POSTTRAUMATIC STRESS DISORDER (PTSD)

M. M. CELLI · 2026 · Case ID: A26036395

GRANTED

Summary

The Veteran, who served in the Marines from December 1971 to August 1974, appeals the denial of service connection for PTSD. The Veteran claims PTSD stemming from an in-service personal assault, specifically rape by two drill instructors during basic training in 1972. The Veteran reported significant behavioral changes following these assaults, including AWOL incidents, requests for duty changes, disciplinary actions, and subsequent diagnoses of PTSD, bipolar disorder, and polysubstance dependence. While the Veteran's service treatment records are silent regarding psychiatric complaints, multiple VA mental health professionals, including treating psychiatrists and examiners, diagnosed PTSD and linked it to the in-service sexual trauma, finding the Veteran's accounts credible and the symptoms consistent with the assaults. The Board found the evidence to be in equipoise regarding the stressor's occurrence, resolving doubt in the Veteran's favor. Service connection for PTSD is therefore granted.

Rationale

Veteran's lay testimony of in-service sexual assault corroborated by multiple VA mental health professionals' findings and diagnoses.; VA psychiatrists and examiners found Veteran's accounts credible and linked PTSD symptoms to military sexual trauma.; Evidence was in equipoise regarding stressor occurrence; doubt resolved in Veteran's favor.

Service Branch

MARINE CORPS

Special Benefit

NO SPECIAL BENEFIT

Docket No.

210504-156963

Full Decision Text

Citation Nr: A26036395
Decision Date: 04/20/26 Archive Date: 04/20/26

DOCKET NO. 210504-156963
DATE: April 20, 2026

ORDER

Service connection for posttraumatic stress disorder (PTSD) is granted.

FINDING OF FACT

Resolving all doubt in the Veteran's favor, his acquired psychiatric disorder, diagnosed as PTSD, is due to in-service personal assault.

CONCLUSION OF LAW

The criteria for service connection for PTSD have 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 on active duty from December 1971 to August 1974.

This case comes before the Board of Veterans' Appeals (Board) on appeal from a rating decision issued in May 2020 by a Department of Veterans Affairs (VA) Regional Office (RO) under the modernized appeals system known as the Appeals Modernization Act (AMA). The May 2020 rating decision performed a higher-level review of a rating decision issued in November 2019.

On May 4, 2021, the Veteran timely submitted a Decision Review Request: Board Appeal (Notice of Disagreement) (VA Form 10182) and requested a Board hearing before a Veterans Law Judge. A hearing was scheduled for January 15, 2025; in a letter received on January 9, 2025, the Veteran cancelled the request for a hearing. As a result, the Board may only consider the evidence of record at the time of the November 2019 Agency of Original Jurisdiction (AOJ) decision that was subsequently subject to higher-level review, as well as any evidence submitted by the Veteran or his representative within 90 days following the receipt of the hearing withdrawal. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the November 2019 decision, and prior to the withdrawal, or (2) more than 90 days following the hearing withdrawal, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801.

Entitlement to service connection for an acquired psychiatric disorder, to include PTSD.

Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Service connection may also be granted for any disease diagnosed after discharge, when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Direct service connection may not be granted without evidence of a current disability; in-service incurrence or aggravation of a disease or injury; and a nexus between the claimed in-service disease or injury and the present disease or injury. Id.; see also Caluza v. Brown, 7 Vet. App. 498, 506 (1995) aff'd, 78 F.3d 604 (Fed. Cir. 1996).

When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990).

As an initial matter, in rating decisions from November 2019 and May 2020, the agency of original jurisdiction (AOJ) favorably found that the Veteran had been diagnosed with bipolar II disorder and cannabis use disorder. 38 C.F.R. § 3.104(c).

To establish entitlement to service connection for PTSD, in addition to the three basic elements of service connection, the record must contain the following: (1) medical evidence giving the Veteran a current diagnosis of PTSD; (2) credible supporting evidence that the claimed in-service stressor actually occurred; and (3) medical evidence of a link between current symptomatology and the claimed in-service stressor. 38 C.F.R. § 3.304(f).

If the evidence establishes a diagnosis of PTSD during service and the claimed stressor is related to that service, in the absence of clear and convincing evidence to the contrary, and provided that the claimed stressor is consistent with the circumstances, conditions, or hardships of the veteran's service, the veteran's lay testimony alone may establish the occurrence of the
addition to the three basic elements of service connection, the record must contain the following: (1) medical evidence giving the Veteran a current diagnosis of PTSD; (2) credible supporting evidence that the claimed in-service stressor actually occurred; and (3) medical evidence of a link between current symptomatology and the claimed in-service stressor. 38 C.F.R. § 3.304(f).

