FIBROMYALGIA

SHEREEN M. MARCUS · 2026 · Case ID: A26040686

DENIED

Summary

The Veteran served in the Army from June 2002 to June 2008, with additional Reserve service until July 2009, including service in Southwest Asia. The Veteran appeals the dismissal of an issue regarding a proposed reduction in his fibromyalgia rating and the denial of service connection for PTSD and depressive disorder. The Board dismissed the fibromyalgia issue, finding that a proposed rating reduction is not a final decision and therefore not appealable to the Board. Regarding the psychiatric claims, the Board acknowledged the Veteran's reported combat stressors in Afghanistan, such as mortar attacks and witnessing aerial combat, and found these sufficient to establish that the Veteran engaged in combat with the enemy. However, the Board found the evidence persuasively weighed against a current DSM-5 diagnosis of PTSD. Post-service treatment records consistently showed negative PTSD screenings, and multiple VA examinations concluded the Veteran did not meet the DSM-5 criteria for PTSD. While some records and a private evaluation suggested a PTSD diagnosis, the Board afforded more weight to VA examinations that explicitly found no PTSD and diagnosed unspecified anxiety disorder or depressive disorder. The Board noted the Veteran was already service-connected for unspecified anxiety disorder and found that his reported symptoms, even if indicative of depressive disorder, were fully contemplated within the existing anxiety disorder rating, rendering a separate service connection for depressive disorder unnecessary. Therefore, service connection for PTSD and depressive disorder was denied.

Rationale

Proposed rating decision is not a final decision; Not appealable to the Board under 38 U.S.C. § 7105; Notice of disagreement improperly docketed

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250228-522220

Full Decision Text

Citation Nr: A26040686
Decision Date: 04/30/26 Archive Date: 04/30/26

DOCKET NO. 250228-522220
DATE: April 30, 2026

ORDER

The appeal of a proposed reduction from 40 percent to 20 percent for fibromyalgia is dismissed.

Entitlement to service connection for a psychiatric disability to include posttraumatic stress disorder (PTSD) and depressive disorder is denied.

FINDINGS OF FACT

1. The January 2025 proposal to reduce the Veteran's disability rating for fibromyalgia was not an adjudicative determination.

2. The persuasive weight of the evidence is against a finding that the Veteran has a DSM-5 diagnosis of PTSD and that his current mental health symptomatology is entirely contemplated within his already service-connected unspecified anxiety disorder.

CONCLUSIONS OF LAW

1. The appeal of a proposed reduction from 40 percent to 20 percent for fibromyalgia is dismissed as a matter of law. 38 U.S.C. § 7105; 38 C.F.R. §§ 3.2500, 20.205.

2. The criteria for service connection for a psychiatric disability to include PTSD and depressive disorder have not been met. 38 C.F.R. §§ 1110, 1154(b), 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304(f).

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from June 2002 to June 2008 with additional service in the Army Reserve from June 2008 to July 2009 and service in Southwest Asia.

This matter comes to the Board of Veterans' Appeals (Board) on appeal from January and February 2025 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO).

In the February 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the January and February 2025 notifications of the agency of original jurisdiction (AOJ) decisions on appeal. 38 C.F.R. § 20.301. Any evidence submitted after notification of the AOJ decisions on appeal cannot be considered by the Board. 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.

The Veteran indicated in his February 2025 VA Form 10182 notice of disagreement that he wished to also appeal the noncompensable rating assigned for his PFB stemming from a March 2024 rating decision. However, the Board notes that the Veteran previously appealed the identical issue, which was addressed previously in a July 2025 Board decision. The Veteran thereafter appealed the Board's decision to the Court of Appeals for Veteran's Claims (Court), which subsequently vacated the Board decision and remanded the said Board decision for further development in accordance with a Joint Motion for Remand. Hence, the Board finds that additional adjudication of the claim for a higher compensable rating for PFB at this time is unnecessary as the matter will be addressed by way of Court Order in a separate Board decision.

