PTSD DUE TO PERSONAL TRAUMA

Summary

The Veteran, who served in the U.S. Marine Corps from July 1980 to July 1984, appeals the denial of service connection for an acquired psychiatric condition due to military sexual trauma (MST). The Veteran claims multiple instances of personal assault by a commanding officer during service, accompanied by threats of retaliation if reported. He reported subsequent difficulties with trust, relationships, hypervigilance, anger, depression, and employment due to these events. The Board found the Veteran's lay statements regarding the assaults and subsequent behavioral changes to be competent and credible, noting his consistent reporting and awareness of stigma. A private medical opinion in January 2024 linked his panic attacks, anxiety, distressing memories, and depression to these in-service experiences. A VA examination in May 2024 diagnosed an unspecified anxiety disorder and opined that the condition was at least as likely as not incurred due to the claimed in-service injury, acknowledging behavioral markers such as termination of employment due to aggression and avoidance of female co-workers. The Board afforded probative weight to both the private and VA opinions, finding them sufficiently detailed and consistent with the evidence. The Board granted service connection for the acquired psychiatric condition (anxiety and depression) due to MST.

Rationale

Veteran's lay statements regarding personal assault and subsequent behavioral changes found competent and credible.; Private medical opinion linked symptoms to in-service experiences.; VA examination opined condition was at least as likely as not incurred due to in-service injury, acknowledging behavioral markers.

Full Decision Text

Citation Nr: A26040432
Decision Date: 04/29/26	Archive Date: 04/29/26

DOCKET NO. 250118-510767
DATE: April 29, 2026

ORDER

Entitlement to service connection for an acquired psychiatric condition as due to military sexual trauma is granted. 

FINDING OF FACT

The Veteran has submitted competent, credible evidence that his acquired psychiatric condition, diagnosed as anxiety and depression, is due to in-service military sexual trauma. 

CONCLUSION OF LAW

The criteria for entitlement to service connection for an acquired psychiatric condition have been met.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304(f), 4.125(a).

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served in the U.S. Marine Corps from July 1980 to July 1984. 

This case is being reviewed according to the appellate process set forth under the Appeals Modernization Act (AMA). 38 C.F.R. § 19.2. The AMA or modernized review system applies to all claims, requests for reopening of finally adjudicated claims, and requests for revision based on clear and unmistakable error for which VA issues notice of an initial decision on or after February 19, 2019, the effective date of the modernized review system. See 38 C.F.R. § 3.2400.

This matter comes before the Board of Veterans' Appeals (Board) following a decision issued in January 2025 by the Department of Veterans Affairs (VA) Regional Office (RO) which denied entitlement to service connection for an acquired psychiatric condition.

The Veteran initiated his claim seeking entitlement to service connection for an acquired psychiatric condition in September 2021. In December 2021 a decision on the Veteran's claim was deferred and a January 2022 rating decision denied service connection. 

In December 2023, the Veteran submitted a VA Form 20-0995, Decision Review Request: Supplemental Claim, and requested readjudication of entitlement to service connection for an acquired psychiatric condition most recently addressed in a January 2022 rating decision. The AOJ addressed the merits of the Veteran's claim which is an implicit finding that new and relevant evidence sufficient to readjudicate the claim had been received. An August 2023 rating decision denied entitlement to service connection for anxiety and two August 2023 decisions deferred a determination regarding service connection for depression. In September 2024, the AOJ denied entitlement to service connection for depression. 

In September 2024, the Veteran submitted a VA Form 20-0996, Decision Review Request: Higher-Level Review (HLR), and requested review of the August and September 2024 decisions.  In January 2025, the agency of original jurisdiction (AOJ) issued the HLR decision on appeal, which considered the evidence of record at the time of the prior August and September 2024 decisions. The January 2025 HLR decision denied the Veteran's claims.

The Veteran filed a VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement) in January 2025 and elected the Direct Review docket. 

Therefore, the Board may only consider the evidence of record at the time of the January 2025 agency of original jurisdiction (AOJ) decision, which was subsequently subject to higher-level review. 38 C.F.R. § 20.301. If evidence was submitted during the period after the AOJ issued the decision, which was subsequently subject to higher-level review the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.301, 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 claims, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. 

