MAJOR DEPRESSIVE DISORDER

B.T. KNOPE · 2026 · Case ID: A26033524

DENIED

Summary

The veteran, who served honorably in the U.S. Army from June 1965 to April 1967, appeals the denial of service connection for major depressive disorder and traumatic brain injury (TBI). The Board found no service connection for either condition. For major depressive disorder, the Board noted the absence of in-service psychiatric treatment, but extensive evidence of antisocial personality disorder and behavioral issues during service. Post-service, the Veteran was diagnosed with adjustment disorder with depressed mood nearly 20 years after separation, with no documented psychiatric symptoms for decades. The Board found the Veteran's claims of survivor's guilt and depression stemming from service not credible, citing inconsistencies and lack of corroborating evidence. VA examinations noted the Veteran was a "difficult historian" with confirmed dishonesty, and while a private opinion suggested a link to service, the Board found it unpersuasive due to reliance on unsupported statements and ignoring post-service trauma. For TBI, service records showed only a laceration above the ear with no mention of head trauma or related symptoms. The Veteran's claims of assault and falls causing head injury were contradicted by inconsistent statements and lack of objective evidence. Post-service treatment records showed normal cognition despite substance abuse and psychiatric complaints. The Board found the Veteran's assertions regarding head trauma and subsequent symptoms not credible and not supported by the objective evidence. The Board concluded that no competent evidence of a current disability or in-service injury for either condition existed, thus denying service connection for both major depressive disorder and TBI.

Rationale

No in-service psychiatric treatment or diagnosis of acquired psychiatric disorder.; No continuity of symptoms established since service.; Veteran's claims of survivor's guilt and depression not credible.

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250724-567920

Full Decision Text

Citation Nr: A26033524
Decision Date: 04/10/26 Archive Date: 04/10/26

DOCKET NO. 250724-567920
DATE: April 10, 2026

ORDER

Entitlement to service connection for major depressive disorder is denied.

Entitlement to service connection for traumatic brain injury is denied.

FINDINGS OF FACT

1. The Veteran's major depressive disorder is not etiologically related to service.

2. The Veteran's claimed traumatic brain injury is not etiologically related to service.

CONCLUSIONS OF LAW

1. The criteria for entitlement to service connection for major depressive disorder have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304.

2. The criteria for entitlement to service connection for traumatic brain injury have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served honorably in the United States Army from June 1965 to April 1967. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a May 2023 and August 2023 rating decisions from a Department of Veterans Affairs (VA) Regional Office (RO). In September 2023, the Veteran submitted a VA Form 10182, Board Appeal (Notice of Disagreement). The Board issued

In March 2024, the Veteran submitted a request for a Higher-Level Review (HLR) of the August 2023 decision. The agency of original jurisdiction (AOJ) issued separate decisions in January 2024 denying the claims. The Veteran filed a VA Form 20-0995 Supplemental Claim Application in March 2024, resulting in separate August 2024 rating decisions. The Veteran filed another Notice of Disagreement (NOD) in September 2024. The Board then remanded the claims in March 2025, resulting in a May 2025 rating decision.

In the July 2025 NOD, the Veteran elected the Hearing docket. A Board hearing was held on August 8, 2025. Therefore, the Board may only consider the evidence of record at the time of the May 2025 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302 (a). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302 (a), 20.801.

The Veteran also testified regarding the issues on appeal at Board hearings in October 2023 and December 2024.

Service Connection

Under the relevant laws and regulations, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. §§ 3.303(a), 3.304, 3.307, 3.309, 3.310. Generally, the evidence must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004); Caluza v. Brown, 7 Vet. App. 498, 505 (1995).

1. Entitlement to service connection for major depressive disorder.

The Veteran contends that his major depressive disorder is related to service. After a review of the evidence, the Board finds that service connection is not warranted.

1. Entitlement to service connection for major depressive disorder.

The Veteran contends that his major depressive disorder is related to service. After a review of the evidence, the Board finds that service connection is not warranted.

