ADJUSTMENT DISORDER WITH MIXED ANXIETY AND DEPRESSED MOOD

STEVEN D. REISS · 2026 · Case ID: A26038249

GRANTED

Summary

The veteran, who served in the United States Air Force from October 2002 to June 2010, including deployments to Iraq and Kuwait, appeals the July 2022 denial of service connection for psychiatric disability and tinnitus. The veteran testified at a March 2026 hearing, incorporating by reference May 2025 VA examinations and a June 2025 rating decision. The veteran claimed psychiatric symptoms, including anxiety, depression, and insomnia, began in service due to combat and continued post-service. He also claimed tinnitus started in service due to noise exposure. The Board found the May 2025 VA examination highly probative, with the examiner diagnosing insomnia disorder and adjustment disorder with mixed anxiety and depressed mood, and opining a positive nexus to service due to in-service treatment for insomnia and the absence of pre-service psychiatric issues. The Board also found the veteran's lay testimony credible and competent. For tinnitus, the Board noted the RO's favorable finding of noise exposure due to the veteran's MOS as a Loadmaster and the VA examiner's opinion that tinnitus was at least as likely as not caused by military noise exposure, supported by objective evidence of auditory damage. Service connection for both psychiatric disability and tinnitus was granted effective December 9, 2021.

Rationale

Service connection granted effective December 9, 2021.; VA examiner found positive nexus to service.; Veteran's lay testimony found credible and competent.

Service Branch

AIR FORCE

Special Benefit

NO SPECIAL BENEFIT

Docket No.

220817-268566

Full Decision Text

Citation Nr: A26038249
Decision Date: 04/23/26 Archive Date: 04/23/26

DOCKET NO. 220817-268566
DATE: April 23, 2026

ORDER

Effective December 9, 2021, service connection for psychiatric disability, diagnosed as chronic adjustment disorder, with mixed anxiety, depressed mood, and insomnia, is granted.

Effective December 9, 2021, service connection for tinnitus is granted.

FINDINGS OF FACT

1. The Veteran's psychiatric disability had its onset in service.

2. The Veteran's tinnitus had its onset in service.

CONCLUSIONS OF LAW

1. Effective December 9, 2021, the criteria for service connection for psychiatric disability, diagnosed as chronic adjustment disorder, with mixed anxiety, depressed mood, and insomnia, have been met. 38 U.S.C. §§ 1110, 1154(a), 5107(b); 38 C.F.R. §§ 3.102, 3.303.

2. Effective December 9, 2021, the criteria for service connection for tinnitus have been met. 38 U.S.C. §§ 1110, 1154(a), 5107(b); 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty with the United States Air Force from October 2002 to June 2010, to include service in Iraq and Kuwait.

This matter is before the Board of Veterans' Appeals (Board) on appeal from a July 2022 Appeals Modernization Act (AMA) rating decision by the Department of Veterans Affairs (VA) Regional Office (RO).

In the August 2022 VA Form 10182 (Notice of Disagreement), the Veteran elected the Hearing docket.

In March 2026, the Veteran testified before the undersigned Veterans Law Judge. During the hearing, the Veteran incorporated by reference the May 2025 VA examinations and June 2025 rating decision. Cash v. Collins, 166 F.4th 1046 (Fed. Cir. 2026) (finding that when, during an AMA evidentiary window, an appellant or their representative clearly identifies evidence previously submitted to the Board, that evidence is considered "submitted" and part of the evidentiary record for that appeal).

As the transcript of the proceeding reflects, during the March 2026 Board hearing, the Veteran waived 90-day period following the proceeding during which he could submit additional evidence in support of his appeal. 38 C.F.R. § 20.300(b). As such, the Board will proceed to adjudicate the Veteran's appeal.

Therefore, the Board may only consider the evidence of record at the time of the July 2022 agency of original jurisdiction (AOJ) decisions, as well as any evidence submitted by the Veteran or his attorney at the hearing. 38 C.F.R. § 20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the decision, which was subsequently subject to higher-level review and prior to the Board hearing, or (2) the period following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801.

The Board further notes that, in a June 2025 rating decision, the RO granted service connection for psychiatric disability, effective February 26, 2025, and service connection for tinnitus, effective February 26, 2025.

As will be discussed in further detail below, the Veteran's claims for service connection have been pending since December 9, 2021, and, as the benefit sought on appeal has not been granted in full, the issue remains on appeal. See generally Johnson v. Collins, 38 Vet. App. 151 (2025); Concepcion-Maldonado v. Collins, 38 Vet. App. 294 (2025); Payne v. Wilkie, 31 Vet. App. 373 (2019); Harper v. Wilkie, 30 Vet. App. 356 (2018).

As a final initial matter, the Board notes that the Board's docketing letter was sent to the Veteran's previous representative, who no longer represents the Veteran. The Board further notes, however, that the Veteran's current attorney was notified on January 12, 2026, of the scheduled hearing date and attended the hearing on behalf of the Veteran. As such, the Board will proceed with adjudication of this matter.

