Posttraumatic Stress Disorder, 64208-64210 [E8-25735]

Download as PDF 64208 Federal Register / Vol. 73, No. 210 / Wednesday, October 29, 2008 / Rules and Regulations I. Regulatory History DEPARTMENT OF HOMELAND SECURITY Coast Guard 33 CFR Part 105 [Docket Nos. TSA–2006–24191; USCG– 2006–24196] Transportation Worker Identification Credential (TWIC) Implementation in the Maritime Sector; Hazardous Materials Endorsement for a Commercial Driver’s License AGENCY: United States Coast Guard; DHS. Notice of extension of compliance date, Captain of the Port Zones Buffalo, Duluth, Detroit, Lake Michigan, and Sault Ste. Marie. ACTION: SUMMARY: This document informs owners and operators of facilities located within Captain of the Port Zones Buffalo, Duluth, Detroit, Lake Michigan, and Sault Ste. Marie that the date by which they must implement access control procedures utilizing TWIC has been extended to no later than December 1, 2008. This extension is due to a building-wide loss of power that occurred on October 21, 2008, at the government facility that houses the TWIC system, which affected the system’s ability to activate TWICs. DATES: The new compliance date for the TWIC regulations found in 33 CFR part 105 for Captain of the Port Zones Buffalo, Duluth, Detroit, Lake Michigan, and Sault Ste. Marie is December 1, 2008. Comments and material received from the public, as well as documents mentioned in this document as being available in the docket, are part of dockets TSA–2006–24191 and USCG–2006–24196, and are available for inspection or copying at the Docket Management Facility, U.S. Department of Transportation, West Building Ground Floor, Room W12–140, 1200 New Jersey Avenue SE., Washington, DC 20590, between 9 a.m. and 5 p.m., Monday through Friday, except Federal holidays. You may also find this docket on the Internet at https:// www.regulations.gov. ADDRESSES: If you have questions on this document, call LCDR Jonathan Maiorine, telephone 1–877–687–2243. If you have questions on viewing the docket, call Renee V. Wright, Program Manager, Docket Operations, telephone 202–493–0402. SUPPLEMENTARY INFORMATION: mstockstill on PROD1PC66 with RULES9 FOR FURTHER INFORMATION CONTACT: VerDate Aug<31>2005 17:40 Oct 28, 2008 Jkt 217001 On May 22, 2006, the Department of Homeland Security (DHS) through the United States Coast Guard (Coast Guard) and the Transportation Security Administration (TSA) published a joint notice of proposed rulemaking entitled ‘‘Transportation Worker Identification Credential (TWIC) Implementation in the Maritime Sector; Hazardous Materials Endorsement for a Commercial Driver’s License’’ in the Federal Register (71 FR 29396). This was followed by a 45-day comment period and four public meetings. The Coast Guard and TSA issued a joint final rule, under the same title, on January 25, 2007 (72 FR 3492) (hereinafter referred to as the original TWIC final rule). The preamble to that final rule contains a discussion of all the comments received on the NPRM, as well as a discussion of the provisions found in the original TWIC final rule, which became effective on March 26, 2007. On May 7, 2008, the Coast Guard and TSA issued a final rule to realign the compliance date for implementation of the Transportation Worker Identification Credential. 73 FR 25562. The date by which mariners need to obtain a TWIC, and by which owners and operators of vessels and outer continental shelf facilities must implement access control procedures utilizing TWIC, is now April 15, 2009 instead of September 25, 2008. Owners and operators of facilities that must comply with 33 CFR part 105 will still be subject to earlier, rolling compliance dates, as set forth in 33 CFR 105.115(e). The Coast Guard announced the rolling compliance dates, as provided in 33 CFR 105.115(e), at least 90 days in advance via notices published in the Federal Register. The final compliance date for all COTP Zones will not be later than April 15, 2009. On July 9, 2008, we announced the compliance date for COTP Zones Buffalo, Duluth, Detroit, Lake Michigan, and Sault Ste. Marie would be October 31, 2008. 