Therefore, the Board may only consider the evidence of record at the time of the March 2025 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or representative with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the date the Board received the VA Form 10182, or (2) more than 90 days following the date the Board received the VA Form 10182, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.303, 20.801.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

As a final preliminary matter, "because [38 C.F.R. § 20.202(c)(2)] gives a claimant the later of one year from the date that the agency of original jurisdiction (AOJ) mails notice of the decision or 60 days from when the Board receives the Notice of Disagreement (NOD) to change the NOD and select a different lane, the Board ordinarily may not decide an appeal before this time period is up." Williams v. McDonough, 37 Vet. App. 305, 307 (2024). Here, however, the Veteran submitted evidence and requests to modify a Notice of Disagreement will not be granted if the appellant has submitted evidence as described in § 20.302. See 38 C.F.R. § 20.202(c)(2). Therefore, the Board will adjudicate the claim.

Depressive Disorder   

Service connection will be granted if the evidence demonstrates that current disability resulted from an injury or disease incurred in the active military, naval, air, or space service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Service connection is also warranted for disability that is proximately due to or the result of service-connected disease or injury. 38 C.F.R. § 3.310 (a).

In his November 2024 VA Form 21-526EZ, Application for Disability The Veteran contends that he has a depressive disorder secondary to service-connected bilateral knee disability.

The evidence of record reflects a current depressive disorder diagnosis.  Specifically, a November 2024 independent medical examination shows a diagnosis of depressive disorder, with depressive features, melancholic features, and anxious distress. Thus, the current disability requirement has been met. Martinez-Bodon v. Wilkie, 32 Vet. App. 393, 404 (2020), aff'd sub nom. Martinez-Bodon v. McDonough, 28 F.4th 1241, 1247 (Fed. Cir. 2022) (a valid DSM-5 diagnosis is required to warrant compensation for a psychiatric disability).

In November
EZ, Application for Disability The Veteran contends that he has a depressive disorder secondary to service-connected bilateral knee disability.

The evidence of record reflects a current depressive disorder diagnosis.  Specifically, a November 2024 independent medical examination shows a diagnosis of depressive disorder, with depressive features, melancholic features, and anxious distress. Thus, the current disability requirement has been met. Martinez-Bodon v. Wilkie, 32 Vet. App. 393, 404 (2020), aff'd sub nom. Martinez-Bodon v. McDonough, 28 F.4th 1241, 1247 (Fed. Cir. 2022) (a valid DSM-5 diagnosis is required to warrant compensation for a psychiatric disability).

In November 2024, the private psychologist opined that the Veteran's depressive disorder is more likely than not secondary to service-connected bilateral knee strain. The psychologist explained that the Veteran has been experiencing a persistent degree of emotional distress following his chronic pain associated with his service-connected bilateral knee disability. The chronic pain has led to significant and intrusive anxious and depressive thoughts and feelings, which adversely impact multiple facets of his life, including social, occupational, academic, and family environments. Additionally, he experiences cognitive consequences to his mood symptoms. The psychologist concluded that the Veteran's current presentation is consistent with a diagnosis of depressive disorder, with depressive features, melancholic features, and anxious distress.  

In March 2025, the Veteran underwent a VA examination. The examiner indicated that the Veteran does not have a mental health diagnosis that conforms to the DSM-5 criteria. The examiner opined that the Veteran's claimed condition is less likely than not proximately due to or the result of the Veteran's service connected condition. The examiner's rationale was that although there are situations where knee strain can be associated with depressive symptoms, there is insufficient evidence to support such a claim. The examiner indicated that he reviewed all available evidence on file and was unable to locate any evidence to support such a nexus. The examiner noted that it does not appear this is supported by his service treatment records nor VA medical records.

In this case, the evidence of record includes conflicting opinions from the private psychologist and VA examiner as to the etiology of the Veteran's depressive disorder. To the extent that the VA examiner's opinion is probative, it is not of greater probative weight than the opinion of the private psychologist.  Thus, the evidence is at least evenly balanced as to whether the Veteran's depressive disorder is caused by his service-connected bilateral knee disability. As the reasonable doubt created by this relative equipoise in the evidence must be resolved in the Veteran's favor, service connection for depressive disorder, with depressive features, melancholic features, anxious distress, secondary to service-connected bilateral knee strain is warranted on a secondary, causation basis.  38 U.S.C. § 5107(b) 38 C.F.R. § 3.102.

As the grant of service connection on a direct basis would not result in an earlier effective date and was not raised by the Veteran or the record, further discussion is unnecessary.

 

Jonathan Hager

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	R. Walker, 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.