MAJOR DEPRESSIVE DISORDER

ERIC S. LEBOFF · 2026 · Case ID: A26040703

DENIED

Summary

The veteran, who served in the Army from March 2013 to March 2017, appeals the denial of service connection for an acquired psychiatric disability, specifically generalized anxiety disorder, depression, and alcohol abuse. The veteran claimed anxiety related to driving and public places, depression stemming from military separation and loss of camaraderie, and alcohol abuse that began in service as a coping mechanism. Service treatment records from 2013-2016 showed no complaints or diagnoses of depression, with negative screens for depression and psychiatric evaluation as normal. While records indicated treatment for substance abuse disorder in 2015 due to excessive drinking, the diagnoses were mild to moderate substance use disorder, not alcohol abuse disorder. A spouse's lay statement corroborated the veteran's excessive drinking and denial of its extent, along with symptoms of anxiety and depression. A March 2024 C&P examination diagnosed unspecified depressive disorder with anxious distress but found the veteran did not meet DSM criteria for generalized anxiety disorder or major depressive disorder. The examiner opined that the claimed conditions were less likely than not due to service, citing negative service treatment records and the onset of symptoms years after separation. The Board found the C&P examiner's opinions probative, noting the lack of service treatment records for mental health issues and the negative separation psychiatric evaluation. While acknowledging in-service treatment for substance abuse, the Board found no current diagnosis of alcohol abuse disorder and that the Veteran's claimed psychiatric symptoms began post-service. The Board denied service connection for all claimed conditions.

Rationale

Service treatment records negative for mental health complaints/diagnoses during service.; Separation psychiatric evaluation normal; Veteran denied mental health history.; Symptoms of depression and anxiety began post-service.; C&P examiner opined conditions less likely than not due to service.

Service Branch

ARMY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

260115-624310

Full Decision Text

Citation Nr: A26040703
Decision Date: 04/30/26 Archive Date: 04/30/26

DOCKET NO. 260115-624310
DATE: April 30, 2026

ORDER

Entitlement to service connection for an acquired psychiatric disability, to include unspecified depressive disorder with anxious distress, claimed as generalized anxiety disorder, depression, and alcohol abuse, is denied.

FINDINGS OF FACT

1. The evidence of record is persuasively against a finding that an acquired psychiatric disability, to include unspecified depressive disorder with anxious distress, manifested during the Veteran's period of active service or that it is otherwise the result of a disease or injury during active service.

2. A diagnosis of alcohol abuse disorder is not shown.

CONCLUSION OF LAW

The criteria for service connection for an acquired psychiatric disability, to include unspecified depressive disorder with anxious distress, claimed as generalized anxiety disorder, depression, and alcohol abuse, have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSION

The Veteran had active service from March 2013 to March 2017.

In an August 2024 rating decision, the Agency of Original Jurisdiction (AOJ) denied service connection for unspecified depressive disorder with anxious distress. In December 2024, the Veteran submitted VA Form 20-0996 Request for Higher-Level Review. In a March 2025 higher-level review rating decision, service connection for unspecified depressive disorder with anxious distress was denied. In the January 2026 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 August 2024 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 claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

Service Connection

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).

Under 38 C.F.R. § 3.303(b), an alternative method of establishing the second and third Shedden/Caluza element is through a demonstration of continuity of symptomatology. Barr v. Nicholson, 21 Vet. App. 303 (2007); see Savage v. Gober, 10 Vet. App. 488, 495-97 (1997). Continuity of symptomatology may be established if a claimant can demonstrate (1) that a condition was "noted" during service; (2) evidence of post-service continuity of the same symptomatology; and (3) medical or, in certain circumstances, lay evidence of a nexus between the present disability and the post-service symptomatology. Savage, 10 Vet. App. at 495-96.

Certain chronic diseases, such as psychoses, 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, 1133, 1137
3) medical or, in certain circumstances, lay evidence of a nexus between the present disability and the post-service symptomatology. Savage, 10 Vet. App. at 495-96.

Certain chronic diseases, such as psychoses, 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, 1133, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309. Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013).