1. The appeal of a proposed reduction from 40 percent to 20 percent for service-connected fibromyalgia is dismissed.

In January 2025, the Veteran underwent a VA examination regarding his service-connected fibromyalgia. In the January 2025 rating decision on appeal, the AOJ proposed to decrease the current rating for fibromyalgia from 40 percent to 20 percent based on the examination results. The Veteran was provided notification of the AOJ's proposed decision in January 2025.

In February 2025, the Veteran filed a VA Form 10182 notice of disagreement purporting to the proposed reduction for fibromyalgia, electing the Direct Review docket. Thereafter, the appeal was docketed to the Board.

Under?38?C.F.R. §?3.105(e), where a reduction in an evaluation of a service-connected disability is considered warranted and the lower evaluation would result in a reduction or discontinu
2025 rating decision on appeal, the AOJ proposed to decrease the current rating for fibromyalgia from 40 percent to 20 percent based on the examination results. The Veteran was provided notification of the AOJ's proposed decision in January 2025.

Under?38?C.F.R. §?3.105(e), where a reduction in an evaluation of a service-connected disability is considered warranted and the lower evaluation would result in a reduction or discontinuance of compensation payments currently being made, a rating proposing the reduction or discontinuance must be prepared setting forth all material facts and reasons.

The January 2025 rating decision appealed in the February 2025 notice of disagreement was a proposed rating decision. No action was taken by the AOJ in the decision.

The Court has held that the AOJ's decision to defer a ruling until a later date does not constitute a final decision by the AOJ because all factual and legal questions relevant to the claim have been reserved for adjudication at a later date. ?See Shipley?v. Shinseki,?24?Vet. App.?458?(2011). ?In other words, a decision that merely refers to future action is not a determination by the AOJ and, therefore, the disagreement with such a proposal does not place the issue in appellate status.

As such, a proposed rating decision is not a final decision and is not appealable to the Board. See 38 U.S.C. § 7105; 38 C.F.R. §§ 20.201, 20.202. Here, the AOJ had not finalized the proposed action on the claim at the time the February 2025 notice of disagreement was filed. As the January 2025 rating decision was a proposed rating decision and not final, the notice of disagreement was improperly docketed at the Board.

Indeed, the Board takes notice that thereafter, the AOJ did not finalize said reduction. See April 2026 Rating Code Sheet.

The Board may dismiss any appeal which fails to identify the specific determination with which the claimant disagrees. 38 U.S.C. § 7105. As the February 2025 notice of disagreement appealed a proposed rating decision that is not appealable to the Board, the issue contained therein (proposed reduction for fibromyalgia) is not properly before the Board. There remain no allegations of errors of fact or law for appellate consideration in the instant appeal. Consequently, dismissal of the pending appeal is the appropriate disposition. See?38?U.S.C. §?7105(d). Accordingly, further action by the Board concerning the claim is not warranted, and the appeal of the claim is dismissed. Id.

SERVICE CONNECTION

Generally, service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 5107; 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).

With regard to mental disorders, the rating schedule incorporates the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM). A valid DSM diagnosis is required to warrant compensation for a psychiatric disability. Martinez-Bodon v. McDonough, 28 F.4th 1241 (Fed. Cir. 2022); see also 38 C.F.R. § 4.125.

In addition to the general service connection requirements for psychiatric disorders, service connection for PTSD specifically requires medical evidence establishing a diagnosis of the condition in accordance with 38 C.F.R. § 4.125 (a); a link, established by medical evidence, between the current symptoms and an in-service stressor; and credible supporting evidence that the claimed in-service stressor occurred. See 38 C.F.R. §§ 3.304 (f), 4.125; see also Cohen v. Brown, 10 Vet. App. 128, 140 (1997).

In rendering this decision, the Board has reviewed all evidence of record whether discussed in detail. See Newhouse v. Nicholson, 497 F.3d 1298, 1302 (Fed.
disorders, service connection for PTSD specifically requires medical evidence establishing a diagnosis of the condition in accordance with 38 C.F.R. § 4.125 (a); a link, established by medical evidence, between the current symptoms and an in-service stressor; and credible supporting evidence that the claimed in-service stressor occurred. See 38 C.F.R. §§ 3.304 (f), 4.125; see also Cohen v. Brown, 10 Vet. App. 128, 140 (1997).