Law and Analysis

In order to establish service connection for a present disability the claimant must show the existence of a present disability, an in-service incurrence or aggravation of a disease or injury, and a causal relationship or "nexus" between the present disability and the in-service injury or disease. Saunders v. Wilkie, 88 F.3d 1356, 1361 (Fed. Cir. 2018); Shedden v. Principi, 381 F.3
2501. If the evidence is new and relevant, VA will issue another decision on the claims, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. 

Law and Analysis

In order to establish service connection for a present disability the claimant must show the existence of a present disability, an in-service incurrence or aggravation of a disease or injury, and a causal relationship or "nexus" between the present disability and the in-service injury or disease. Saunders v. Wilkie, 88 F.3d 1356, 1361 (Fed. Cir. 2018); Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004).

The Veteran's claim is predicated on allegations of sexual assault and sexual harassment while he was in the military.  The Court has set a relatively low bar for interpreting a claim for an acquired psychiatric condition to include PTSD involving a personal assault stressor for which the provisions of 38 C.F.R. § 3.304(f)(5) are applicable.  See, e.g., Bradford v. Nicholson, 20 Vet. App. 200 (2006) (veteran alleged that his sergeant kicked him down a set of stairs).  In this regard, VA has defined "personal trauma" in a broad sense.  Personal trauma for the purpose of VA disability compensation claims based on an acquired psychiatric condition refers broadly to stressor events involving harm perpetrated by a person who is not considered part of an enemy force.  Examples include assault, battery, robbery, mugging, stalking, and harassment.  Military sexual trauma (MST) is a subset of personal trauma and refers to sexual harassment, sexual assault, or rape that occurs in a military setting.

Because personal assault is an extremely personal and sensitive issue, many incidents are not officially reported, which creates a proof problem with respect to the occurrence of the claimed stressor.  In such situations, it is not unusual for there to be an absence of service records documenting the events the veteran has alleged surrounding the assault.  The victims of such trauma may not necessarily report the full circumstances of the trauma for many years after the trauma.  Therefore, the Federal Circuit has held that VA cannot use the absence of service record documentation or a veteran's lack of report of in-service sexual assault to military authorities as evidence to conclude that a sexual assault did not occur.  AZ v. Shinseki, 731 F.3d 1303, 1318 (Fed. Cir. 2013).  Further, for an acquired psychiatric condition claims in general, corroboration of every detail of a claimed stressor, including the veteran's personal participation, is not required; rather, a veteran only needs to offer independent evidence of a stressful event that is sufficient to imply his or her personal exposure.  See Pentecost v. Principi, 16 Vet. App. 124, 128 (2002) (quoting Suozzi v. Brown, 10 Vet. App. 307 (1997)).

When an acquired psychiatric condition 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); see also Patton v. West, 12 Vet. App. 272, 277 (1999).  Examples of such alternative 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.  38 C.F.R. § 3.304(f)(5).  Personal diaries and journals can also be relevant.

If primary evidence such as service treatment and personnel records contain no explicit documentation that personal trauma occurred, and alternative sources of evidence do not provide credible supporting evidence of the trauma, evidence of behavioral changes around the time of, and after, the incident(s), may constitute a "marker" of a personal trauma stressor.  The term "marker" means an indicator of the effect or consequences of the personal trauma on the veteran.  A marker could be one or more behavioral events, or a pattern of changed behavior. Even if there is no reference to the personal trauma, evidence of behavior changes may circumstantially support the possibility that the claimed stressor occurred.  Evidence of behavior changes or "markers" following the claimed assault, which 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
 of behavioral changes around the time of, and after, the incident(s), may constitute a "marker" of a personal trauma stressor.  The term "marker" means an indicator of the effect or consequences of the personal trauma on the veteran.  A marker could be one or more behavioral events, or a pattern of changed behavior. Even if there is no reference to the personal trauma, evidence of behavior changes may circumstantially support the possibility that the claimed stressor occurred.  Evidence of behavior changes or "markers" following the claimed assault, which 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.  38 C.F.R. § 3.304(f)(5).