If a stressor claimed by a veteran is related to the veteran's fear of hostile military or terrorist activity and a VA psychiatrist or psychologist, or a psychiatrist or psychologist with whom VA has contracted, confirms that the claimed stressor is adequate to support a diagnosis of PTSD, and the veteran's symptoms are related to the claimed stressor, in the absence of clear and convincing evidence to the contrary, and provided the claimed stressor is consistent with the places and circumstances of the veteran's service, the veteran's lay testimony alone may establish the occurrence of the claimed in-service stressor. For purposes of this paragraph, "fear of hostile military or terrorist activity" means that a veteran experienced, witnessed, or was confronted with an event or circumstance that involved actual or threatened death or serious injury, or a threat to the physical integrity of the veteran or others, such as from an actual or potential improvised explosive device; vehicle-imbedded explosive device; incoming artillery, rocket, or mortar fire; grenade; small arms fire, including suspected sniper fire; or attack upon friendly military aircraft, and the veteran's response to the event or circumstance involved a psychological or psycho-physiological state of fear, helplessness, or horror. 38 C.F.R. § 3.304(f)(3).

If the evidence establishes that the veteran engaged in combat with the enemy and the claimed stressor is related to that combat, in the absence of clear and convincing evidence to the contrary, and provided that the claimed stressor is consistent with the circumstances, conditions, or hardships of the veteran's service, the veteran's lay testimony alone may establish the occurrence of the claimed in-service stressor. 38 C.F.R. § 3.304(f)(2).

If the evidence establishes that the veteran was a prisoner-of-war and the claimed stressor is related to that prisoner-of-war experience, in the absence of clear and convincing evidence to the contrary, and provided that the claimed stressor is consistent with the circumstances, conditions, or hardships of the veteran's service, the veteran's lay testimony alone may establish the occurrence of the claimed in-service stressor. 38 C.F.R. § 3.304(f)(4).

If a PTSD claim is based on in-service personal assault, evidence from sources other than the veteran's service records may corroborate the veteran's account of the stressor incident. 38 C.F.R. § 3.304(f)(5). Examples of such evidence include but are not limited to records from law enforcement authorities, rape crisis centers, mental health counseling centers, hospitals, or physicians; pregnancy tests or tests for sexually transmitted diseases; and statements from family members, roommates, fellow service members, or clergy. Evidence of behavior changes following the claimed assault is one type of relevant evidence that may be found in these sources. Examples of behavior changes that may constitute credible evidence of the stressor include but are not limited to a request for a transfer to another military duty assignment; deterioration in work performance; substance abuse; episodes of depression, panic attacks, or anxiety without an identifiable cause; or unexplained economic or social behavior changes.

In addition, VA may submit any evidence that it receives to an appropriate medical or mental health professional for an opinion as to whether it indicates that a personal assault occurred. 38 C.F.R. § 3.304(f)(5). It is important to note that, for personal assault PTSD claims, an after-the-fact medical opinion may serve as the credible supporting evidence of the reported stressor. See Menegassi v. Shinseki, 683 F.3d 1379, 1382-83 (Fed. Cir. 2011); Bradford v. Nicholson, 20 Vet. App. 200, 207 (2006); Patton, supra.

The Board also notes that, while service connection requires verification or corroboration of the reported in-service stressor events, other mental health diagnoses, such as bipolar disorder, do not require such corroboration.

Looking at the evidence of record, in a November 2003
)(5). It is important to note that, for personal assault PTSD claims, an after-the-fact medical opinion may serve as the credible supporting evidence of the reported stressor. See Menegassi v. Shinseki, 683 F.3d 1379, 1382-83 (Fed. Cir. 2011); Bradford v. Nicholson, 20 Vet. App. 200, 207 (2006); Patton, supra.

Looking at the evidence of record, in a November 2003 claim of entitlement to service connection for PTSD, the Veteran also claimed service connection for bipolar disorder, personality disorder, and schizophrenia. In an October 2024 statement, the Veteran reported that he had depressive symptoms, anxiety symptoms, mood instability, polysubstance dependence, maladaptive substance use, increased risk of suicidal behavior, increased risk of violence, trauma history, psychotic symptoms, relationship instability, homeless, and unstable housing.

In statements from January 2005, April 2008, July 2017, and January 2019, the Veteran reported that, during active service between January and February 1972, he was raped. The Veteran reported that, during basic training, there were rumors that the Veteran was homosexual because he had an earring in his left ear. He also described several traumatic incidents involving his drill instructor. The Veteran reported that, after these incidents, he made sudden requests for changes in his duty assignment or military occupational specialty; there were changes in his performance evaluations; he had increased use of leave without a medical reason; episodes of depression, panic attacks, and anxiety; increased and decreased use of prescription medication; alcohol and substance abuse; disregard for military or civilian authority; obsessive behavior such as over-eating or under-eating; and unexpected economic or social behavior changes.