73 FR 39323. II. Notice of Facility Compliance Date— COTP Zones Buffalo, Duluth, Detroit, Lake Michigan, and Sault Ste. Marie Title 33 CFR 105.115(e) currently states that ‘‘[f]acility owners and operators must be operating in accordance with the TWIC provisions in this part by the date set by the Coast Guard in a Notice to be published in the Federal Register.’’ Through this Notice, the Coast Guard informs the owners and operators of facilities subject to 33 CFR 105.115(e) located within COTP Zones PO 00000 Frm 00030 Fmt 4700 Sfmt 4700 Buffalo, Duluth, Detroit, Lake Michigan, and Sault Ste. Marie that the deadline for their compliance with Coast Guard and TSA TWIC requirements has been extended until December 1, 2008. This extension is being granted due to the disruption to TWIC activations caused by a building-wide loss of power that occurred on October 21, 2008, at the government facility that houses the TWIC system. The TSA and Coast Guard have determined that the new compliance date provides sufficient time for those who were unable to activate their TWICs during the disruption to return to an enrollment center and complete activation. We strongly encourage persons requiring unescorted access to facilities regulated by 33 CFR part 105 and located in this COTP Zone to enroll for their TWIC as soon as possible, if they haven’t already. Additionally, we note that the TWIC Final Rule advises owners and operators of MTSA regulated facilities of their responsibility to notify employees of the TWIC requirements. Specifically, 33 CFR 105.200(b)(14) requires owners or operators of MTSA regulated facilities to ‘‘[i]nform facility personnel of their responsibility to apply for and maintain a TWIC, including the deadlines and methods for such applications.’’ Information on enrollment procedures, as well as a link to the pre-enrollment website (which will also enable an applicant to make an appointment for enrollment), may be found at https:// twicprogram.tsa.dhs.gov/ TWICWebApp/. You may visit our Web site at homeport.uscg.mil/twic for a listing of all compliance dates by COTP Zone. This list is subject to change; any changes in compliance dates will appear on that website and be announced in the Federal Register as early as possible. Dated: October 24, 2008. David W. Murk, Commander, U.S. Coast Guard, Acting Chief, Ports and Facilities Activities. [FR Doc. E8–25933 Filed 10–27–08; 4:15 pm] BILLING CODE 4910–15–P DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 3 RIN 2900–AN04 Posttraumatic Stress Disorder Department of Veterans Affairs. Interim final rule. AGENCY: ACTION: SUMMARY: The Department of Veterans Affairs (VA) is amending its E:\FR\FM\29OCR1.SGM 29OCR1 mstockstill on PROD1PC66 with RULES9 Federal Register / Vol. 73, No. 210 / Wednesday, October 29, 2008 / Rules and Regulations adjudication regulations regarding service connection for posttraumatic stress disorder (PTSD) by eliminating the requirement of evidence corroborating occurrence of the claimed in-service stressor in claims in which PTSD is diagnosed in service. This amendment is necessary to facilitate the proof of service connection in such claims. By this amendment, we intend to reduce claim-processing time for such claims. DATES: Effective Date: This interim final rule is effective October 29, 2008. Comments must be received by VA on or before November 28, 2008. Applicability Date: VA will apply this interim final rule to claims pending before VA on the effective date of this rule, as well as to claims filed after that date. ADDRESSES: Written comments may be submitted through www.Regulations.gov; by mail or handdelivery to the Director, Regulations Management (02REG), Office of the General Counsel, Department of Veterans Affairs, 810 Vermont Ave., NW., Room 1068, Washington, DC 20420; or by fax to (202) 273–9026. Comments should indicate that they are submitted in response to ‘‘RIN 2900– AN04—Posttraumatic Stress Disorder.’’ Copies of comments received will be available for public inspection in the Office of Regulation Policy and Management, Room 1063B, between the hours of 8 a.m. and 4:30 p.m. Monday through Friday (except holidays). Please call (202) 461–4902 for an appointment. (This is not a toll-free number.) In addition, during the comment period, comments may be viewed online through the Federal Docket Management System (FDMS) at www.Regulations.gov. FOR FURTHER INFORMATION CONTACT: Maya Ferrandino, Regulations Staff (211D), Compensation and Pension Service, Veterans Benefits Administration, Department of Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420, (727) 319–5847. (This is not a toll-free number.) SUPPLEMENTARY INFORMATION: The Secretary of Veterans Affairs has the authority to prescribe regulations governing the nature and extent of proof and evidence required to establish entitlement to benefits. 38 U.S.C. 501(a)(1). Under 38 CFR 3.303(a), one of the ways that service connection of a disability may be established is by affirmatively showing inception or aggravation during service of a disease or injury that resulted in that disability. However, in order to establish service connection for PTSD in cases in which a veteran did not engage in combat with VerDate Aug<31>2005 17:40 Oct 28, 2008 Jkt 217001 the enemy or was not a prisoner of war, current 38 CFR 3.304(f) requires: (1) Medical evidence diagnosing PTSD; (2) medical evidence establishing a link between a veteran’s current symptoms and an in-service stressor; and (3) credible supporting evidence that the claimed in-service stressor occurred. The longstanding requirement in § 3.304(f) of credible supporting evidence that the claimed in-service stressor occurred is based on the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (1994) (DSM–IV), to which a diagnosis of a mental disorder must conform. 38 CFR 3.304(f) and 4.125(a). According to DSM–IV at 427, the first diagnostic criterion for PTSD is: The person has been exposed to a traumatic event in which both of the following were present: (1) The person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others (2) The person’s response involved intense fear, helplessness, or horror. The symptoms of PTSD ‘‘usually begin within the first 3 months after the trauma, although there may be a delay of months, or even years, before symptoms appear.’’ DSM–IV at 426. Given the delay that may occur between the occurrence of a stressor and the onset of PTSD and the subjective nature of a person’s response to an event, VA concluded, when it first promulgated § 3.304(f) in 1993, that it is reasonable to require corroboration of the in-service stressor, a conclusion with which the United States Court of Appeals for the Federal Circuit agreed. 58 FR 29109 (1993); Nat’l Org. of Veterans’ Advocates, Inc. v. Sec’y of Veterans Affairs, 330 F.3d 1345, 1351–52 (Fed. Cir. 2003). Also, according to DSM–IV at 424–25, a ‘‘person commonly makes deliberate efforts to avoid thoughts, feelings, or conversations about the traumatic event * * * and to avoid activities, situations, or people who arouse recollections of it. * * * This avoidance of reminders may include amnesia for an important aspect of the traumatic event.’’ We believed that it was reasonable for § 3.304(f) to require corroboration of the occurrence of the stressor in order to substantiate aspects of the event that a veteran may not remember. However, VA has found, based on claims submitted since September 11, 2001, that service members are increasingly being diagnosed with PTSD while still in service, rather than after discharge from service. The increased PO 00000 Frm 00031 Fmt 4700 Sfmt 4700 64209 incidence of in-service diagnoses of PTSD is attributable to advances in medicine and increased monitoring of service members’ mental health by the service departments. Given the ability to more quickly diagnose PTSD and the proximity between an in-service diagnosis of PTSD and the claimed occurrence of the stressor, VA no longer believes it is necessary to require evidence corroborating occurrence of the stressor in claims based on an inservice diagnosis. We are therefore amending § 3.304(f) to