The clinical evidence does not show treatment for a psychiatric disorder during service. However, service treatment records and military personnel records are replete with evidence of misconduct due to a personality disorder. In short, the Veteran was held responsible for frequent violations of the Uniform Code of Military Justice, to include Court Martial conviction on 3 separate charges. He was granted transfer to a new unit in July 1966 to complete his service only to display "performance of duty characterized by extensional shirking of duties" and behavior leading to multiple UCMJ infractions due to "his own attitude and lack of appropriate interest," according to his new commanding officer. He was diagnosed with passive-aggressive personality disorder in February 1967. He denied any mental health symptoms such as depression or anxiety at separation. He was diagnosed with depressive disorder, not otherwise specified, in April 2002.

As an initial matter, the Boad observes that personality disorders are not diseases or injuries in the meaning of applicable legislation for disability compensation purposes. 38 C.F.R. §§ 4.9, 4.127. Hence, the second Shedden element-the in-service incurrence or aggravation of a disease or injury-has not been met with regard to an acquired psychiatric disorder.

After service, the Veteran was hospitalized in September 1974, over 7 years removed from active service, due to his anti-social behavior. He explained that former associates insisted that he continue to "push" drugs and that he refused. He became somewhat depressed and began to isolate himself inside his home. He was diagnosed with transient, situational disturbance, with depressive features, associated with fear of former criminal associates and Anti-social personality. The examiner noted that the Veteran had been incarcerated twice since separation from active service for armed robbery.

The Veteran was again admitted to the same hospital for a second time in June 1976 for opioid dependence and his antisocial personality diagnosis was confirmed. During treatment in July 1976, the Veteran admitted that he began using drugs during service and the examiner found him to be "smoldering with contempt for authority." Later, in August 1976, the Veteran expressed that he may have some psychological problems due to a tendency to feel tense and nervous. In the examiner's opinion, the Veteran's judgement seemed to be impaired to a slight degree in test situations in which he was rather noncommittal. He was also evasive about true life situations where his antisocial behavior had been manifested by poor judgement. Overall, the examiner found the Veteran's emotional status to be essentially the same as that described in service and later during treatment in 1974.

The Veteran was hospitalized again for drug abuse in February 1986. He reported that his wife had been shot and killed two weeks prior and he was unable to cope. He was diagnosed with adjustment disorder with depressed mood. This diagnosis, rendered nearly 20 years after separation from service, represents the first diagnosis of a psychiatric disorder of record.

A treatment note from August 2001 noted that the Veteran met with a VA mental health therapist for most of 2001. During that time, he disclosed that he believed his wife was killed to scare him. He had observed multiple mental health symptoms since wife's murder, to include depression, nightmares, guilt, withdrawal, and isolation. His therapy sessions revolved around emotions expressed since disclosing this information to his daughter.

At an April 2002 VA examination, the Veteran reported guilt over the death of his wife. The examiner found him to be a "difficult historian" who was remarkably vague and non-specific about his symptoms, with confirmed dishonesty regarding recent substance use. He was diagnosed with opioid dependence and depressive disorder, not otherwise specified.

Overall, the clinical evidence does not show diagnosis or treatment for an acquired psychiatric disorder until many years after separation from active service. To be sure, the evidence definitively shows continued behavior consistent with an antisocial personality. However, the clinician's that treated the Veteran in the years following service did not detect the presence of a concomitant psychiatric disorder.

At his October 2023 Board hearing, the Veteran reported survivor's guilt for the first time, though he related it to service. He reported that he was one of the only members of his AIT class-individualized job training after basic training-that did not receive orders to Vietnam. He asserted that his depression began at that time and continued throughout active service. He also reported receiving psychiatric treatment during service due to the survivor's guilt. However, based on overwhelming evidence to the contrary, the Board finds the Veteran's assertions less than credible.

The Board must assess the credibility and weight of all the evidence, including the medical evidence, to determine its probative value, accounting for the evidence which it finds to be persuasive or unpersuasive, and providing reasons for rejecting any evidence favorable to the claimant. See Masors v. Derwinski, 2 Vet. App. 181 (1992). Equal weight is not accorded to each piece of evidence contained in the record; every item of evidence does not have the same probative value. Here, the evidence shows that the Veteran's psychological evaluation during service was related exclusively to his antisocial personality. Service treatment records are replete with evidence of antisocial behavior with no mention of depressive symptoms at any time. Indeed, treatment records during service and for two decades after confirm the presence of antisocial personality without associated psychiatric symptoms. Accordingly, based on the medical and lay evidence of record, a continuity of symptoms since service has not been established.