In an April 2009 military sexual trauma intake form, the Veteran reported that he was sexually abused during active service by two drill instructors (a sergeant and a staff sergeant), and it was the worst time in his life. After boot camp, he would go Absent Without Leave (AWOL) because he was being harassed and sexually abused, and he received disciplinary actions for going AWOL. The Veteran stated that, if he told anyone about his sexual assaults, no one would listen, and his abuser would be defended. He also stated that he could not report his sexual assaults for fear of retaliation.

In a June 2007 statement, the Veteran's representative reported that the Veteran was diagnosed with PTSD based on an in-service personal assault. The Veteran's representative stated that the Veteran's service records do not reflect any direct complaints about the assaults, but they raise several questions that indicate that the Veteran suffered from personal assault during service. The Veteran went on unauthorized absence on several occasions following the assaults. The company commander interceded on his behalf following the periods on unauthorized absence and helped him get an honorable discharge despite the prolonged absences from duty. The Veteran's personnel records indicated that the Veteran was convicted of unauthorized absence and sentenced to confinement, incarceration, and hard labor. Despite this, the records suggest that his proficiency and conduct marks for the relevant periods of active duty were higher than scores for his entire reserve period. The Veteran's representative asserted that this corroborates the Veteran's contention that his assailant was the company commander who arranged for the honorable discharge.

In an April 2025 statement, the Veteran's representative stated that the Veteran was first diagnosed with PTSD, bipolar disorder, and substance abuse at a VA medical center on June 9, 2004.

The Veteran's service treatment records (STRs) from his active service are silent for any complaint, diagnosis, or treatment referrable to psychiatric disorders.

The Veteran's military personnel records reflect that he served as a field artillery man and cannoneer during active service. The record also reflects that the Veteran went AWOL in October 1972, January 1973, and September 1973. In February 1974, he underwent a court martial for a violation of Article 86 of the UCMJ. The Veteran was also disciplined in October 1972 and May 1973 for disobeying a lawful order, and he was disciplined in February 1973 for failure to report. In March 1973, he was suspended for three months. In October 1973, he was declared a deserter and dropped from the rolls. In January 1974, he was referred for an unauthorized absence.

In the Veteran's VA treatment records from the period on appeal, the Veteran was regularly treated for acquired psychiatric disorders, including PTSD, bipolar disorder, adjustment disorder with depressed mood and psychotic features, depression, anxiety,
. In February 1974, he underwent a court martial for a violation of Article 86 of the UCMJ. The Veteran was also disciplined in October 1972 and May 1973 for disobeying a lawful order, and he was disciplined in February 1973 for failure to report. In March 1973, he was suspended for three months. In October 1973, he was declared a deserter and dropped from the rolls. In January 1974, he was referred for an unauthorized absence.

In the Veteran's VA treatment records from the period on appeal, the Veteran was regularly treated for acquired psychiatric disorders, including PTSD, bipolar disorder, adjustment disorder with depressed mood and psychotic features, depression, anxiety, insomnia, polysubstance abuse and dependence, and alcohol use and dependence. In a March 1999 VA Mental Health Note, the Veteran endorsed bipolar symptoms, and he also admitted to heavy alcohol and drug use at the same time and during depressive episodes. The examiner stated that it was unclear as to whether these symptoms were primary or secondary due to the alcohol and drug use, and it was unclear whether the mood disorder or the alcohol and drug use came first. The examiner also stated that the Veteran met the criteria for PTSD, antisocial personality disorder, and borderline personality disorder.

In a March 2004 VA Mental Health Outpatient Treatment Plan Note, the Veteran reported that he had a history of multiple sexual trauma events starting in the military, and he asked to be referred to the military sexual trauma team.

In a March 2004 VA Mental Health Attending Note, the examiner diagnosed PTSD, bipolar disorder, polysubstance dependence, and personality disorder (with antisocial and borderline traits). The Veteran talked about his abuse by his uncles and the abuse he endured in the military (sexual and emotional).

In a November 2004 VA Mental Health E&M Note, the examiner found that, under DSM-IV criteria, the Veteran's CAPS score was considered significant and diagnostic for the presence of severe PTSD. The Veteran described his in-service sexual assault events. The Veteran reported that many of his symptoms began immediately after his first sexual assault in 1972, and they had continued chronically since then. The examiner diagnosed PTSD, bipolar disorder, and polysubstance dependence. The examiner stated that the Veteran's symptoms and reports were consistent with a diagnosis of chronic severe PTSD that was a result of the rapes and sexual abuse the Veteran suffered while in the Marines.

In a December 2004 letter, a VA physician reported that the Veteran completed a 12-week intensive cognitive processing therapy group for men with military sexual trauma, and the focus of the group was trauma recovery and improvement of mood and PTSD symptoms.