relax the requirements for establishing service connection for PTSD that was diagnosed in service. We are adding a new paragraph, which provides that, if the evidence shows that the veteran’s PTSD was diagnosed during service and the claimed stressor is related to that service, 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. We believe that this change will contribute to faster processing of PTSD claims by eliminating the need for VA to develop evidence of occurrence of the in-service stressor in claims in which the veteran’s PTSD was diagnosed during service. For claims based on a postservice diagnosis of PTSD, we will continue to require credible supporting evidence of the occurrence of the claimed in-service stressor. The U.S. Court of Appeals for Veterans Claims (CAVC) has held that VA is ‘‘not bound to accept [the claimant’s] uncorroborated account’’ of a stressor or a ‘‘social worker’s and psychiatrist’s unsubstantiated * * * opinions that the alleged PTSD had its origins in appellant’s [military service].’’ Wood v. Derwinski, 1 Vet. App. 190, 192 (1991). Further, the CAVC stated that VA ‘‘is not required to accept doctors’ opinions that are based upon the appellant’s recitation of medical history.’’ Godfrey v. Brown, 8 Vet. App. 113, 121 (1995). A post-service diagnosis of PTSD is often based on a claimant’s personal account of a stressful event that may have occurred many years before the doctor’s examination. In order to ensure a competent and credible diagnosis of PTSD, there must be corroboration of the claimed in-service stressor. This standard is the same as that generally applied by VA when a post-service diagnosis of a disability is allegedly due to an injury incurred or disease contracted during service. E:\FR\FM\29OCR1.SGM 29OCR1 64210 Federal Register / Vol. 73, No. 210 / Wednesday, October 29, 2008 / Rules and Regulations Also, we are eliminating the hyphen in the term ‘‘post-traumatic stress disorder’’ in § 3.304(f) to reflect current medical terminology. Administrative Procedure Act In accordance with 5 U.S.C. 553(b)(3)(B), the Secretary of Veterans Affairs finds that there is good cause to dispense with the opportunity for prior comment with respect to this rule, which eliminates the need for evidence to corroborate the occurrence of a stressor in claims in which a veteran was diagnosed with PTSD during service. The Secretary finds that it is impracticable, unnecessary, and contrary to the public interest to delay this regulation, which will speed up processing of PTSD claims, for the purpose of soliciting prior public comment because the regulation relieves an unnecessary proof requirement for certain veterans disabled by serviceconnected PTSD who need VA benefits as soon as possible to compensate for loss in wage-earning capacity. For the foregoing reasons, the Secretary of Veterans Affairs is issuing this rule as an interim final rule. The Secretary of Veterans Affairs will consider and address comments that are received within 30 days of the date this interim final rule is published in the Federal Register. Paperwork Reduction Act This document contains no provisions constituting a collection of information under the Paperwork Reduction Act (44 U.S.C. 3501–3521). mstockstill on PROD1PC66 with RULES9 Regulatory Flexibility Act The Secretary hereby certifies that this interim final rule will not have a significant economic impact on a substantial number of small entities as they are defined in the Regulatory Flexibility Act, 5 U.S.C. 601–612. This interim final rule will not affect any small entities. Only VA beneficiaries could be directly affected. Therefore, pursuant to 5 U.S.C. 605(b), this interim final rule is exempt from the initial and final regulatory flexibility analysis requirements of sections 603 and 604. Executive Order 12866 Executive Order 12866 directs agencies to assess all costs and benefits of available regulatory alternatives and, when regulation is necessary, to select regulatory approaches that maximize net benefits (including potential economic, environmental, public health and