In rendering this decision, the Board has reviewed all evidence of record whether discussed in detail. See Newhouse v. Nicholson, 497 F.3d 1298, 1302 (Fed. Cir. 2007) (holding the Board must only discuss the evidence which is relevant to the issues on appeal). To the extent the evidence is found in "approximate balance," the Board will afford the benefit of the doubt in favor of the Veteran. Lynch v. McDonough, 21 F. 4th 776 (Fed, Cir. 2021) (holding that exact equipoise is not required for the benefit of the doubt to be applied, but rather the Veteran is entitled to the benefit of the doubt when the evidence is in approximate balance or "nearly equal").

The Board will address the issues asserted and any reasonably raised theory found in the record even if not explicitly raised by the claimant, but this obligation "does not require the Board to assume the impossible task of inventing and rejecting every conceivable argument in order to produce a valid decision." Robinson v. Peake, 21 Vet. App. 545, 554 (2008) ("As a nonadversarial adjudicator, the Board's obligation to analyze claims goes beyond the arguments explicitly made. However, it does not require the Board to assume the impossible task of inventing and rejecting every conceivable argument in order to produce a valid decision.").

2. Entitlement to service connection for a psychiatric disability to include posttraumatic stress disorder (PTSD) and depressive disorder is denied.

The Veteran contends that service connection is warranted for a psychiatric disability to include PTSD. As will be discussed, based on the relevant evidence of record, the Board finds that service connection for a psychiatric disability, to include PTSD is not warranted.

The Board notes that the record contains psychiatric diagnoses other than the claimed PTSD. Therefore, the Board has expanded the issue on appeal to include all psychiatric disorders, to include depressive disorder in addition to the claimed PTSD, consistent with the holding in Clemons v. Shinseki, 23 Vet. App. 1 (2009).

The Board also notes that the Veteran is currently service connected for unspecified anxiety disorder, but not, specifically, depressive disorder or PTSD. While the Board acknowledges different psychiatric disabilities can be separately service connected because the manifestations of each could be separate, it is also important to emphasize that there are times where a grant of one could moot out the other. See Amberman v. Shinseki, 570 F. 3d 1277, 1381 (Fed. Cir. 2009); Bean v. McDonough, 66 F.4th 979 (Fed. Cir. 2023).

Here, the Board finds that the Veteran's mental health disability, however diagnosed throughout time, has been attributed to manifestations fully contemplated in the Veteran's unspecified anxiety disorder rating. Indeed, the medical evidence specifically indicates that to the extent the Veteran has varying diagnoses, the manifestations cannot be differentiated. Thus, whether the Veteran has PTSD (which, as will be explained below, the persuasive weight of the evidence, indicates he does not), or depressive disorder, his unspecified anxiety disorder rating has rendered his other pending service connection appeal here obsolete. Nonetheless, even for the sake of argument considering the appeal on the merits, the Board finds the appeal must be denied.

Turning to the evidence of record, in a November 2019 statement, the Veteran reported that he experienced constant nightly mortar attacks during service wherein the aircraft would scramble and alarms would sound. He stated that he did gate guard watching for "unfriendlies" entering the post, and was deployed to multiple sites via helicopter, witnessing aerial combat.

He added that due to his in-service stressors of exposure to mortar attacks while serving on the flight line, witnessing a helicopter open fire on the enemy, and exposure to loud alarms and engines, he now avoids bright lights and objects, seeks peaceful places, and has short to the point conversations as lengthy conversations are stressful.

A finding that a veteran engaged in combat with the enemy under 38 U.S.C. § 1154(b) and 38 C.F.R. § 3.304(d) requires that the Veteran participated in events constituting an actual fight or encounter with a military foe or hostile unit or
gate guard watching for "unfriendlies" entering the post, and was deployed to multiple sites via helicopter, witnessing aerial combat.

