Citation Nr: 18148648 Decision Date: 11/08/18 Archive Date: 11/07/18 DOCKET NO. 12-29 003 DATE: November 8, 2018 ORDER Service connection for the residuals of a traumatic brain injury is denied. VETERAN’S CONTENTIONS The Veteran asserts that his current symptoms of headaches, dizziness, mood swings, difficulty concentrating, and memory loss are related to a mild traumatic brain injury (TBI) he sustained in service, when he hit his head on an LVT (Landing Vehicle, Tracked). FINDINGS OF FACT 1. The Veteran suffered a mild TBI in service, when he fell on an LVT and hit his head. The Veteran experienced dizziness and headaches following the injury. See October 2012 Substantive Appeal; June 2016 Board Hearing; July 2018 VHA Expert Opinion. 2. The Veteran currently experiences headaches, dizziness, mood swings, difficulty concentrating, and memory loss. See June 2016 Board Hearing. 3. The Veteran’s initial TBI symptoms resolved in service, by around April 1981. See April 1981 Service Treatment Record; July 2018 VHA Expert Opinion. The Veteran’s current headaches, dizziness, mood swings, difficulty concentrating, and memory loss are not related to his in-service mild TBI. See February 2017 VA examination; July 2018 VHA Expert Opinion. CONCLUSION OF LAW The criteria for service connection for the residuals of a traumatic brain injury are not met. 38 U.S.C. §§ 1111, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran served on active duty in the Navy from May 1977 to July 1987. This case is before the Board of Veterans’ Appeals (Board) on appeal from a February 2011 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in San Diego, California. In June 2016, the Veteran testified at a hearing before the undersigned. A transcript of the hearing is of record. The Board remanded this claim, and the claim of entitlement to service connection for the residuals of an eye injury in September 2016. In an April 2017 rating decision, the RO granted service connection for a left eye retinal tear, effective June 7, 2010. The Veteran disagreed with the initial rating assigned but has not yet perfected an appeal as to that downstream issue. See Grantham v. Brown, 114 F.3d 1156, 1158-59 (Fed. Cir. 1997) (holding that where an appealed claim for service connection is granted during the pendency of the appeal, a second notice of disagreement must thereafter be timely filed to initiate appellate review of the claim concerning “downstream” issues, such as the compensation level assigned for the disability and the effective date); see also 38 C.F.R. § 20.200. Generally, in order to prove service connection, there must be competent, credible evidence of 1) a current disability, 2) in-service incurrence or aggravation of an injury or disease, and 3) a nexus, or link, between the current disability and the in-service disease or injury. See, e.g., Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Pond v. West, 12 Vet. App. 341 (1999). As noted in the above findings of fact, the Veteran currently experiences a disability manifested by symptoms including headaches, mood swings, and dizziness. In addition, the Veteran sustained a mild TBI in service. Therefore, the first and second elements of service connection are satisfied. However, the Board finds that there is no nexus between the Veteran’s in-service TBI and his current disability, such that the claim for service connection must be denied. At a June 2016 hearing before the Board, the Veteran testified that he had experienced headaches, dizziness, and mood swings from the time of his in-service injury until the present. Although the Veteran’s service treatment records contain no indication of a head injury, the Board credits the Veteran’s testimony that he injured his head in a fall on an LVT. Further, in a July 2018 opinion, a VHA expert indicated that, crediting the Veteran’s testimony, he “suffered a mild TBI in military service.” However, in an April 1981 physical examination questionnaire, although he endorsed infrequent headaches, the Veteran explicitly denied problems with dizziness, mood, or memory and concentration. In light of the April 1981 service treatment record, the July 2018 VHA expert opined: “If we presume as true the Veteran’s current account of a head injury in service and his reports of continuity of symptomatology from the time of his injury/discharge from service until the present, the patient’s report in service treatment records on an annual medical exam on 4/22/81 . . . leads to the conclusion that while the patient suffered a mild TBI in military service, the currently reported problems of impaired memory/concentration, mood swings, dizziness, and headache are less likely than not . . . related to the TBI sustained while in military service.” A February 2017 VA examination report supports the VHA expert’s opinion. The examiner acknowledged the Veteran’s head injury, but stated: “Residuals related to concussion/mTBI [mild TBI] start immediately after the concussion and show progressive improvement over time, usually within several days up to a few months after the event. In very few cases of mTBI symptoms may persist longer. The review of available medical records provides limited evidence that the Veteran experienced signs/symptoms consistent with TBI or residuals of TBI soon after incurring the head injury. Today’s evaluation does not provide objective evidence consistent with residuals of TBI. No diagnosis of TBI is endorsed.” The opinions of the VHA expert and VA examiner are competent, credible, and entitled to significant weight. Taken together, the medical evidence of record indicates that in most cases the symptoms of a mild TBI improve within days to a few months after the event, and, consistent with this, in the Veteran’s case, residuals of his in-service TBI had almost entirely resolved by April 1981. The only evidence to the contrary is the Veteran’s hearing testimony that he has experienced continuous symptoms of headaches, mood swings, and dizziness from the time of his injury to the present. The Board does not doubt the sincerity of the Veteran’s testimony. However, this testimony is contradicted by the Veteran’s own report made to a medical examiner in April 1981. Statements made for the purpose of medical diagnosis or treatment are considered exceptionally trustworthy, because the declarant has a strong motive to tell the truth in order to receive a proper diagnosis or treatment. White v. Illinois, 502 U.S. 346, 355-56 (1991); Rucker v. Brown, 10 Vet. App. 67, 73 (1997) (observing that, although formal rules of evidence do not apply before the Board, recourse to the Federal Rules of Evidence may be appropriate). For this reason, the Board finds that the medical evidence of record is more probative than the Veteran’s hearing testimony, given directly to the Board in support of his appeal. Therefore, the Board finds that the residuals of the Veteran’s mild TBI resolved in service, and his current disability, manifested by symptoms of headaches, dizziness, mood swings, difficulty concentrating, and memory loss, is not related to his in-service TBI. Accordingly, service connection for residuals of a TBI is not warranted. S. C. KREMBS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD P. Timmerman, Associate Counsel