Findings of Fact 154 Ct. Cl. aminations and evaluations, he was variously considered to have a mental disorder of psychogenic origin, traumatic encephalopathy, and combinations of these. He is now receiving compensation from the Veterans Administration for a minimum rating of the diagnosis of traumatic encephalopathy. His occupational record is spotty, but he is apparently working successfully at present. 2. It is the opinion of the Surgeon General that the findings of the Air Force Disability Review Board should be adhered to. (d) On March 20, 1958, the Board, on the basis of plaintiff's request, the transcript of the hearing, plaintiff's Army and Air Force personnel records and his VA records, found: 18. Careful consideration has been given to the application with supporting documents, the argument of counsel and the evidence of record. It is shown that applicant was denied retirement pay benefits as an officer because it was held that his incapacity was not incurred while he was a commissioned officer. The army retiring board found that his incapacity was incurred sometime prior to commissioning and was first manifested while he was serving as an aviation cadet. The army retiring board was not confronted with the problem that was eventually resolved in 1950 to the effect that if the incapacity was incurred in enlisted status and service was continuous and the incapacity was determined while in officer status, the incapacity was incident to service for retirement pay purposes as an officer. In fact, until the case was reviewed by the Disability Review Board no finding had been made that the incapacity was incurred as an aviation cadet or existing prior to entrance on military service. Because it was held not to have been incurred in commissioned status does not require a finding that it was incurred in aviation cadet status. The Disability Review Board found as a fact that it existed prior to entrance into military service. That finding did not change any finding of the army retiring board; it merely fixed with certainty a finding of the army retiring board to the effect that the incapacity existed sometime prior to commissioned status. În a word we reject the proposition that the rationale of the Capps case is determining of the present case. 19. Independent of the foregoing we have considered whether or not the incapacity is an incident of service. If over-emphasis has been placed on the "fish bone story" in this record such emphasis is not our doing. It arose 215 Findings of Fact in a conclusion of counsel that it was a determining factor in the EPTS finding. Reference to it appears in the early Veterans Administration examinations. For about twelve years, up to 1955, there was universal agreement on the diagnosis of psychoneurosis, hysteria the only changes being those to reflect changes in psychiatric nomenclature for the same disorder. In 1955, the diagnosis was changed to Chronic brain syndrome, associated with brain trauma with neurotic reaction, manifested by headaches and symptomatic convulsive disorder. Both may be correct; neither one rules out the other. Nonetheless the symptom complex which resulted in a finding of incapacity were those of a psychoneurosis, hysteria. We conclude that the incapacity was as found by the Army Retiring Board, namely, Psychoneurosis, hysteria. A careful study of all the physical examination in and out of service demonstrates that applicant has been a life-long neurotic. The fear of bombing children, fear of choking on fish bones, and the fear of falling is not the whole story. The fact is that the physical and mental examination showed him to be an "excitable, talkative, emotionally unstable individual" who showed hysterical dissociation, hypersuggestibility and hypochondriasis. He described his complaints with emphasis. He showed signs of vaso-motor instability and the biological components of tension. He was a dramatic, immature individual obsessed with the idea that he had a brain tumor. The fear of bombing children was immediately relieved when it was pointed out to him that if they were not killed as children, they would grow up to fight us later on. It was not just fear of choking on fishbones. It was such an uncontrolled life-long phobia that even the thought or smell of fish would cause nausea and vomiting. We conclude, therefore, that the incapacitating defect existed prior to service and was not an incident of service. The applicant has failed to demonstrate any error or injustice in his case. It accordingly recommended that plaintiff's application be denied. On the same day, the Assistant Secretary of the Air Force approved such recommendation and denied plaintiff's application. Plaintiff was so advised by letter of March 24, 1958. On May 6, 1958, plaintiff's petition herein was filed 35. Plaintiff's symptoms (headache, dizziness, nausea, vomiting, insomnia, irritability, personality changes, seizures, tinnitus (ringing in the ears)) are consistent with a head or brain injury. If this is the true cause of plaintiff's 1 Findings of Fact 154 Ct. CI. condition, they can only be related to the injury to his head received during the airplane landing on July 22, 1943, since the symptoms commenced shortly thereafter and there appears to be no record of any other head injury to which to relate such symptoms. However, the same symptoms are also consistent with a psychoneurotic condition without brain damage. They may, in some cases, be brought about by a minor head blow which causes no brain damage. While in some cases the symptoms may be related to brain damage and in others may be entirely psychological in origin, in many cases both factors may play a contributing role. Patients who had previously shown a normal adjustment to life may also develop post-traumatic symptoms, and this is so even in situations where the injury is not severe. However, they are more likely to occur in patients who had manifested neurotic symptoms before the injury. The desire to obtain compensation may serve to prolong such symptoms after they develop, or may even play a part in their development. The evidence does not clearly and convincingly establish whether plaintiff's condition is due to an organic brain injury, or to a psychoneurotic condition, or to both. The entire subject of the relation between head injury and mental disease is a highly controversial one in the medical world. 