safety, and other advantages; distributive impacts; and equity). The Executive Order classifies a ‘‘significant regulatory action,’’ requiring review by VerDate Aug<31>2005 17:40 Oct 28, 2008 Jkt 217001 the Office of Management and Budget (OMB), as any regulatory action that is likely to result in a rule that may: (1) Have an annual effect on the economy of $100 million or more or adversely affect in a material way the economy, a sector of the economy, productivity, competition, jobs, the environment, public health or safety, or State, local, or tribal governments or communities; (2) create a serious inconsistency or otherwise interfere with an action taken or planned by another agency; (3) materially alter the budgetary impact of entitlements, grants, user fees, or loan programs or the rights and obligations of recipients thereof; or (4) raise novel legal or policy issues arising out of legal mandates, the President’s priorities, or the principles set forth in the Executive Order. The economic, interagency, budgetary, legal, and policy implications of this interim final rule have been examined, and it has been determined not to be a significant regulatory action under the Executive Order. Unfunded Mandates The Unfunded Mandates Reform Act of 1995 requires, at 2 U.S.C. 1532, that agencies prepare an assessment of anticipated costs and benefits before issuing any rule that may result in the expenditure by State, local, and tribal governments, in the aggregate, or by the private sector, of $100 million or more (adjusted annually for inflation) in any year. This interim final rule would have no such effect on State, local, and tribal governments, or on the private sector. Catalog of Federal Domestic Assistance Numbers and Titles The Catalog of Federal Domestic Assistance program numbers and titles for this rule are 64.109, Veterans Compensation for Service-Connected Disability and 64.110, Veterans Dependency and Indemnity Compensation for Service-Connected Death. List of Subjects in 38 CFR Part 3 Administrative practice and procedure, Claims, Disability benefits, Health care, Pensions, Radioactive materials, Veterans, Vietnam. PART 3—ADJUDICATION 1. The authority citation for part 3, subpart A continues to read as follows: ■ Authority: 38 U.S.C. 501(a), unless otherwise noted. 2. Amend § 3.304(f) by: a. Revising the paragraph heading and introductory text. ■ b. Redesignating paragraphs (1), (2), and (3) as paragraphs (2), (3), and (4), respectively, and by adding new paragraph (1). ■ c. Removing ‘‘post-traumatic’’ each place it appears and add, in its place, ‘‘posttraumatic’’. The revisions and addition read as follows: ■ ■ § 3.304 Direct service connection; wartime and peacetime. * * * * * (f) Posttraumatic stress disorder. Service connection for posttraumatic stress disorder requires medical evidence diagnosing the condition in accordance with § 4.125(a) of this chapter; a link, established by medical evidence, between current symptoms and an in-service stressor; and credible supporting evidence that the claimed inservice stressor occurred. The following provisions apply to claims for service connection of posttraumatic stress disorder diagnosed during service or based on specified in-service stressors: (1) If the evidence establishes a diagnosis of posttraumatic stress disorder during service and the claimed stressor is related to that service, 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. * * * * * [FR Doc. E8–25735 Filed 10–28–08; 8:45 am] BILLING CODE 8320–01–P ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 52 [EPA–R03–OAR–2008–0656; FRL–8735–4] Approved: October 7, 2008. Gordon H. Mansfield, Deputy Secretary of Veterans Affairs. For the reasons set out in the preamble, VA is amending 38 CFR part 3 as follows: Approval and Promulgation of Air Quality Implementation Plans; Virginia; Movement of Richmond and Hampton Roads 8-Hour Ozone Areas From the Nonattainment Area List to the Maintenance Area List AGENCY: ■ PO 00000 Frm 00032 Fmt 4700 Sfmt 4700 Environmental Protection Agency (EPA). E:\FR\FM\29OCR1.SGM 29OCR1