In a December 2004 letter from the Veteran's VA psychiatrist, Dr. EN reported that she had treated the Veteran since June 2002. She stated that he was initially treated for bipolar disorder until it became evident that he was also suffering from PTSD due to severe, repeated sexual abuse; he was currently in treatment with the VA military sexual trauma team.

In an October 2005 letter, a VA psychiatrist from the VA military sexual trauma team, Dr. AS, stated that the Veteran was originally diagnosed with schizoaffective disorder, bipolar subtype, and polysubstance dependence. He detailed a long history of sexual abuse while on active duty to which his response was to act out, go AWOL, and do whatever he could to get kicked out of the military so he could get away from his abusers. The Veteran was diagnosed with chronic, severe PTSD, bipolar disorder, and polysubstance dependence.

In a November 2005 letter, the Veteran's VA psychiatrist, Dr. EN, stated that the Veteran's initial diagnoses included psychosis, schizoaffective disorder, intermittent explosive disorder, polysubstance dependence, and antisocial personality disorder. In the last three years, it became evident that the Veteran suffered from PTSD due to his history of sexual abuse, and he was referred to treatment in the military sexual trauma group. Dr. EN believed that many of the Veteran's chronic symptoms could be explained by the diagnosis of complex PTSD; his diagnoses of bipolar disorder and polysubstance dependence may be intimately related to his PTSD diagnosis.

In a June 2008 VA examination, the VA examiner diagnosed PTSD, military sexual trauma, severe borderline personality disorder, antisocial personality disorder, and polysubstance dependency. The VA examiner could not find anything in the Veteran's service medical records to suggest complaints of sexual harassment, and there was no record of an incident of alleged sexual molestation. The VA examiner stated that the Veteran reported that he was raped in the military in 1972, and since that time, he had experienced symptoms of emotional distress. The VA examiner found that it was as likely as not that the Veteran had PTSD related to military sexual trauma. However, the VA examiner had great difficulty with the idea that PTSD was the sole cause of the Veteran's inappropriate behavior and unstable mood. The Veteran also had a family history of four suicides, and he was sexually molested as a child and in prison. The VA examiner suspected that a strong component of personality disorder caused the Veteran's unstable mood or behavior. The VA examiner also noted that the Veteran went many years without mentioning any complaints of military sexual trauma, and it had only been in recent years that the Veteran's complaints of military sexual trauma came to the forefront.

In a December 2008 VA medical opinion, the VA examiner was asked whether there was evidence of behavior changes in the medical records to suggest the claimed sexual assault. The VA examiner could not say with any certainty that the pattern of behavior exhibited by the Veteran while he was in the military was indicative of a response to the claimed sexual assault. As in many of these cases, there was simply not a clear-cut pattern of behavior in the military to reflect any specific diagnosis.

At a March 2019 VA examination, the VA examiner diagnosed bipolar disorder and mild cannabis use disorder. In a related medical opinion, the March 2019 VA examiner found that the claimed condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The VA examiner stated that there was no PTSD diagnosis. The VA examiner also stated that there were no clear markers for military sexual trauma occurring during the Veteran's time in service. The Veteran stated that he went to the medical clinic when the military sexual trauma first occurred, but there were no in-service records discussing the military sexual trauma or other markers indicating that military sexual trauma might have occurred at that time.

In an April 2019 VA Mental Health Attending Note, the examiner stated that the Veteran had a history of PTSD from military sexual trauma.

In an April 2019 letter, the Veteran's VA psychiatrist, Dr. JS, stated that the Veteran had been diagnosed with PTSD from military sexual trauma since 2004, and he had undergone numerous extensive evaluations at VA for this condition. Dr. JS stated that the Veteran was raped in the military around 1971 and 1972, and he reported significant changes to his behavior after the incident. These included going AWOL on five different occasions to get away from reminders of the assault. He also lost rank and was sent to the brig for his behavior. The Veteran reported being told that he should not report the rape as there could be retaliation.

Based on the aforementioned evidence, the Board finds that the evidence of record is at least in equipoise?as to?whether the Veteran's PTSD is due to military sexual trauma. Specifically, the Veteran's VA psychiatrists stated on several occasions that his PTSD was caused by or related to his in-service military sexual trauma. In addition, his psychiatric care providers regularly found the Veteran's accounts of his military sexual trauma and the ensuing behavioral changes and problems to be credible. As noted previously, an after-the-fact medical opinion may serve as the credible supporting evidence of the reported stressor for personal assault PTSD claims. See Menegassi, supra; Bradford, supra; Patton, supra. As such, the Board resolves all doubt in favor of the Veteran and finds that he has an acquired psychiatric disorder, diagnosed as PTSD, related to his in-service stressors involving personal assault. Therefore, the Board finds that service connection for PTSD is warranted. 38 U.S.C. §?5107; 38 C.F.R. §?3.102.

M. M. Celli

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Leung, Dawn

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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