36. Army Regulation 40-1025, dated December 12, 1944, provided: Par. 63 b. Basic provision for determining line of duty.—A disease or injury that a militarized person contracts or sustains, while in the active military service of the United States, will be presumed to have been incurred in line of duty, unless there is substantial evidence to show that such disease or injury— * (4) Existed prior to the individual's current active service and was not aggravated by the service (g below). g. Existed prior to individual's current active service and was not aggravated by service (EPTS). (2) Basic provision.-Irrespective of length of service, an Army patient will be presumed to have been in sound condition upon entering active service, unless the 215 Findings of Fact disease or injury, or the conditions which brought about the disease, injury, or death, were noted on the patient's physical examination upon entrance into the service, or unless clear and unmistakable evidence ((3) below) demonstrates that the injury or disease, or the conditions which caused the disease, injury, or death, though not noted, existed prior to the patient's active service. Further, even if the existence of the condition prior to entering active service has been established, only specific findings of "natural progress" of the disease or injury, based on well-established medical principles, are able to overcome the presumption of service-aggravated ((4) below). This provision will serve as a basis for judging line of duty in all cases, on or after 7 December 1941, and before the termination of hostilities incident to the present war. (It will be borne in mind that in determining line of duty with respect to eligibility for retirement benefits, the incapacity, whether resulting from a condition incident to service, or from a condition that existed prior to service but aggravated by the service beyond the "natural progress" of the condition, must be permanent; that is, the incapacity caused by the condition must be such that the removal of the disability within a reasonable time is highly improbable; *** (3) Clear and unmistakable evidence.-Medical judgment alone, as distinguished from well-established medical principles, will not be considered sufficient to rebut the presumption of the patient's sound condition at the time of his entrance into active military service. * * * (4) Service-aggravated.—Any increase in disability during active service resulting from a condition that existed prior to active service will be presumed to have been service-aggravated, unless it can be proved otherwise on the bases of well-established medical principles. Medical or surgical treatment furnished during service for preexisting conditions does not of itself establish increase in disability; however, if such treatment was necessitated by increase in severity of preexisting conditions, then such disability will be considered as serviceaggravated, unless the condition was improved by such treatment. *** (5) Psychiatric cases. In line of duty.-The following cases will be considered to be in line of duty irrespective of length of service: 2. Cases of *** psychoneurosis occurring in individuals in whom predisposition to these diseases, but Findings of Fact 154 Ct. CI. not the actual disease itself, existed prior to entry into the service. Neurotic traits in themselves will not be regarded as necessarily indicating the presence of psychoneurosis or psychosis. 3. Psychiatric conditions occurring in individuals in whom such conditions existed prior to entry into the service, but where there is evidence to show that the disorder has been aggravated by the service. ** (b) Not in line of duty.-The following cases will be considered to be not in line of duty: cases of *** psychoneurosis where available evidence clearly indicates the existence of the disease prior to entry into the service, and that the disease was not aggravated by the service. 37. In 1949, the Medical Service, Joint Armed Forces, published, as a regulation, a booklet entitled "Nomenclature and Method of Recording Psychiatric Conditions", which states in part as follows: 5. Psychoneurotic Disorders This generic term refers to psychiatric disorders resulting from the exclusion from consciousness (i.e., repression) of powerful emotional charges, usually attached to certain infantile and childhood developmental experiences. Hereditary, constitutional organic situational, and cultural factors are involved, but the extent to which they are contributory to the particular disorder is difficult to determine. However, these factors should be carefully considered in evaluating "external precipitating stress" and "premorbid personality and predisposition" ***. These repressed emotional charges, which may not be apparent without an extensive and deep investigation of the personality, may or may not be adequately controlled in the absence of external stress. Longitudinal (lifelong) studies of individuals with such disorders usually present evidence of periodic or constant maladjustment of varying degree. Special stress may make the symptomatic expressions of such disorders acute. The chief characteristics of these disorders is "anxiety," which may be either "free floating" and unbound ("anxiety reaction"), and directly felt and expressed, or it may be unconsciously and automatically controlled by the utilization of various psychological defense mechanisms (repression, conversion, displacement, etc.). In contrast to psychotics, patients with psychoneurotic disorders do not exhibit gross distortion or falsification of |