In addition, other relevant behavior changes or "markers" include increased use of leave with no apparent reason; medical treatment at a clinic without any specific diagnosis; use of or increased interest in pregnancy or STD tests around the time of the incident; changes in prescription usage and over-the-counter usage; increased disregard for any type of authority; treatment for physical injuries around the time of the alleged trauma, but without mention of the actual trauma; and the breakup of a primary relationship.  Notably, behavior changes can be verified through both documentary evidence and lay statements.  Id.

For personal assault claims, an after-the-fact medical opinion can also serve as the credible supporting evidence of the stressor.  That is, VA examiners can interpret the evidence of record to confirm the occurrence of in-service sexual assaults, personal trauma, and harassment.  38 C.F.R. § 3.304(f)(5); Menegassi v. Shinseki, 638 F.3d 1379, 1383 (Fed. Cir. 2011).  In fact, evidence of behavioral changes typically needs interpretation by a clinician in personal trauma claims.  The VA examiner should determine whether credible factual evidence of behavior changes demonstrated by the Veteran is consistent with the expected reaction or adjustment of a person who has been subjected to an assault.  If the VA examiner offers a credible, unequivocal, and non-speculative assessment that the evidence of record is consistent with the occurrence of the claimed assault, that opinion can constitute credible supporting evidence that the claimed in-service stressor actually occurred.  If the opinion is merely speculative, equivocal, contradictory, or otherwise insufficient for rating purposes, it should be returned for clarification.  If the VA examiner determines that a personal assault did occur, the VA examiner should then opine whether or not the Veteran has an acquired psychiatric condition due to the confirmed personal assault.

Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits. VA shall consider all information and lay and medical evidence of record in a case and when there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (benefit-of-the-doubt rule not for application when evidence persuasively favors one side or the other).

Acquired Psychiatric Condition 

The Veteran seeks entitlement to service connection for depression and anxiety due to military sexual trauma (MST). The Board recharacterizes the Veteran's claim to include any acquired psychiatric condition that is reasonably raised by the record. Clemons v. Shinseki, 23 Vet. App. 1 (2009).

The January 2025 rating decision made the favorable findings that the Veteran has current diagnoses of anxiety disorder and major depressive disorder. The Board is bound by the favorable findings of the AOJ, absent clear and unmistakable evidence to the contrary. 38 U.S.C. § 5104A; 38 C.F.R. § 20.801(a).

The Veteran has provided two statements in January 2024 describing multiple personal assaults from a commanding officer while in service. He reports being isolated by a female commanding officer, grabbed in a sexual manner, and threatened to be reported as the aggressor if he told anyone. The Veteran described multiple incidents of personal assault where each was followed by threats of retaliation if he reported the assault. The Veteran reported subsequent difficulty working with women or having a woman as a boss. He noted difficulty maintaining employment as a result of this and his symptoms of anger, depression, and anxiety related to the personal assault. The Veteran's statements note difficulty reporting the personal assault due to the stigma around the events. At the time of the events, he did not think anyone would believe his claim. See January 2024
 January 2024 describing multiple personal assaults from a commanding officer while in service. He reports being isolated by a female commanding officer, grabbed in a sexual manner, and threatened to be reported as the aggressor if he told anyone. The Veteran described multiple incidents of personal assault where each was followed by threats of retaliation if he reported the assault. The Veteran reported subsequent difficulty working with women or having a woman as a boss. He noted difficulty maintaining employment as a result of this and his symptoms of anger, depression, and anxiety related to the personal assault. The Veteran's statements note difficulty reporting the personal assault due to the stigma around the events. At the time of the events, he did not think anyone would believe his claim. See January 2024 and January 2024 lay statements. 

The Veteran provided a January 2024 private medical opinion which opined the Veteran's panic attacks, anxiety, distressing memories, and depression are more likely than not related to his in-service experiences. The provider noted the Veteran's report of multiple instances of sexual assault from a female commanding officer including the threats of retaliation should the Veteran report the events. The provider described ongoing trust issues, difficulty in relationships, suspiciousness, anger, depression, and continual hypervigilance associated with his in-service personal assault. See January 2024 private medical opinion. 