Agencies

[Federal Register Volume 73, Number 210 (Wednesday, October 29, 2008)]
[Rules and Regulations]
[Pages 64208-64210]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E8-25735]


=======================================================================
-----------------------------------------------------------------------

DEPARTMENT OF VETERANS AFFAIRS

38 CFR Part 3

RIN 2900-AN04


Posttraumatic Stress Disorder

AGENCY: Department of Veterans Affairs.

ACTION: Interim final rule.

-----------------------------------------------------------------------

SUMMARY: The Department of Veterans Affairs (VA) is amending its

[[Page 64209]]

adjudication regulations regarding service connection for posttraumatic 
stress disorder (PTSD) by eliminating the requirement of evidence 
corroborating occurrence of the claimed in-service stressor in claims 
in which PTSD is diagnosed in service. This amendment is necessary to 
facilitate the proof of service connection in such claims. By this 
amendment, we intend to reduce claim-processing time for such claims.

DATES: Effective Date: This interim final rule is effective October 29, 
2008. Comments must be received by VA on or before November 28, 2008.
    Applicability Date: VA will apply this interim final rule to claims 
pending before VA on the effective date of this rule, as well as to 
claims filed after that date.

ADDRESSES: Written comments may be submitted through 
www.Regulations.gov; by mail or hand-delivery to the Director, 
Regulations Management (02REG), Office of the General Counsel, 
Department of Veterans Affairs, 810 Vermont Ave., NW., Room 1068, 
Washington, DC 20420; or by fax to (202) 273-9026. Comments should 
indicate that they are submitted in response to ``RIN 2900-AN04--
Posttraumatic Stress Disorder.'' Copies of comments received will be 
available for public inspection in the Office of Regulation Policy and 
Management, Room 1063B, between the hours of 8 a.m. and 4:30 p.m. 
Monday through Friday (except holidays). Please call (202) 461-4902 for 
an appointment. (This is not a toll-free number.) In addition, during 
the comment period, comments may be viewed online through the Federal 
Docket Management System (FDMS) at www.Regulations.gov.

FOR FURTHER INFORMATION CONTACT: Maya Ferrandino, Regulations Staff 
(211D), Compensation and Pension Service, Veterans Benefits 
Administration, Department of Veterans Affairs, 810 Vermont Avenue, 
NW., Washington, DC 20420, (727) 319-5847. (This is not a toll-free 
number.)

SUPPLEMENTARY INFORMATION: The Secretary of Veterans Affairs has the 
authority to prescribe regulations governing the nature and extent of 
proof and evidence required to establish entitlement to benefits. 38 
U.S.C. 501(a)(1). Under 38 CFR 3.303(a), one of the ways that service 
connection of a disability may be established is by affirmatively 
showing inception or aggravation during service of a disease or injury 
that resulted in that disability. However, in order to establish 
service connection for PTSD in cases in which a veteran did not engage 
in combat with the enemy or was not a prisoner of war, current 38 CFR 
3.304(f) requires: (1) Medical evidence diagnosing PTSD; (2) medical 
evidence establishing a link between a veteran's current symptoms and 
an in-service stressor; and (3) credible supporting evidence that the 
claimed in-service stressor occurred.
    The longstanding requirement in Sec.  3.304(f) of credible 
supporting evidence that the claimed in-service stressor occurred is 
based on the American Psychiatric Association's Diagnostic and 
Statistical Manual of Mental Disorders, Fourth Edition (1994) (DSM-IV), 
to which a diagnosis of a mental disorder must conform. 38 CFR 3.304(f) 
and 4.125(a). According to DSM-IV at 427, the first diagnostic 
criterion for PTSD is:

    The person has been exposed to a traumatic event in which both 
of the following were present:
    (1) The person experienced, witnessed, or was confronted with an 
event or events that involved actual or threatened death or serious 
injury, or a threat to the physical integrity of self or others
    (2) The person's response involved intense fear, helplessness, 
or horror.