A finding that a veteran engaged in combat with the enemy under 38 U.S.C. § 1154(b) and 38 C.F.R. § 3.304(d) requires that the Veteran participated in events constituting an actual fight or encounter with a military foe or hostile unit or instrumentality. In addressing the question of whether the Veteran engaged in combat, the benefit of the doubt doctrine is for application. 38 U.S.C. § 5107(b) 38 C.F.R. § §3.102 (benefit of the doubt doctrine applies to "any other point"); Sizemore v. Principi, 18 Vet. App. 264, 276 (2004) (Board's determination of combat status and corroboration of stressors must be made consistent with the benefit of the doubt doctrine). Here, the Veteran has reported "experiencing" constant nightly mortar attacks while serving on the flight line and his DD-214 indicates that his military occupational specialty (MOS) was as an automated logistical specialist with service in Afghanistan. He is also a recipient of the Afghanistan Campaign Medal amongst other decorations, but no decorations which would indicate participation in an actual fight with a military foe. (i.e. Purple Heart, Combat Action Badge.) However, the Court has found that receiving enemy fire or firing on an enemy can constitute participation in combat. See Sizemore v. Principi, 18 Vet. App. 264, 272 (2004). Additionally, evidence submitted to support a claim that a veteran engaged in combat may include the veteran's own statements and an "almost unlimited" variety of other types of evidence. Gaines v. West, 11 Vet. App. 353, 359 (1998). Considering the Veteran's competent statements regarding exposure to constant mortar attacks while on the flight line, consistent with his circumstances of service in Afghanistan, the Board finds that the evidence is sufficient to establish that the Veteran engaged in combat with the enemy.

Nonetheless, the Veteran's service treatment records do not reflect treatment for or complaints of a psychiatric disability or symptoms associated with a psychiatric disability. A clinician noted a negative screen for depression, anxiety, and hallucinations in March 2005, and an October 2007 survey reflects that he was not bothered by thoughts that he would be better off dead or of hurting himself. It is also of note that his April 2008 medical examination report upon separation is normal with regards to "psychiatric" issues.

In an August 2008 VA examination report shortly after discharge from service, the examiner indicated that the Veteran was alert and oriented to time, place and year, and appeared capable of managing his own finances in his own best interests.

The Board notes that there are numerous post-service VA treatment records, including PTSD screenings from March 2010, September 2012, and July 2017 wherein the Veteran's PTSD score was noted as "0".

June 2019 VA treatment records indicate the Veteran reported nightmares, hypervigilance, agitation, startle response, and that he avoids people and loud noises. He had a DSM-5 diagnosis of unspecified anxiety disorder.

In a December 2019 VA examination report, the psychologist noted that the Veteran does not have a diagnosis of PTSD that conforms to the DSM-5 criteria. There was no mental disorder diagnosed. The psychologist noted that the Veteran had been diagnosed with unspecified adjustment reaction in September 2014 and unspecified personality disorder in April 2015. The Veteran did meet the stressor 1 criteria as he experienced mortar attacks in his vicinity during service in Afghanistan, but no symptoms of PTSD were described or noted by the psychologist. The psychologist indicated that the Veteran completed a Trauma Symptoms Inventory and stated that the test results are valid and did not indicate clinically significant symptoms of depression, anxiety, or PTSD. The psychologist concluded that the Veteran did not report sufficient symptoms that would be consistent with the diagnoses of anxiety, depression, sleep disturbance, or other mood/anxiety disorder at this time, and does not meet the criteria for any mental health disorder.

December 2019 VA treatment records reflect an Axis I diagnosis of PTSD anxiety by a mental health social worker, while an independent social worker indicated that the Veteran did not meet the criteria for PTSD treatment.

A January 2020 VA treatment record indicates that the Veteran underwent a psychiatric evaluation for complaints and was diagnosed with
the psychologist. The psychologist indicated that the Veteran completed a Trauma Symptoms Inventory and stated that the test results are valid and did not indicate clinically significant symptoms of depression, anxiety, or PTSD. The psychologist concluded that the Veteran did not report sufficient symptoms that would be consistent with the diagnoses of anxiety, depression, sleep disturbance, or other mood/anxiety disorder at this time, and does not meet the criteria for any mental health disorder.

A January 2020 VA treatment record indicates that the Veteran underwent a psychiatric evaluation for complaints and was diagnosed with adjustment disorder with anxious and depressed mood, chronic r/o PTSD.

