POSTTRAUMATIC STRESS DISORDER (PTSD)

Summary

The Veteran, an Army Veteran who served from February 1968 to February 1971, including service in Vietnam at Long Binh base, appeals the denial of service connection for PTSD, insomnia/sleep disorder, and unspecified anxiety disorder. The Veteran submitted a claim in September 2024, detailing combat experiences in Vietnam during the Tet offensive, including mortar and rocket attacks and exposure to small arms fire. He reported continuous sleep difficulties since the 1970s and anxiety symptoms. The Board reviewed the Veteran's service records, which confirmed his Vietnam service and a meritorious service award related to military operations against a hostile force. The Board found the Veteran's reports of stressful events consistent with his service and deemed him competent and credible in reporting them. The RO had conceded a stressor based on Vietnam service. While a VA examiner in October 2024 did not diagnose PTSD, a private psychiatric evaluation in September 2025, submitted in January 2026, diagnosed PTSD under DSM-5 criteria and found the Veteran's sleep and anxiety disorders to be secondary to PTSD. The private examiner detailed chronic PTSD symptoms and linked them to the in-service trauma, concluding intelligence was unrelated to PTSD. The Board found the private evaluation persuasive, resolving reasonable doubt in the Veteran's favor to grant service connection for PTSD. The Board also found the insomnia/sleep disorder and unspecified anxiety disorder to be due to the service-connected PTSD, granting service connection for all three conditions.

Rationale

Veteran's service records confirm Vietnam service and meritorious award related to hostile operations.; Veteran's reports of stressful events deemed consistent with service and credible.; RO conceded a stressor based on Vietnam service.; Private psychiatric evaluation diagnosed PTSD under DSM-5 criteria and linked it to in-service trauma.; Board resolved reasonable doubt in Veteran's favor to grant PTSD.

Full Decision Text

Citation Nr: A26040453
Decision Date: 04/30/26	Archive Date: 04/30/26

DOCKET NO. 260112-614263
DATE: April 30, 2026

ORDER

Entitlement to service connection for posttraumatic stress disorder (PTSD) is granted.

Entitlement to service connection for insomnia/sleep disorder is granted.

Entitlement to service connection for unspecified anxiety disorder (also claimed as anxiety, depression, and panic disorder) is granted. 

FINDINGS OF FACT

1. Resolving reasonable doubt in the Veteran's favor, it is at least as likely as not that he has PTSD, which is related to the stressful events that he witnessed during his active service.

2. The Veteran's insomnia/sleep disorder is due to his PTSD.

3. The Veteran's unspecified anxiety disorder (also claimed as anxiety, depression, and panic disorder) is due to PTSD.

CONCLUSIONS OF LAW

1. The criteria for entitlement to service connection for PTSD have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 4.125.

2. The criteria for entitlement to service connection for insomnia/sleep disorder have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.310.

3. The criteria for entitlement to service connection for unspecified anxiety disorder (also claimed as anxiety, depression, and panic disorder) have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.310.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty in the United States Army from February 1968 to February 1971.

This case comes before the Board of Veterans' Appeals (Board) on appeal from a January 2025 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO).

In the January 12, 2026 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Evidence Submission docket. Therefore, the Board may only consider the evidence of record at the time of the January 2025 RO decision on appeal, as well as any evidence submitted by the Veteran or representative with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the RO issued the decision on appeal and prior to the date the Board received the VA Form 10182, or (2) more than 90 days following the date the Board received the VA Form 10182, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.303, 20.801.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a supplemental claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the 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.

1. Entitlement to service connection for PTSD is granted.

2. Entitlement to service connection for insomnia/sleep disorder is granted.

3. Entitlement to service connection for unspecified anxiety disorder (also claimed as anxiety, depression, and panic disorder) is granted.

In September 2024, the Veteran filed a claim for a psychiatric disorder, to include insomnia/sleep disorder, PTSD, anxiety, depression, and panic disorder, and stated that his psychiatric disorders are related to his combat service in Republic of Vietnam. In a September 2024 statement in support of claim, the Veteran stated that during his service in Vietnam, he was in combat where he was shot at by an AK 47 when he was on Long Binh for the second Tet offensive. They were attacked with mortars and rockets in a ground attack where the perimeter was breached. He stated that Cobra gunships and the 11th armored CAV came in and cleaned out the enemy. The Veteran asserted that after his service in Vietnam, he has been using medicine to sleep since the 1970s, and have been prescribed Paroxetine for about 10 years. He stated that he gets anxious anytime he
 and stated that his psychiatric disorders are related to his combat service in Republic of Vietnam. In a September 2024 statement in support of claim, the Veteran stated that during his service in Vietnam, he was in combat where he was shot at by an AK 47 when he was on Long Binh for the second Tet offensive. They were attacked with mortars and rockets in a ground attack where the perimeter was breached. He stated that Cobra gunships and the 11th armored CAV came in and cleaned out the enemy. The Veteran asserted that after his service in Vietnam, he has been using medicine to sleep since the 1970s, and have been prescribed Paroxetine for about 10 years. He stated that he gets anxious anytime he must wait or stuck in traffic. He is not violent but gets upset.