As to nexus, the Veteran was afforded a VA examination in May 2023. He was diagnosed with major depressive disorder. The examiner noted no relevant history of mental health treatment based on record review, though an extensive history of behavioral problems and drug abuse was noted. The examiner opined that the Veteran's current depression was not related to service. The Veteran reiterated that he had always carried survivors guilt about not being sent to Vietnam. The examiner reasoned that the Veteran's longstanding history of depression occurred significantly after separation from service. Indeed, the Veteran placed the onset of his depression 16 years prior to the examination.

In a November 2023 private medical opinion, the examiner opined that the Veteran's current psychiatric disorder was more likely than not stems from his reported in-service development whereby he would lose 'friends' during service while continually worsening as years progressed. The Board finds the opinion unpersuasive. The opinion is based solely on the Veteran's unsupported statements during his Board hearing that he suffered from survivors' guilt during service. The Veteran has not produced evidence that anyone he knew from AIT was killed in Vietnam and the objective evidence contradicts his assertion of in-service psychiatric symptoms. Moreover, the examiner ignored all other relevant post-service evidence of trauma, to include the Veteran's drug abuse, criminal convictions, and the death of his spouse. Hence, the opinion lacks probative value.

At a subsequent VA examination in April 2024, the examiner confirmed the diagnosis of major depressive disorder. However, the examiner found that the Veteran did not meet criteria for PTSD related to finding out that his fellow soldiers were killed in Vietnam and did not report other history of traumas that are interfering with his functioning during the evaluation. The examiner did not render a nexus opinion.

In August 2024, another VA examiner opined that the Veteran did meet PTSD criteria related to the death of his wife. The examiner reasoned that if the Veteran's symptoms are rooted in multiple prior traumatic experiences reportedly from before, during, and after service, his diagnosis is more likely a trauma-related disorder. Since he did not meet full criteria for PTSD during his April 2024 examination, a diagnosis of Unspecified Trauma and Stressor Related Disorder is more consistent with his symptoms. However, there is insufficient evidence to opine as to whether or not the stressor event that occurred during service caused his trauma-related disorder. Several traumatic experiences took place after service and there are no records of mental health diagnoses or treatment for decades after he was discharged.

The Veteran next submitted another private opinion in support of his claim from December 2024. Unfortunately, the opinion is based on the same incredible reports of survivors' guilt related to service. Moreover, the Veteran reported hospitalization for suicidal ideation during the 1980's whereas the evidence shows that his hospitalizations were related to drug use and
April 2024 examination, a diagnosis of Unspecified Trauma and Stressor Related Disorder is more consistent with his symptoms. However, there is insufficient evidence to opine as to whether or not the stressor event that occurred during service caused his trauma-related disorder. Several traumatic experiences took place after service and there are no records of mental health diagnoses or treatment for decades after he was discharged.

The Veteran next submitted another private opinion in support of his claim from December 2024. Unfortunately, the opinion is based on the same incredible reports of survivors' guilt related to service. Moreover, the Veteran reported hospitalization for suicidal ideation during the 1980's whereas the evidence shows that his hospitalizations were related to drug use and the death of his spouse. The opinion does not mention the Veteran's history of The examiner also misstates the Veteran's disciplinary issues as related to mental health issues when the record clearly indicates the in-service discipline was due to behavioral problems related to an antisocial personality. Based on the foregoing inconsistencies and contradictions, the Board cannot afford the private opinion any probative weight.

Overall, significantly more weight is given to the opinions rendered by the VA clinicians that examined the Veteran. The opinions were provided by qualified medical professionals after review of the claims file and application of the facts to current medical knowledge. On the other hand, the private opinions are based almost entirely on incredible statements by Veteran and ignore relevant evidence. Accordingly, a nexus has not been established.

In reaching this conclusion, the Board has considered the statements made by the Veteran regarding a relation between his acquired psychiatric disorder and active service. However, in this case the Veteran is not competent to testify regarding the etiology of his acquired psychiatric disorder. See Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). The diagnosis and evaluation of such a disorder requires the expertise of a qualified medical professional. Therefore, the unsubstantiated statements made by the Veteran are found to lack competency.