The symptoms of PTSD ``usually begin within the first 3 months after 
the trauma, although there may be a delay of months, or even years, 
before symptoms appear.'' DSM-IV at 426. Given the delay that may occur 
between the occurrence of a stressor and the onset of PTSD and the 
subjective nature of a person's response to an event, VA concluded, 
when it first promulgated Sec.  3.304(f) in 1993, that it is reasonable 
to require corroboration of the in-service stressor, a conclusion with 
which the United States Court of Appeals for the Federal Circuit 
agreed. 58 FR 29109 (1993); Nat'l Org. of Veterans' Advocates, Inc. v. 
Sec'y of Veterans Affairs, 330 F.3d 1345, 1351-52 (Fed. Cir. 2003). 
Also, according to DSM-IV at 424-25, a ``person commonly makes 
deliberate efforts to avoid thoughts, feelings, or conversations about 
the traumatic event * * * and to avoid activities, situations, or 
people who arouse recollections of it. * * * This avoidance of 
reminders may include amnesia for an important aspect of the traumatic 
event.'' We believed that it was reasonable for Sec.  3.304(f) to 
require corroboration of the occurrence of the stressor in order to 
substantiate aspects of the event that a veteran may not remember.
    However, VA has found, based on claims submitted since September 
11, 2001, that service members are increasingly being diagnosed with 
PTSD while still in service, rather than after discharge from service. 
The increased incidence of in-service diagnoses of PTSD is attributable 
to advances in medicine and increased monitoring of service members' 
mental health by the service departments. Given the ability to more 
quickly diagnose PTSD and the proximity between an in-service diagnosis 
of PTSD and the claimed occurrence of the stressor, VA no longer 
believes it is necessary to require evidence corroborating occurrence 
of the stressor in claims based on an in-service diagnosis.
    We are therefore amending Sec.  3.304(f) to relax the requirements 
for establishing service connection for PTSD that was diagnosed in 
service. We are adding a new paragraph, which provides that, if the 
evidence shows that the veteran's PTSD was diagnosed during service and 
the claimed stressor is related to that service, 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. We 
believe that this change will contribute to faster processing of PTSD 
claims by eliminating the need for VA to develop evidence of occurrence 
of the in-service stressor in claims in which the veteran's PTSD was 
diagnosed during service.
    For claims based on a postservice diagnosis of PTSD, we will 
continue to require credible supporting evidence of the occurrence of 
the claimed in-service stressor. The U.S. Court of Appeals for Veterans 
Claims (CAVC) has held that VA is ``not bound to accept [the 
claimant's] uncorroborated account'' of a stressor or a ``social 
worker's and psychiatrist's unsubstantiated * * * opinions that the 
alleged PTSD had its origins in appellant's [military service].'' Wood 
v. Derwinski, 1 Vet. App. 190, 192 (1991). Further, the CAVC stated 
that VA ``is not required to accept doctors' opinions that are based 
upon the appellant's recitation of medical history.'' Godfrey v. Brown, 
8 Vet. App. 113, 121 (1995). A post-service diagnosis of PTSD is often 
based on a claimant's personal account of a stressful event that may 
have occurred many years before the doctor's examination. In order to 
ensure a competent and credible diagnosis of PTSD, there must be 
corroboration of the claimed in-service stressor. This standard is the 
same as that generally applied by VA when a post-service diagnosis of a 
disability is allegedly due to an injury incurred or disease contracted 
during service.

[[Page 64210]]

    Also, we are eliminating the hyphen in the term ``post-traumatic 
stress disorder'' in Sec.  3.304(f) to reflect current medical 
terminology.

Administrative Procedure Act

    In accordance with 5 U.S.C. 553(b)(3)(B), the Secretary of Veterans 
Affairs finds that there is good cause to dispense with the opportunity 
for prior comment with respect to this rule, which eliminates the need 
for evidence to corroborate the occurrence of a stressor in claims in 
which a veteran was diagnosed with PTSD during service. The Secretary 
finds that it is impracticable, unnecessary, and contrary to the public 
interest to delay this regulation, which will speed up processing of 
PTSD claims, for the purpose of soliciting prior public comment because 
the regulation relieves an unnecessary proof requirement for certain 
veterans disabled by service-connected PTSD who need VA benefits as 
soon as possible to compensate for loss in wage-earning capacity. For 
the foregoing reasons, the Secretary of Veterans Affairs is issuing 
this rule as an interim final rule. The Secretary of Veterans Affairs 
will consider and address comments that are received within 30 days of 
the date this interim final rule is published in the Federal Register.

Paperwork Reduction Act

    This document contains no provisions constituting a collection of 
information under the Paperwork Reduction Act (44 U.S.C. 3501-3521).

Regulatory Flexibility Act

    The Secretary hereby certifies that this interim final rule will 
not have a significant economic impact on a substantial number of small 
entities as they are defined in the Regulatory Flexibility Act, 5 
U.S.C. 601-612. This interim final rule will not affect any small 
entities. Only VA beneficiaries could be directly affected. Therefore, 
pursuant to 5 U.S.C. 605(b), this interim final rule is exempt from the 
initial and final regulatory flexibility analysis requirements of 
sections 603 and 604.