Service Connection

The Veteran seeks
onado v. Collins, 38 Vet. App. 294 (2025); Payne v. Wilkie, 31 Vet. App. 373 (2019); Harper v. Wilkie, 30 Vet. App. 356 (2018).

Service Connection

The Veteran seeks service connection for psychiatric disability and tinnitus, which the Veteran contends both started in service and have continued since then. See March 2026 hearing testimony.

Here, on December 9, 2021, the Veteran filed a VA Form 21-526EZ, Fully Developed Claim.

In a July 2022 rating decision, the RO denied service connection for both psychiatric disability and tinnitus. In a timely August 2022 VA Form 10182 Notice of Disagreement, the Veteran appealed the RO's decision.

During the pendency of the Veteran's appeal before the Board, in May 2025, the Veteran filed a VA Form 20-0995 Supplemental Claim seeking service connection for psychiatric disability and tinnitus. In a June 2025 rating decision, the RO granted service connection for psychiatric disability, effective February 26, 2025, and tinnitus, effective February 26, 2025, the date of the Veteran filed a VA Form 21-0966 Intent to File.

The Board finds that the claims for service connection for psychiatric disability and service connection for tinnitus have been pending since December 9, 2021, and, as the Veteran's claims have not been granted in full, it remains on appeal. See generally Concepcion-Maldonado, 38 Vet. App. 294, 300 ("[a]n appeal is live when there's still outstanding relief that the Court can provide." (citing Philbrook v. Wilkie, 32 Vet. App. 342,345 (2020)).

Based on the evidence, which will be discussed in further detail below, the Board finds that service connection for psychiatric disability and service connection for tinnitus is warranted from December 9, 2021.

Service connection may be granted for a disability resulting from disease or injury incurred or aggravated during active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Disorders diagnosed after discharge will be service connected if all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d).

Generally, service connection requires (1) the existence of a present disability, (2) in-service incurrence or aggravation of an injury or disease, 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 (Fed. Cir. 2004).

Certain chronic diseases, including tinnitus, will be presumed related to service, absent an intercurrent cause, if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service (or within an applicable presumptive period) with continuity of symptomatology since service that is attributable to the chronic disease. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309; Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013); see also Fountain v. McDonald, 27 Vet. App. 258, 271 (2015) (stating that tinnitus is a chronic disease for purposes of service connection).

The Board also notes that under certain circumstances, lay evidence may be sufficient to establish a nexus. See Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009); see also Layno v. Brown, 6 Vet. App. 465, 469 (1994). Lay evidence has been found to be competent regarding a disease that has "unique and readily identifiable features" that are "capable of lay observation." See Barr v. Nicholson, 21 Vet. App
. McDonald, 27 Vet. App. 258, 271 (2015) (stating that tinnitus is a chronic disease for purposes of service connection).

The Board is charged with the duty to assess the credibility and weight given to evidence. Madden v. Gober, 125 F.3d 1477, 1481 (Fed. Cir. 1997), cert. denied, 523 U.S. 1046 (1998); Wensch v. Principi, 15 Vet. App. 362, 367 (2001). Indeed, in Jefferson v. Principi, 271 F.3d 1072 (Fed. Cir. 2001), the United States Court of Appeals for the Federal Circuit (Federal Circuit), citing its decision in Madden, recognized that that Board had inherent fact-finding ability. Id. at 1076; see also 38 U.S.C. § 7104(a) (West 2002). Moreover, the United States Court of Appeals for Veterans Claims (Court) has declared that in adjudicating a claim, the Board has the responsibility to weigh and assess the evidence. Bryan v. West, 13 Vet. App. 482, 488-89 (2000); Wilson v. Derwinski, 2 Vet. App. 614, 618 (1992).

As a finder of fact, when considering whether lay evidence is satisfactory, the Board may also properly consider internal inconsistency of the statements, facial plausibility, consistency with other evidence submitted on behalf of the Veteran, and the Veteran's demeanor when testifying at a hearing. See Dalton v. Nicholson, 21 Vet. App. 23, 38 (2007); Caluza v. Brown, 7 Vet. App. 498, 511 (1995), aff'd per curiam, 78 F.3d 604 (Fed. Cir. 1996).

When the evidence is in approximate balance in the Veteran's favor or nearly equal 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; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990); Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc).

1. Effective December 9, 2021, service connection for psychiatric disability, is granted.

As noted above, the Veteran seeks service connection for psychiatric disability, which he contends started during his active deployment.

During the March 2026 hearing, the Veteran testified that, during one of his deployments, he was in the middle of war, flying around and being shot at, and developed anxiety due to never knowing what is going to happen the following day or on his next mission.

The Veteran testified that he sought treatment on two different occasions for insomnia during service, which he reported is due to his anxiety and later from pain and nerve damage in his knee. The Veteran stated that his anxiety, depression, and insomnia symptoms have continued since his separation from service.