Generally, service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004).

Service connection may also be granted for a disability that is due to, caused by, or resulted from, or aggravated by, service-connected disease or injury. 38 C.F.R. § 3.310. Secondary service connection requires: (1) a service-connected disability; (2) a nonservice-connected disability; and (3) evidence that the nonservice-connected disability is either (a) due to, caused by, or the result of the service-connected disability or (b) aggravated (increased in severity) by the service-connected disability. Id.

Service connection for PTSD requires (1) medical evidence diagnosing the condition in accordance with 38 C.F.R. § 4.125(a); (2) a link, established by medical evidence, between current symptoms and an in-service stressor; and (3) credible supporting evidence that the claimed in-service stressor occurred. 38 C.F.R. § 3.304(f).

For cases certified to the Board on or after August 4, 2014, the diagnosis of PTSD must be in accordance with the American Psychiatric Association's Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition (DSM-5), otherwise DSM-IV is applicable. See 38 C.F.R. § 4.125(a); 79 Fed. Reg. 45,093, 45,094 (Aug. 4, 2014); 80 Fed. Reg. 14,308 (Mar. 19, 2015). This case was certified to the Board after August 4, 2014; therefore, DSM-5 is applicable.

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).

When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the benefit of the doubt should be given to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. When, after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding service origin, the degree of disability, or any other point, such doubt should be resolved in favor of the claimant. 38 C.F.R. § 3.102.

Thus, the question for the Board is whether the Veteran has a current psychiatric disorder that began during active service or is at least as likely as not related to an in-service injury, event, or disease, including the above noted in-service stressor.

Initially, the Board notes that the Veteran's personnel records reflect that he served in Vietnam at Long Binh base from January 1969 to January 1970 during active service, and he received an award for meritorious service in connection with military operations against a hostile force. Thus, the Board finds that the Veteran's reports of in-service stressful events are consistent with places and circumstances of his service. There is no evidence to contradict the Veteran's reports of stressful events that occurred during his active service, and the Board finds the Veteran competent and credible in reporting these
 current psychiatric disorder that began during active service or is at least as likely as not related to an in-service injury, event, or disease, including the above noted in-service stressor.

Initially, the Board notes that the Veteran's personnel records reflect that he served in Vietnam at Long Binh base from January 1969 to January 1970 during active service, and he received an award for meritorious service in connection with military operations against a hostile force. Thus, the Board finds that the Veteran's reports of in-service stressful events are consistent with places and circumstances of his service. There is no evidence to contradict the Veteran's reports of stressful events that occurred during his active service, and the Board finds the Veteran competent and credible in reporting these events. Additionally, as a favorable finding, in the January 2025 rating decision on appeal, the RO conceded a stressor based on the Veteran's service in Vietnam.

Regarding the current diagnosis of a psychiatric disorder, as a favorable finding, in the January 2025 rating decision on appeal, the RO noted that the Veteran has unspecified anxiety disorder and insomnia. Also, several VA treatment records, including an October 2024 VA treatment record, noted the diagnoses of anxiety and insomnia.

Regarding the diagnosis of PTSD, in an October 2024 VA examination report for PTSD, the VA examiner noted that the Veteran did not meet the criteria for a diagnosis of PTSD. However, in a September 2025 private psychiatric evaluation, which was submitted in January 2026 during the evidentiary period, a psychiatrist noted that the Veteran has the diagnosis of PTSD under DSM-5 criteria. The psychiatrist stated that the Veteran has a broad range of chronic PTSD symptoms that, while not the most severe, meet DSM-5-TR criteria. Thus, after resolving reasonable doubt in the Veteran's favor, the Board finds that the Veteran has the diagnosis of PTSD.

In the September 2025 private psychiatric evaluation, the private examiner described in detail the Veteran's family, social, and work history, and observations during the mental status examination. The examiner noted that the Veteran has the diagnosis of PTSD under DSM-5 criteria, and that his sleep and anxiety disorders are significant, but best understood as resulting from his stress and trauma disorder, rather than as separate entities. The examiner explained that the Veteran has a broad range of chronic PTSD symptoms that, while not the most severe, meet DSM-5-TR criteria. The examiner stated that these symptoms have been present to varying degrees since the Veteran's time in service, when he began re-experiencing problems following his yearlong combat deployment in Vietnam. The major stressful traumatic event was the attack that penetrated his base and directly exposed him to fire while he watched a jeep and a bus he had been wanting to shelter under, blow up in flames. In addition to multiple mortar and rocket attacks, he was also exposed to direct small arms fire from closer range. Other incidents contributed to this condition.