In March 2024, the Veteran filed a claim of service connection for generalized anxiety disorder, depression, and alcohol abuse. With regard to generalized anxiety disorder, he asserted that he has major anxiety while driving from eye surgery side effects (starbursts), and oncoming headlights are blinding making it hard to see while commuting when it is dark outside. He has anxiety in restaurants and stores. He always has to sit facing the exits to be aware of any threats that may come in the building. He is always scanning crowds or people walking by in case they are going to attack. With regard to depression, he reported depression caused by military separation leading to alcohol abuse and weight gain. It was hard to find friends like the ones he served with, with the same comradery and loyalty. He misses serving and feeling "a part of something." With regard to alcohol abuse, he reported that it started in 2015. He discovered if he drank enough and he did not need to take sleeping aids in order to fall asleep to cope with insomnia. He drank almost every day while he was in the service. While in Korea there was not much to do other than drink your boredom away while not on duty. He discovered alcohol helped numb body pains. He was sent to Alcoholics Anonymous twice in 2015.

Service treatment records reflect that in April and May 2013 the Veteran denied feelings of depression. In December 2013 the Veteran replied 'No' with regard to any issues with depression. In August 2014, March 2015, and November 2016 depression screens were negative. 03/18/2024 STR-Medical-Photocopy.

Service treatment records reflect that in May 2015 the Veteran was referred to the Army Substance Abuse Program (ASAP) as he smelled like alcohol. He reported drinking 15 beers on May 10, 2015, and drinks one time per month. He denied drug use. He denied current or previous mental health treatment for problems other than alcohol/drug abuse. He was diagnosed with mild substance use disorder. In December 2015 the Veteran was referred to the ASAP as he "drank way too much." He reported that he last drank on November 25, 2015, and he drinks 4/5 - 10 drinks each time. He denied drug use. He denied current or previous mental health treatment for problems other than alcohol/drug abuse. He was diagnosed with moderate substance use disorder. 03/18/2024 STR (2 entries).

A November 2016 Report of Medical History reflects that the Veteran checked the 'No' boxes for 'nervous trouble of any sort,' 'depression or excessive worry,' and 'been evaluated or treated for a mental condition.' A December 2016 Report of Medical Examination reflects that his 'psychiatric' state was clinically evaluated as normal.

In December 2016, he reported drinking beer one time per week, and 2 drinks per occasion. A depression screen was negative, and he denied suicidal/homicidal ideation. 03/18/2024 STR-Medical-Photocopy. 03/18/2024 STR.

A February 2022 private treatment record reflects the Veteran's report that he gave up alcohol and was not currently using alcohol. 03/18/2024 Correspondence.

In March 2024, the Veteran's spouse submitted a lay statement pertaining to the Veteran's claimed generalized anxiety disorder, depression, and alcohol abuse. She stated that the Veteran engaged in frequent and excessive drinking, often consuming large quantities of alcohol in a single sitting. He would binge drinks on weekends or use alcohol as a coping mechanism to deal with stress, anxiety, or other emotional difficulties. Despite attempts to limit his alcohol intake, he often found himself unable to control his drinking behavior. He continued to drink beyond his limit, leading to loss of inhibitions, impaired judgment and risky behaviors. She stated that the Veteran denies the extent of his alcohol abuse, downplaying the severity of his drinking, or rationalizing his behavior. She also reported his symptoms associated with generalized anxiety disorder and depression.

In April 2024 the Veteran underwent a C&P examination wherein the examiner diagnosed unspecified depressive disorder with anxious distress. The examiner noted review of the claims folder. The Veteran denied a history of mental health during service. He reported that he started experiencing anxiety in the past 3-4 years mostly related to driving at night. He reported having to face the door in public places like a restaurant. His depression started about 2 years ago. This mostly related to some of his Army buddies that have passed away over the years, some from suicide, some for medical reasons. He had an Army buddy who passed away from a stroke while he was driving. He had some difficulty falling asleep and has a hard time going back to sleep if he wakes up in the middle of the night. He denied suicidal ideation. The examiner noted that with regard to the contention of alcohol abuse, Veteran does not meet the DSM criteria for alcohol use disorder at this time. For the contention of generalized anxiety disorder, the Veteran does not meet the DSM criteria for generalized anxiety disorder. The examiner stated that anxiety is subsumed under the diagnosis of unspecified depressive disorder with anxious distress. For the contention of depression (major depressive disorder), the Veteran does not meet the DSM criteria for major depressive disorder but meets the DSM criteria for unspecified depressive disorder at this time.