In a May 2021 private psychological examination, the psychologist noted that the Veteran endorsed symptoms including anxiety, worry, difficulty concentrating at work, depression, irritability, difficulty with relationships, sleep problems, fatigue, chronic physical pain, and memory difficulties. The psychologist noted the Veteran's reported in-service stressors wherein he feared for his life and safety during deployment to Afghanistan, and the Veteran's reports that his struggles have increased since 2008 with significant worsening since 2014. The psychologist indicated that the Veteran scored "37" on the PTSD checklist; above the threshold of 31 and indicative of a probable PTSD diagnosis, noting the PTSD checklist for DSM-5.

In an August 2021 VA examination report, the psychologist indicated that the Veteran had been diagnosed with PTSD and that the Veteran reported ongoing nightmares, avoidance of military experiences, anxiousness, hypervigilance, and difficulty with relationships and sleep.

A September 2021 VA examination report indicates that following a video telehealth examination, the psychologist indicated that the Veteran did not have a diagnosis of PTSD or any mental disorder that conforms to DSM-5 criteria. The psychologist noted the Veteran's reports of frequent mortar attacks in service but that he was never injured and never saw anyone injured. The Veteran additionally reported occasionally thinking about his service in Afghanistan but did not describe thinking about an intrusive memory of trauma. The psychologist addressed the December 2019 VA examination report, the May 2021 private psychologist's evaluation, and the August 2021 VA examination report. The psychologist reported that the Veteran's 2006 deployment to Afghanistan did not meet Criterion A as he was never injured and never saw any significant injury, and was not related to fear of hostile military or terrorist activity as the Veteran did not report fear of hostile activity. The psychologist concluded that the Veteran does not meet the DSM-5 criteria for PTSD nor endorse core symptoms of PTSD. He also noted that the Veteran does not report sufficient symptoms that would be consistent with the diagnoses of anxiety, depression, sleep disturbance or other mood/anxiety disorder at this time. The psychologist stated that none of the symptoms reported in the August 2021 examination report were found at this evaluation and the diagnosis of PTSD is clearly in error, stating that the Veteran has no mental health diagnosis at the current examination.

In a December 2023 VA examination report, the psychologist noted a diagnosis of unspecified anxiety disorder and indicated that the Veteran did not have more than one mental disorder diagnosed. Current symptoms were reported as anxiety, difficulty in establishing and maintaining effective work and social relationships, and chronic sleep impairment.

A February 2024 VA examination report reflects that the Veteran has a diagnosis of unspecified anxiety disorder that conforms to DSM-5 criteria, and symptoms were noted as anxiety, chronic sleep impairment, and difficulty establishing and maintaining effective work and social relationships.

An October 2024 VA examination report indicates that the Veteran does not have a diagnosis of PTSD that conforms to DSM-5 criteria with the psychologist noting that the Veteran's symptoms do not meet the diagnostic criteria for PTSD under DSM-5 criteria. The psychologist indicated that the Veteran has a diagnosis of depressive disorder and noted the Veteran's reported stressors of exposure to attacks and awareness of casualties during service in Afghanistan, indicating that the stressor related to the Veteran's fear of hostile military or terrorist activity. The examination report indicates that the Veteran's depressive disorder symptoms include depressed mood, chronic sleep impairment, disturbances of motivation and mood, and anxiety. The psychologist stated that depression is a new diagnosis and that anxiety is a symptom subsumed under the Veteran's depression. He added that there is no evidence of anxiety diagnosed or treated by a mental health provider while in service or evidence of anxiety that may have been in existence while on active duty being the same etiologically as the various causes (family, relationships, work, finances, anxiety with and inability to maintain a relationship with a woman, deaths of family, career choice) occurring since active duty.

The psychologist opined that the Veteran does not have a diagnosis of PTSD but instead has a diagnosis of depressive disorder
indicates that the Veteran's depressive disorder symptoms include depressed mood, chronic sleep impairment, disturbances of motivation and mood, and anxiety. The psychologist stated that depression is a new diagnosis and that anxiety is a symptom subsumed under the Veteran's depression. He added that there is no evidence of anxiety diagnosed or treated by a mental health provider while in service or evidence of anxiety that may have been in existence while on active duty being the same etiologically as the various causes (family, relationships, work, finances, anxiety with and inability to maintain a relationship with a woman, deaths of family, career choice) occurring since active duty.