Furthermore, the examiner stated that the Veteran's PTSD symptoms over time have included nightmares, intrusive and disturbing memories triggered by a variety of recollections or events, flashbacks, hypervigilance, startle reflex, social distancing, panic, isolation and avoidance, and proneness to rage and anger. These have been accompanied by long-term sleep disturbance, and chronic anxiety with panic attacks. All of these directly result from his in-service traumatic exposures and have led to a chronically diminished quality of life. His ability to be free from depression and anxiety disappeared during his time in Vietnam. His generally good work history was made possible largely due to being able to work alone and independently.

The examiner noted that it has been alleged that the Veteran had mental health problems prior to his Army service, which involves a misunderstanding of the circumstances of his induction. The examiner noted that it is well documented that when more troops were needed because the escalation of the war required increased draft calls and troop levels, Secretary of Defense R. S. M. implemented a policy termed "Project 100,000". This allowed the recruitment of draftees who would previously have been below military mental standards. Specifically, standards were dropped by 6 percent to an IQ of 80, representing the 10th percentile, and that change then encompassed the Veteran's score. He did not have pre-military mental health problems; he scored low on the mental aptitude test in 1965, but by the new standard he became draft eligible. Therefore, the examiner concluded that intelligence is completely unrelated to a condition such as PTSD.

In this regard, the Board notes that in the January 2025 rating decision on appeal, the RO noted that entrance examination dated June 27, 1967 in service treatment records show that a mental condition existed prior to military service. However, the Board notes that only in the June 27, 1967 Pre-induction Report of Medical History, the Veteran noted that he was previously rejected in June 
10th percentile, and that change then encompassed the Veteran's score. He did not have pre-military mental health problems; he scored low on the mental aptitude test in 1965, but by the new standard he became draft eligible. Therefore, the examiner concluded that intelligence is completely unrelated to a condition such as PTSD.

In this regard, the Board notes that in the January 2025 rating decision on appeal, the RO noted that entrance examination dated June 27, 1967 in service treatment records show that a mental condition existed prior to military service. However, the Board notes that only in the June 27, 1967 Pre-induction Report of Medical History, the Veteran noted that he was previously rejected in June 1965 for "mental" reason, which does not reflect that he had a mental health condition. Additionally, in the June 27, 1967 Pre-induction Examination report, the examiner did not note any mental health condition. Only the conditions that are recorded in the entrance examination report are considered as existed prior to the military entrance. See 38 C.F.R. § 3.304(b). In the Veteran's case, no mental health condition was noted by the examiner on the entrance examination report.

Thus, the Board finds that the above noted September 2025 private psychiatric evaluation and opinion are adequate and have great probative value because the examiner provided adequate explanation that contains clear conclusions and supporting data. See Nieves Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008).

The Board notes that in the October 2024 VA examination report for PTSD, the examiner did not note the diagnosis of PTSD, but noted the diagnosis of unspecified anxiety disorder. However, the examiner did not provide an opinion as to whether the Veteran's claimed psychiatric disorder is related to active service.

Thus, upon review of the record, the Board finds the evidence of record is at least in equipoise as to whether the Veteran has current diagnosis of PTSD, which is at least as likely as not related to the stressful events that he witnessed during his active service.

Accordingly, after resolving reasonable doubt in the Veteran's favor, the Board finds that entitlement to service connection for PTSD is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102.

Regarding the Veteran's diagnosed insomnia/sleep disorder and unspecified anxiety disorder, the Board finds that these are due to his PTSD. As noted above, in the September 2025 private psychiatric evaluation, the examiner stated that the Veteran's sleep and anxiety disorders are significant, but best understood as resulting from his stress and trauma disorder, rather than as separate entities. Furthermore, the examiner stated that the Veteran's PTSD symptoms over time have included nightmares, intrusive and disturbing memories triggered by a variety of recollections or events, flashbacks, hypervigilance, startle reflex, social distancing, panic, isolation and avoidance, and proneness to rage and anger. These symptoms have been accompanied by long-term sleep disturbance, and chronic anxiety with panic attacks.

Accordingly, the Board concludes that the Veteran's insomnia/sleep disorder and unspecified anxiety disorder (also claimed as anxiety, depression, and panic disorder) are due to PTSD, which is now a service-connected condition.

Consequently, entitlement to service connection for PTSD, insomnia/sleep disorder, and unspecified anxiety disorder (also claimed as anxiety, depression, and panic disorder) is granted.

 

 

MICHAEL MARTIN

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Nadeem Tariq, 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.