Executive Order 12866

    Executive Order 12866 directs agencies to assess all costs and 
benefits of available regulatory alternatives and, when regulation is 
necessary, to select regulatory approaches that maximize net benefits 
(including potential economic, environmental, public health and safety, 
and other advantages; distributive impacts; and equity). The Executive 
Order classifies a ``significant regulatory action,'' requiring review 
by the Office of Management and Budget (OMB), as any regulatory action 
that is likely to result in a rule that may: (1) Have an annual effect 
on the economy of $100 million or more or adversely affect in a 
material way the economy, a sector of the economy, productivity, 
competition, jobs, the environment, public health or safety, or State, 
local, or tribal governments or communities; (2) create a serious 
inconsistency or otherwise interfere with an action taken or planned by 
another agency; (3) materially alter the budgetary impact of 
entitlements, grants, user fees, or loan programs or the rights and 
obligations of recipients thereof; or (4) raise novel legal or policy 
issues arising out of legal mandates, the President's priorities, or 
the principles set forth in the Executive Order.
    The economic, interagency, budgetary, legal, and policy 
implications of this interim final rule have been examined, and it has 
been determined not to be a significant regulatory action under the 
Executive Order.

Unfunded Mandates

    The Unfunded Mandates Reform Act of 1995 requires, at 2 U.S.C. 
1532, that agencies prepare an assessment of anticipated costs and 
benefits before issuing any rule that may result in the expenditure by 
State, local, and tribal governments, in the aggregate, or by the 
private sector, of $100 million or more (adjusted annually for 
inflation) in any year. This interim final rule would have no such 
effect on State, local, and tribal governments, or on the private 
sector.

Catalog of Federal Domestic Assistance Numbers and Titles

    The Catalog of Federal Domestic Assistance program numbers and 
titles for this rule are 64.109, Veterans Compensation for Service-
Connected Disability and 64.110, Veterans Dependency and Indemnity 
Compensation for Service-Connected Death.

List of Subjects in 38 CFR Part 3

    Administrative practice and procedure, Claims, Disability benefits, 
Health care, Pensions, Radioactive materials, Veterans, Vietnam.

    Approved: October 7, 2008.
Gordon H. Mansfield,
Deputy Secretary of Veterans Affairs.

0
For the reasons set out in the preamble, VA is amending 38 CFR part 3 
as follows:

PART 3--ADJUDICATION

0
1. The authority citation for part 3, subpart A continues to read as 
follows:

    Authority: 38 U.S.C. 501(a), unless otherwise noted.


0
2. Amend Sec.  3.304(f) by:
0
a. Revising the paragraph heading and introductory text.
0
b. Redesignating paragraphs (1), (2), and (3) as paragraphs (2), (3), 
and (4), respectively, and by adding new paragraph (1).
0
c. Removing ``post-traumatic'' each place it appears and add, in its 
place, ``posttraumatic''.
    The revisions and addition read as follows:


Sec.  3.304  Direct service connection; wartime and peacetime.

* * * * *
    (f) Posttraumatic stress disorder. Service connection for 
posttraumatic stress disorder requires medical evidence diagnosing the 
condition in accordance with Sec.  4.125(a) of this chapter; a link, 
established by medical evidence, between current symptoms and an in-
service stressor; and credible supporting evidence that the claimed in-
service stressor occurred. The following provisions apply to claims for 
service connection of posttraumatic stress disorder diagnosed during 
service or based on specified in-service stressors:
    (1) If the evidence establishes a diagnosis of posttraumatic stress 
disorder during service and the claimed stressor is related to that 
service, 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.
* * * * *
[FR Doc. E8-25735 Filed 10-28-08; 8:45 am]
BILLING CODE 8320-01-P