The psychologist opined that the Veteran does not have a diagnosis of PTSD but instead has a diagnosis of depressive disorder, thus PTSD it is less likely than not incurred in or caused by the claimed in-service injury, event, or illness.

A November 2024 VA examination report indicates that the Veteran has a diagnosis of unspecified anxiety disorder and not more than one mental disorder. The Veteran's unspecified anxiety disorder symptoms were noted as depressed mood, anxiety, and disturbances of motivation and mood. The psychologist reported that the Veteran continues to meet DSM-5 criteria for unspecified anxiety disorder at this time, noting that he continues to feel tense and anxious on at least 2 to 3 occasions per week, worries about finances and relationships, and limits social interaction and proximity to groups of people as a way of avoiding these symptoms. He indicated that the Veteran also continues to experience restless sleep and depressed mood and motivation. The psychologist noted that the Veteran has maintained full-time employment and has not participated in any mental health treatment for his anxiety symptoms since the February 2024 VA examination. The psychologist concluded that given the lack of reporting of new symptoms and lack of clear changes in occupational and social functioning, the severity and associated impairment of the Veteran's unspecified anxiety disorder has not increased significantly in this nine-month period.

In a January 2025 VA examination addendum report the psychologist who provided the October 2024 opinion emphasized that there is no PTSD diagnosed as the Veteran did not meet PTSD diagnostic criteria. He reiterated his previous response from the October 2024 examination that "Depression hasn't been diagnosed previously. His anxiety is a symptom subsumed under his depression. There is no evidence of anxiety diagnosed or treated by a mental health provider while in service or evidence of anxiety that may have been in existence while on active duty being the same etiologically as the various causes (family, relationships, work, finances, anxiety with an inability to maintain a relationship with a woman, deaths of family, career choice) occurring since active duty."

The psychologist opined that the Veteran's currently diagnosed depressive disorder is less likely than not military service connected.

Analysis

Regarding the Veteran's claim for service connection for PTSD, the Veteran has consistently and competently reported stressors generally surrounding events involving combat with the enemy and fear of hostile military activity. The Board finds these stressors to be generally consistent with the circumstances of the Veteran's service as his DD-214 reflects that his military occupational specialty was as an automated logistical specialist with service in Afghanistan.

However, viewing the lay and medical evidence as a whole, the Board finds that the evidence persuasively weighs against a finding that the Veteran has a current diagnosis of PTSD meeting DSM-5 requirements at any time during, or proximate to, the claims period. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). To this end, the Veteran's post-service VA treatment records consistently reflect PTSD screening which indicate that the Veteran's PTSD score is "0" over the course of several years following service. Additionally, the December 2019, September 2021, and October 2024 (reiterated in January 2025) VA examination reports each reflect that the Veteran failed to meet the DSM-5 criteria for PTSD with the psychologists, in aggregate, noting a lack of symptoms of PTSD. Significantly, December 2023 and November 2024 psychologists indicated that the Veteran had a diagnosis of unspecified anxiety disorder and not more than one mental health disorder, while the February 2024 and November 2024 VA examination reports reflect a diagnosis of unspecified anxiety disorder which conformed to DSM-5 criteria.