The examiner opined that the claimed condition is less likely as not due to service. Entrance and separation exams are negative for mental health. The Veteran denied any history of mental health prior to joining the service. The Veteran denied any history of mental health during his time in the service. The Veteran started experiencing depression about 2 years ago. This is mostly related to some of his Army buddies that have passed away over the years, some from suicide, some from medical reasons. He had an Army buddy who recently passed away from a stroke while he was driving. He had some difficulty falling asleep and has a hard time going back to sleep if he wakes up in the middle of the night. The Veteran denied any suicidal ideation. The examiner stated that the Veteran does not meet the DSM criteria for major depressive disorder at this time but meets the DSM criteria for unspecified depressive disorder. His symptoms related to depression only started about 2-3 years prior, a few years after being separated from the service. As such, the claimed condition of depression (major depressive disorder) is less likely than not incurred in or caused by (the) treatment during service.

The examiner opined that the claimed condition is less likely as not due to service. The examiner noted that entrance and separation exams were negative for mental health. The Veteran denied any history of mental health prior to joining the service. He denied any history of mental health during his time in the service. He started experiencing anxiety in the past 3-4 years, mostly related to driving at night. He reported having to face the door in public places like restaurant. He had some

difficulty falling asleep and has a hard time going back to sleep if he wakes up in the middle of the night. He did not meet the DSM criteria for generalized anxiety disorder at this time and mild symptoms related to anxiety only started about 3-4 years ago, a few years after being separated from the service. As such, the claimed

condition of generalized anxiety disorder was less likely than not incurred in or caused by (the) treatment during service.

The examiner also opined that the Veteran's claimed alcohol abuse is less likely as not due to service. The examiner stated that his entrance and separation exams are negative for mental health. The Veteran attended ASAP in 2015 after being arrested for public intoxication. Per the ASAP evaluation, he would only drink on the weekends, about 6 beers. He only drank occasionally and would only drink a couple of drinks. He denied any other substance used. The examiner stated that he does not meet the DSM criteria for alcohol use disorder. Therefore, the claimed condition of alcohol abuse is less likely than not incurred in or caused by (the) treatment during service.

Initially, the Board notes that in a January 2026 statement, the Veteran's representative asserted that the April 2024 C&P examiner's opinion was inadequate for rating purposes. The Veteran's representative asserted the following:

The favorable findings of the decision cite substance abuse treatment during active duty. We agree with the rating decision that this alcohol use and subsequent treatment is a clear marker in service of the onset of his depression, but the C&P examiner's medical opinion is silent for any consideration of it or explanation for why that was not evidence of symptoms beginning during active duty. An incident in service requires the manifestation of that condition, not treatment, and the criteria for chronicity is chronicity of symptomatology, not chronicity of treatment. A claimant need not engage in mental health treatment in order to establish the onset of that condition, contrary to the rationale the C&P examiner offers. Because it did not cover this important evidence of substance use and treatment during active duty we believe it is inadequate for rating purposes.

Additionally, during the HLR informal conference the veteran reported the examiner asked vague questions and did not inquire directly about his depression or anxiety. He explained to the C&P examiner that he began getting increasingly anxious driving at night and described examples of his depression, but the medical opinion characterized those as the onset of these symptoms 2-3 years prior rather than a chronic pattern which began while in the military. No further development was conducted after the informal conference, and in fact the rating decision was issued the same day. We believe a new medical opinion is necessary to correct the duty to assist error.

As detailed above, the April 2024 C&P examination was conducted by a psychologist. The examiner noted a detailed history, conducted a mental status examination, and provided a diagnosis based on the results of the examination. The examiner determined that he had a diagnosis of unspecified depressive disorder with anxious distress but did not have a diagnosis of alcohol abuse. The examiner noted review of the claims folder, to include acknowledging his treatment for alcohol abuse. In formulating the opinions, the examiner cited to the service treatment records and offered an appropriate rationale. The Board finds that the examination and opinions of the April 2024 examiner are entitled to probative weight. As detailed, the Veteran requested higher-level review of the July 2024 rating decision. The Veteran was afforded an informal conference with a Decision Review Officer (DRO). The DRO issued a higher-level review rating decision in March 2025 based on review of the entire evidence of record. It is not clear to this Board the basis for the further development as the Veteran was afforded the opportunity to submit lay and medical evidence in support of his claims and he was afforded a C&P examination. The Board finds no pre-decisional error to warrant a remand.