In conclusion, the evidence is persuasively against the claim. As there is not an approximate balance of positive and negative evidence, the benefit-of-the-doubt doctrine is not applicable and service connection for an acquired psychiatric disorder, variously diagnosed as major depressive disorder and PTSD, is not warranted. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. The claim is denied.

2. Entitlement to service connection for traumatic brain injury.

The Veteran contends that he suffers from traumatic brain injury related to service. After a review of the evidence, the Board finds that service connection is not warranted.

Service treatment records show that the Veteran received several sutures above his left ear for a 2cm wide and 8cm deep laceration several days prior to separation from service. At the time, the Veteran reports that he was struck by glass but further details of the incident are not provided. No other head injuries are of record during service. A currently diagnosed traumatic brain injury is not of record.

Turing to the lay evidence, the Veteran reports traumatic brain injury during service due to a personal assault and from falls while performing his duties. However, the Veteran's assertions are not supported by the record. First, the Veteran asserted at his October 2023 Board hearing that he was assaulted during his last week of service in Germany. He reported being hit in the head with something and losing consciousness. In this regard, the Board has no reason to doubt the Veteran's assertion that he was involved in a physical confrontation. However, service treatment records from the time show no evidence of head injury beyond the laceration above his left ear. Excessive bleeding is the only symptoms noted at the time and no follow up treatment is of record. At his December 2024 hearing, the Veteran reported that he was kind of confused after the event and that the night "was all kind of blurry." He reported headaches, lightheadedness, dizziness, and memory loss for some time after the event. However, there is no evidence in the record of such symptoms immediately after or within several years of separation from service.

Next, the Veteran contends that he suffered head injuries during performance of his duties a pole climber during service. At his October 2023 Board hearing, the Veteran reported that he injured his back falling from telephone poles on several occasions. He reported that the safety belt would ensure that he would land on his legs and butt any time he fell. He was adamant that the falls always involved the legs and rear end but never mentioned hitting his head. Indeed, he submitted a lay statement in December 2023 reiterating that he injured his back during such falls with no mention of head trauma. Then his narrative changed at his December 2024 hearing. He stated that it was possible that his head fell forward upon impact and hit the pole though he could not state so definitively. Yet, at his August 2025 hearing, he again stated that injury was limited to his back and legs when he fell with no mention of injury to his head. Thus, based on the foregoing, the Board finds that the medical and lay evidence does support the occurrence of a traumatic brain injury during service.

The post-service clinical evidence does not show treatment for symptoms indicative of traumatic brain injury residuals. Indeed, although the Veteran received extensive inpatient treatment for substance abuse and associated psychiatric complaints in the several decades after service, his cognitive faculties were always found to be normal. Moreover, normal cognitive abilities were consistently found during treatment for other medical conditions. Private treatment records from December 2022, note an abnormal EEG secondary to moderate slowing disorganization. The findings were suggestive of encephalopathy. The examiner noted that the Veteran had clearing of his mental status with extubation and that his mental status had returned to normal. No cause was found and no diagnosis was rendered. Prior this event, there is no clinical evidence of any cognitive dysfunction in the record. Thus, a continuity of symptoms since service has not been established based on the clinical evidence.

The Veteran reported at his October 2023 Board hearing that he has suffered from hearing issues and psychiatric problems since suffering the in service head laceration. No other residual symptoms were reported prior to a recent "blackout." He also reported the onset of headaches and memory loss during service but stated that those symptoms began prior to his head trauma during the last week of service. At his December 2024 hearing, the Veteran reported headaches, dizziness, lightheadedness, dizziness, and memory loss in the weeks following his head laceration. His representative inquired as to whether he felt such symptoms since service and the Veteran replied in the affirmative. However, the only specific incident he could recall was the blackout mentioned at the previous hearing. With regard to the Veteran's statements, the Board observes that the Veteran is competent to testify to that which is actually observed and within the realm of personal knowledge. See Layno v. Brown, 6 Vat. App. 465 (1994). However, the record does not show treatment for any such symptoms after service. Accordingly, a continuity of symptoms since service has not been established based on either the medical or lay evidence of record.