To the extent that the evidence of record indicates that the Veteran has had a diagnosis of PTSD during the period of appeal, the Board finds this evidence unpersuasive. While December 2019 VA treatment records, the May 2021 private psychologist examination report, and August 2021 VA examination report denote a diagnosis of PTSD, the clinicians either do not provide adequate rationales as to how the Veteran's psychiatric disability meets the DSM-5 criteria for PTSD, or do not provide a definitive diagnosis of PTSD. Specifically, the December 2019 VA treatment records reflect that a mental health social worker indicated that the Veteran had an Axis I diagnosis of PTSD anxiety but failed to address whether the diagnosis of PTSD meets the DSM-5 criteria. The May 2021 private psychologist considered the Veteran's in-service stressors but reported only a "probable" PTSD diagnosis based on a PTSD checklist for DSM-5 score. As for the August 2021 VA examination report, the psychologist merely referenced a previous diagnosis of PTSD without specifying whether the diagnosis was based on the DSM-5 criteria. Thus, the Board affords more probative weight to the December 2019, September 2021, and October 2024 VA examination reports which explicitly found that the Veteran did not have a diagnosis of PTSD which conformed to DSM-5 criteria and provided a thorough rationale to support their findings based on an accurate characterization of the evidence of record. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008) (most of the probative value of a medical opinion comes from its reasoning; threshold considerations are whether the person opining is suitably qualified and sufficiently informed). These opinions are additionally buoyed by the numerous negative PTSD screenings noted in the VA treatment records.

As previously discussed, for service connection of a mental health disorder, a diagnosis under DSM-5 criteria is required. See Martinez-Bodon, 28 F.4th 1241; see also 38 C.F.R. § 4.125. Accordingly, the Veteran does not meet the current disability requirement for his PTSD service connection claim.

To the extent that the Veteran believes that he has a current diagnosis of PTSD, he is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education. The regulation specifically provides that service connection for PTSD requires medical evidence diagnosing the condition in accordance with DSM-5. See 38 C.F.R. §§ 4.125 (a), 3.304(f). The December 2019, September 2021, and October 2024 examiners considered the Veteran's reports, reviewed the Veteran's file, examined the Veteran, and explained that he met the DSM-5 criteria for unspecified anxiety disorder and depressive disorder, but did not report that the DSM-5 criteria for PTSD had been met. The Board finds the December 2019, September 2021, and October 2024 examiners' findings highly probative in this regard, as they are based on review of the file and consideration of the Veteran's reports in addition to examination and are consistent with the diagnoses in the Veteran's treatment records.

As previously noted, the evidence of record reflects a diagnosis of depressive disorder as reflected by the October 2024 VA examination report. The Board emphasizes that the Veteran has been service connected for unspecified anxiety disorder since August 2023. Here, under the particular circumstances in this case, there is no indication that the Veteran has a separate psychiatric disability or mental health symptomatology that is not already compensated by his service-connected psychiatric disability. See Amberman v. Shinseki, 570 F.3d 1377, 1381 (Fed. Cir. 2009); Bean v. McDonough, 66 F.4th 979 (Fed. Cir. 2023). Indeed, while the October 2024 psychologist noted a diagnosis of depressive disorder, he also reported symptomatology which included depressed mood, chronic sleep impairment, disturbances of motivation and mood, and anxiety, symptoms which have already been considered as reflected by the previously discussed December 2023 and November 2024 VA examination reports, and are compensated by the service connected unspecified anxiety disorder. As the Veteran is compensated for all of his psychiatric symptoms, the Board will not separately adjudicate a claim for service connection for depressive disorder. Mittleider v. West, 11 Vet. App. 181 (1998) (VA must apply the benefit of the doubt doctrine and attribute the inseparable
979 (Fed. Cir. 2023). Indeed, while the October 2024 psychologist noted a diagnosis of depressive disorder, he also reported symptomatology which included depressed mood, chronic sleep impairment, disturbances of motivation and mood, and anxiety, symptoms which have already been considered as reflected by the previously discussed December 2023 and November 2024 VA examination reports, and are compensated by the service connected unspecified anxiety disorder. As the Veteran is compensated for all of his psychiatric symptoms, the Board will not separately adjudicate a claim for service connection for depressive disorder. Mittleider v. West, 11 Vet. App. 181 (1998) (VA must apply the benefit of the doubt doctrine and attribute the inseparable effects of a disability to the claimant's service-connected disability).

As the evidence is not in at least approximate balance as to whether the Veteran has a current diagnosis of PTSD under DSM-5 criteria, and the symptoms associated with the Veteran's depressive disorder are compensated by his service connected unspecified anxiety disorder, the Veteran's claim for service connection for a psychiatric disability, specifically PTSD and depressive disorder is denied.

SHEREEN M. MARCUS

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board R. Maddox, 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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