The Veteran was afforded a VA examination in May 2024 which found he does not have a diagnosis of posttraumatic stress disorder which conforms to the DSM-V. The examiner noted a diagnosis of unspecified anxiety disorder. The examiner opined the Veteran's condition was at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) incurred in or caused by the claimed in-service injury, event, or illness. The rationale acknowledged the Veteran's military personnel records and service treatment records do not reflect an in-service instance of MST. The examiner found that the Veteran's behavioral changes following service constitute markers of the in-service stressor including the Veteran's reports of termination of employment due to over aggression, difficulty establishing and maintaining romantic relationships, and avoidance of female co-workers. The examiner found that, given the totality of the evidence, the claimed condition was at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) incurred in or caused by the claimed in-service injury, event, or illness. See May 2024 medical opinion. 

The Board affords probative weight to the January 2024 private medical opinion and May 2024 VA medical opinion as both providers considered the whole of the Veteran's lay reports, ongoing psychiatric symptoms, and their own medical knowledge in reaching the provided opinions. 

The Board notes there is no reasons and bases requirement on examiners, and no need for them to comment of every favorable piece of evidence in the claims file. Acevedo v. Shinseki, 25 Vet. App. 286, 293-94 (2012). Additionally, a medical opinion must be read as a whole. Monzingo v. Shinseki, 26 Vet. App. 97, 106 (2012) (indicating that an examiner does not need to explicitly lay out their "journey from facts to a conclusion," because the medical report must be read as a whole). Upon review, the Board finds that the January and May 2024 opinions, when read as a whole, sufficiently informs the Board of the medical experts' judgment on the relevant medical questions and the "essential rationale" for the opinions. Monzingo, supra; Acevedo, supra. In this regard, where the opinion is lacking in detail, "the Board is permitted to draw inferences based on the overall report so long as the inference does not result in a medical determination." Acevedo, 25 Vet. App. at 294.

The Board also find the Veteran's reports of an in-service personal assault are competent and credible. The Board notes a lay person is competent to report the onset and recurrence of his symptoms. See Layno v. Brown, 6 Vet. App. 465 (1994).

The Board further finds the Veteran's reports of an in-service personal assault are credible. When assessing the credibility of lay evidence, the Board may consider factors such as facial plausibility, bias, self-interest, and consistency with other evidence of record. Southall-Norman v. McDonald, 28 Vet. App. 346, 355 (2016). Here, the Veteran has consistently reported multiple instances of assault and his subsequent onset of psychiatric symptoms. The Veteran also has noted he did not report the events during service as he was aware of the stigma associated with personal assault and he did not think others in service would believe him. The medical opinions of record concluded the Veteran's symptoms are more likely than not the result of his reported in-service personal assault due to his behavioral markers
 reports of an in-service personal assault are credible. When assessing the credibility of lay evidence, the Board may consider factors such as facial plausibility, bias, self-interest, and consistency with other evidence of record. Southall-Norman v. McDonald, 28 Vet. App. 346, 355 (2016). Here, the Veteran has consistently reported multiple instances of assault and his subsequent onset of psychiatric symptoms. The Veteran also has noted he did not report the events during service as he was aware of the stigma associated with personal assault and he did not think others in service would believe him. The medical opinions of record concluded the Veteran's symptoms are more likely than not the result of his reported in-service personal assault due to his behavioral markers. 

Based on the foregoing, the Board finds the Veteran's acquired psychiatric condition diagnosed as anxiety disorder and major depressive disorder is due to his reported in-service MST. 

Accordingly, entitlement to service connection for an acquired psychiatric condition is granted. 

(Continued on the next page)

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The Board acknowledges the Veteran also raised entitlement to service connection for an acquired psychiatric condition due to service-connected tinnitus. See November 2024 statement. As the Board is granting the Veteran's claim on a direct basis which represents a full grant of the benefit sought, the theory of entitlement regarding secondary service connection is not addressed.

 

 

K. Parakkal

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Filsinger, Alexandra Q.

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.