Based on review of the evidence of record, while it is clear that the Veteran was treated for a substance abuse disorder on two occasions during service, the service treatment records are negative for any complaints, treatment, or diagnosis of a mental health disability. Moreover, on separation his psychiatric state was clinically evaluated as normal, and he denied any mental health symptoms. Based on the Veteran's lay assertions and his spouse's lay assertions, and his in-service treatment for a substance abuse disorder, he was afforded an examination in April 2024 wherein the examiner diagnosed unspecified depressive disorder with anxious distress and proffered negative etiological opinions. Such opinions were based on examination of the Veteran and review of the claims folder, to include consideration of the Veteran's lay assertions. The Board finds that the opinions of the C&P examiner are entitled to probative weight. See Nieves-Rodriguez v. Peake, 22 Vet. App
, or diagnosis of a mental health disability. Moreover, on separation his psychiatric state was clinically evaluated as normal, and he denied any mental health symptoms. Based on the Veteran's lay assertions and his spouse's lay assertions, and his in-service treatment for a substance abuse disorder, he was afforded an examination in April 2024 wherein the examiner diagnosed unspecified depressive disorder with anxious distress and proffered negative etiological opinions. Such opinions were based on examination of the Veteran and review of the claims folder, to include consideration of the Veteran's lay assertions. The Board finds that the opinions of the C&P examiner are entitled to probative weight. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 302-04 (2008) (holding that it is the factually accurate, fully articulated, sound reasoning for the conclusion that contributes to the probative value of a medical opinion). There is also no contrary medical opinion. It is acknowledged that the Veteran's claim was received in March 2024, thus approximately 7 years after separation from active service, and the post-service private treatment records received reflect no mental health diagnosis and the Veteran's report in February 2022 that he gave up alcohol. Based on the above, the evidence of record is against a finding that the Veteran has an acquired psychiatric disability due to active service.

With regard to his specific claim of alcohol abuse, while he treated for a substance abuse disorder during service there is no showing of a current substance/alcohol abuse disorder. Despite the Veteran's spouse's lay assertions, the Veteran has denied the use of alcohol and has not been diagnosed with alcohol abuse post-service. In the absence of proof of a current diagnosis of alcohol abuse there can be no valid claim. Boyer v. West, 210 F.3d 1351, 1353 (Fed. Cir. 2000); Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). Congress has specifically limited entitlement to service connection to cases where such incidents have resulted in a disability. Brammer, 3 Vet. App. at 225. As detailed, the probative medical evidence based on objective testing does not reflect a disability of alcohol abuse. Thus, the Board cannot conclude that the Veteran currently suffers from such a disability.

The Board acknowledges that the Veteran and his spouse are competent to describe symptoms related to his claimed psychiatric disability and alcohol abuse and acknowledges their lay statements. However, the question of whether the symptoms the Veteran experienced in service or following service are related to a current disability or whether such disability is due to service are matters that require medical expertise to determine. See Clyburn v. West, 12 Vet. App. 296, 301 (1999) ("Although the veteran is competent to testify to the pain he has experienced since his tour in the Persian Gulf, he is not competent to testify to the fact that what he experienced in service and since service is the same condition he is currently diagnosed with."). While the Veteran believes he has a psychiatric disability due to active military service, the persuasive evidence of record weighs against finding a nexus relationship. The Veteran and his spouse are not competent to provide a nexus opinion regarding this issue. The issue is medically complex and requires knowledge of pathology. Therefore, it is outside the competence of the Veteran and his spouse in this case because the record does not show that they have the skills or medical training to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377; see Kahana v. Shinseki, 24. Vet. App. 428 (2011).

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Based on the foregoing, the persuasive evidence of record is against a finding of service connection for an acquired psychiatric disability.

Eric S. Leboff

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Kreindler, Marcy W.

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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