Citation Nr: 18140298 Decision Date: 10/02/18 Archive Date: 10/02/18 DOCKET NO. 16-44 865 DATE: October 2, 2018 ORDER Service connection for residuals of a traumatic brain injury (TBI) is granted. Service connection for Parkinson’s disease, claimed as secondary to TBI, is granted. Service connection for tremors of the left hand, claimed as secondary to Parkinson’s disease, is granted. Service connection for tremors of the right hand, claimed as secondary to Parkinson’s disease, is granted. Service connection for blurred vision, claimed as secondary to Parkinson’s disease, is granted. FINDINGS OF FACT 1. Resolving all doubt in his favor, a TBI was incurred during his military service. 2. Resolving all doubt in his favor, the Veteran has a current diagnosis of Parkinson’s disease which has been related to his in-service TBI. 3. Resolving all doubt in his favor, the Veteran has a current diagnosis of tremors of the left hand which has been related to his now service-connected Parkinson’s disease. 4. Resolving all doubt in his favor, the Veteran has a current diagnosis of tremors of the right hand which has been related to his now service-connected Parkinson’s disease. 5. Resolving all doubt in his favor, the Veteran experiences blurred vision which has been related to his now service-connected Parkinson’s disease. CONCLUSIONS OF LAW 1. Resolving reasonable doubt in the Veteran’s favor, the Veteran’s TBI was incurred in or is otherwise related to his active service. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. 2. Resolving reasonable doubt in the Veteran’s favor, the Veteran’s Parkinson’s disease is related to his active service. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.310. 3. Resolving reasonable doubt in the Veteran’s favor, the Veteran’s tremors of the left hand are related to his now service-connected Parkinson’s disease. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.310. 4. Resolving reasonable doubt in the Veteran’s favor, the Veteran’s tremors of the right hand are related to his now service-connected Parkinson’s disease. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.310. 5. Resolving reasonable doubt in the Veteran’s favor, the Veteran’s blurred vision is related to his now service-connected Parkinson’s disease. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from April 1955 to February 1957. This case is before the Board of Veterans’ Appeals (Board) on appeal from a March 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Winston-Salem, North Carolina. In June 2018, the Veteran and his wife, testified at a Board video conference hearing at the RO in Winston-Salem, North Carolina, before the undersigned Veterans Law Judge sitting at the Central Office in Washington, DC. A transcript of the hearing is associated with the file. Legal Criteria Service connection may be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred or aggravated in active military service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303(a). Generally, service connection requires evidence of a current disability with a relationship or connection to an injury or disease or some other manifestation of the disability during service. Boyer v. West, 210 F.3d 1351, 1353 (Fed. Cir. 2000). Service connection may be established on a secondary basis for a disability which is proximately due to or the result of service-connected disease or injury. 38 C.F.R. § 3.310(a). Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists and (2) that the current disability was either (a) proximately caused by or (b) proximately aggravated by a service-connected disability. Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination, the benefit of the doubt is afforded the claimant. 38 U.S.C. § 5107(b). Analysis The Veteran contends that he experienced a TBI during his military service. Specifically, during the June 2018 Board videoconference hearing, the Veteran’s wife testified that, while stationed in Korea in 1956, the Veteran was operating a heavy vehicle truck with a crane mounted on the back. While traveling along a narrow road, he was involved in a collision and, while was attempting to exit the disabled vehicle, he was struck in the head with the crane. The Veteran further contends that he currently suffers from residuals of this TBI, to include Parkinson’s disease, tremors of the bilateral upper extremities, and blurred vision. Unfortunately, there is no confirmation of the Veteran’s alleged TBI as the Veteran’s service treatment records are considered fire-related. However, in cases where the service records are unavailable, a heightened duty exists to assist in the development of the case. See O’Hare v. Derwinski, 1 Vet. App. 365 (1991). While the Veteran’s service treatment records are unavailable, there is competent evidence in the claims file that a TBI did occur during his military service. First, a November 1979 private treatment note shows a diagnosis of migraine headaches and notes a history of headaches since 1956 (during the Veteran’s military service). Second, the Veteran has submitted statements from his sister, brother, and wife dated in March and July 2015 noting a history of an in-service head injury as well as headaches ever since the head injury. A review of the record shows that the Veteran was diagnosed with Parkinson’s disease in October 2013 and an October 2014 disability benefits questionnaire shows that the Veteran’s Parkinson’s disease has resulted in tremors of the upper extremities as well as blurred vision. The Veteran was not afforded a VA examination in this case. However, he has submitted statements from his treating VA physicians noting a relationship between an in-service TBI and current residuals of the TBI. In a June 2014 statement, Dr. C.L. wrote that the Veteran had Parkinson’s disease as well as post-traumatic migraine headaches. Dr. C.L. also noted an in-service blast injury where the Veteran developed migraine headaches within a few days of the injury. Similarly, in a May 2017 statement from Dr. A.B., it was noted that the Veteran had a head injury while in Korea and had a diagnosis of Parkinson’s disease. Significantly, Dr. A.B. wrote that it was medically recognized that head injuries are one cause of Parkinson’s disease. In this case, resolving all reasonable doubt in favor of the veteran, the Board finds that the Veteran sustained a TBI during his military service and currently suffers from residuals of the TBI, to include Parkinson’s disease, tremors of the bilateral upper extremities, and blurred vision. See 38 U.S.C. § 5107(b). Initially, while the Veteran’s service treatment records are unavailable, the Veteran, through his wife, was a highly credible witness during the June 2018 Board videoconference hearing. Moreover, post-service treatment records show migraine headaches as early as November 1979 with a history of headaches beginning in 1956 (while the Veteran was in service). Furthermore, the June 2014 and May 2017 medical opinions provide a plausible basis to conclude that the Veteran’s in-service TBI has resulted in his current Parkinson’s disease and associated tremors of the upper extremities as well as blurred vision. As such, service connection for residuals of a TBI, to include post-traumatic migraine headaches, Parkinson’s disease, tremors of the bilateral upper extremities, and blurred vision is granted. L. M. BARNARD Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD April Maddox, Counsel