Next, the Board observes that the evidence does not support a currently diagnosed traumatic brain injury. In August 2023, a VA examiner was unable to confer a diagnosis based on record review and examination of the Veteran. The examiner confirmed that the Veteran sustained a laceration to his left ear and head in April 1967 for which he required stitches. Subsequent treatment records do not indicate any continued signs or symptoms related to his head laceration. He was able to work without any issues until 10 years ago when he had to quit working due to his back pain and other issues. His interim history is also compatible with chronic opioid dependency for over 35 years which may have caused some cognitive changes, though his cognition appeared normal for his age during examination. There was no apparent neurocognitive deficit. There are no medical records to indicate any diagnosis of traumatic brain injury or related residuals. Therefore, the veteran did not have a true traumatic brain injury when he sustained a laceration on his head and left ear during service.

During a November 2023 private examination, the Veteran reported that he may have passed out when receiving the laceration over his ear during service. He reported that he has suffered headaches and instances of blacking out ever since. Based on these statements, the examiner opined that such symptoms were residuals of a head injury. However, an actual traumatic brain injury diagnosis was not rendered.

Another VA medical opinion was obtained to address the Veteran's hearing testimony and the November 2023 private opinion. The examiner
are no medical records to indicate any diagnosis of traumatic brain injury or related residuals. Therefore, the veteran did not have a true traumatic brain injury when he sustained a laceration on his head and left ear during service.

Another VA medical opinion was obtained to address the Veteran's hearing testimony and the November 2023 private opinion. The examiner determined that there is no diagnosis because there are no findings, signs and or symptoms to support a diagnosis. The in-service treatment note does not indicate any head injury or any other injury requiring sutures. There is no evidence to indicate a head injury resulting in loss of consciousness, amnesia, headache, nausea, vomiting or any residuals secondary to any head injury.

Another private opinion from December 2024 was submitted in support of the claim. In this opinion, the examiner noted that the Veteran lost consciousness and suffered from amnesia as a result of the in-service assault. The private examiner opined that the in-service event itself would qualify for a diagnosis of traumatic brain injury. In this regard the Board reiterates that service treatment records make no mention of symptoms other than excessive bleeding and no follow up treatment for additional symptoms indicative of head trauma is of record. Hence, the Board finds that Veteran's assertions not credible. The examiner next refers to the Veteran's statements that he hit his head when falling from telephone poles during service and has suffered from a long history of headaches, dizziness, light-headedness and memory loss as evidence of traumatic brain injury. Yet these statements have also been shown to be unsupported by the objective evidence of record. Based on the foregoing, the Board finds the examiner's diagnosis of a traumatic brain injury during service is not credible. See Reonal v. Brown, 5 Vet. App. 458, 461 (1993) ("An opinion based upon an inaccurate factual premise has no probative value.").

To the extent that the Veteran asserts that he has a traumatic brain injury, the Board reiterates that he may attest to factual matters of which he has first-hand knowledge and that his assertions in that regard are entitled to some probative weight. See Layno, 6 Vet. App. 465. He is not, however, competent to render an opinion as to whether there is a currently existing traumatic brain injury, because he does not have the requisite medical knowledge or training, and because such matters are beyond the ability of a lay person to observe. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). On the other hand, the VA clinicians that evaluated the Veteran and the objective evidence of record found no evidence of a current traumatic brain injury. Indeed, as explained above, the evidence does not support the finding of a traumatic brain injury during service or at any time thereafter.

Consequently, when a claimed condition is not shown, there may be no grant of service connection. 38 U.S.C. § 1110, 1131; Rabideau v. Derwinski, 2 Vet. App. 141 (1992) (Congress specifically limits entitlement for service-connected disease or injury to cases where such incidents have resulted in a disability). In the absence of proof of a present disability there can be no valid claim. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992).

In summation, there is no competent evidence of a current disability upon which to predicate a grant of service connection on any basis, and, hence, no valid claim for service connection. Id. As such, service connection for a traumatic brain injury must be denied as a matter of law, and the benefit of the doubt doctrine is therefore not for application. See Sabonis v. Brown, 6 Vet. App. 426, 430 (1994). 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.

B.T. KNOPE

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Ballinger, Daniel

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