The Veteran further testified that his psychiatric symptoms, noted during the May 2025 VA examination, would have been the same in 2021 had he received a VA examination. The Veteran stated that his symptoms impact his ability to work and impacted his previous marriage.

Based on the evidence of record, the Board finds that service connection for PTSD from December 9, 2021, is warranted. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(d); Shedden, 381 F.3d at 1166-67.

First, in the July 2022 rating decision, the RO favorably found that the evidence shows that a qualifying event, injury, or disease had its onset during the Veteran's service, noting that the Veteran's service treatment records dated November 6, 2007, document that the Veteran was prescribed Ambien. The Board is bound by these favorable findings. 38
previous marriage.

Based on the evidence of record, the Board finds that service connection for PTSD from December 9, 2021, is warranted. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(d); Shedden, 381 F.3d at 1166-67.

Next, in the May 2025 VA examination, which was properly incorporated during the March 2026 hearing, the VA examiner diagnosed the Veteran as having insomnia disorder and adjustment disorder with mixed anxiety and depressed mood. The examiner noted that the Veteran's service treatment records (STRs) show that the Veteran was prescribed Ambien for insomnia.

The examiner opined that the Veteran's psychiatric disability was at least as likely as not incurred in or caused by the claimed in-service injury, event, or illness, reasoning that the Veteran's enlistment documents did not suggest any prior psychiatric issues before entering into the military and that the Veteran was then was treated for insomnia and prescribed Ambien for sleep during service.

The examiner further stated that the Veteran's mood issues started in service and worsened over time due to several life stressors, such as the death of friends.

The Board finds the May 2025 VA opinion to be highly probative, as it presents the medical opinion of a competent expert, based on the physical examination of the Veteran and review of the record. Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008).

In its role as a finder of fact, the Board finds the Veteran' reports of his insomnia, depression, and anxiety during and since service to be credible. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). The Board further finds that the Veteran is competent to report his psychiatric symptomatology during and since service. See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009).

As such, the Board finds that the competent and credible medical and lay evidence supports the claim, and, as such, from December 9, 2021, service connection for psychiatric disability is warranted. 38 U.S.C. § 5107 (b); Lynch, 21 F.4th 776.

2. Effective December 9, 2021, service connection for tinnitus is granted.

The Veteran seeks service connection for tinnitus, which he testified started in service and have continued since then. See March 2026 hearing testimony.

Based on the evidence of record, the Board finds that service connection for tinnitus from December 9, 2021, is warranted. Additionally, the Board notes that tinnitus is a chronic disability under 38 C.F.R. §§ 3.307, 3.309. See Fountain, 27 Vet. App. at 271.

First, in the July 2022 rating decision, the RO favorably found that the evidence shows that a qualifying event, injury, or disease had its onset during the Veteran's service, noting that the Veteran's military occupational specialty (MOS) while on active duty, Loadmaster, had a high probability for hazardous noise exposure. The RO additionally conceded the Veteran's noise exposure. The Board is bound by these favorable findings. 38 C.F.R. § 3.104(c).

In the May 2025 VA examination, which was appropriately incorporated during the March 2026 hearing, the VA examiner diagnosed the Veteran with tinnitus and opined that it was at least as likely as not that the Veteran's tinnitus was caused by or a result of military noise exposure.

The examiner reasoned that the Veteran had a significant shift in hearing thresholds from entrance audiogram dated September 2002 to audiogram dated May 2005, which the examiner stated is indicative of possible damage to the auditory system from conceded noise on active duty. The examiner further stated that the relationship between noise exposure, auditory damage, and tinnitus is well-documented, and the objective evidence supports a nexus of auditory damage.

During the examination, the Veteran reported that his tinnitus started suddenly in 2009, while teaching a class. The examiner further stated that he continues to have bilateral recurrent tinnitus.

The Board finds the May 2025
the Veteran's tinnitus was caused by or a result of military noise exposure.

During the examination, the Veteran reported that his tinnitus started suddenly in 2009, while teaching a class. The examiner further stated that he continues to have bilateral recurrent tinnitus.

The Board finds the May 2025 VA examination report to be probative, as it is consistent with the evidence of record.

Further, tinnitus is a disability for which a lay person may offer a competent diagnosis. See Charles v. Principi, 16 Vet. App. 370, 374 (2002). The Veteran was competent to report what he has experienced, and the Board has found the Veteran to be credible. Therefore, the Veteran's statements that his tinnitus began during active service due to noise exposure and continued since are assigned significant probative weight.

As such, the Board finds that the competent and credible medical and lay evidence supports the claim, and, as such, from December 9, 2021, service connection for tinnitus is warranted. 38 U.S.C. § 5107(b); Lynch, 21 F.4th 776.

STEVEN D. REISS

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board B. Mountjoy, 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.

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