Citation Nr: 18151698
Decision Date: 11/20/18	Archive Date: 11/19/18

DOCKET NO. 16-35 202A
DATE:	November 20, 2018
REMANDED
Entitlement to service connection for seizures and blackouts is remanded.
Entitlement to special monthly compensation (SMC) for aid and attendance is remanded.
REASONS FOR REMAND
The Veteran served on active duty from September 1988 to September 1993.  He received the National Defense Service Medal, Army Service Ribbon, and Expert Marksmanship Badge.
Service Connection for Seizures and Blackouts
The Veteran underwent a VA examination in August 2017, and the examiner opined that it was less likely than not that the Veteran’s blackouts and seizures are due to or the result of the Veteran’s service-connected neck disability because his 1994 neck x-ray was normal, and there were no complaints of seizures until 2014.  However, the examiner did not consider the Veteran’s contentions of episodes of syncope or dizziness prior to 2014, nor did the examiner consider the March 2008 treatment note documenting intermittent dizziness.  Accordingly, the Agency of Original Jurisdiction should obtain a new opinion on remand that fully considers the Veteran’s history and contentions. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008); See Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007).
SMC for Aid and Attendance
The issue of entitlement to SMC for aid and attendance is inextricably intertwined with the issue of service connection for seizures and blackouts, and it would be premature to decide the former issue before there has been a final adjudication of the latter issue. See Harris v. Derwinski, 1 Vet. App. 180 (1991) (two issues are “inextricably intertwined” when they are so closely tied together that a final decision on one issue cannot be rendered until a decision on the other issue has been rendered).  As the issue of service connection for seizures and blackouts is being remanded, the issue of entitlement to SMC must also be remanded.
The matters are REMANDED for the following action:
Obtain a VA opinion that addresses the nature and etiology of the Veteran’s seizures and blackouts.  If deemed necessary by the examiner designated to provide the opinion, schedule the Veteran for an examination.  Any indicated evaluations, studies, and tests deemed necessary by the examiner should be accomplished.  The entire claims file, to include a complete copy of this REMAND, should be made available to the examiner designated to provide an opinion, and the examination report should include a discussion of the Veteran’s documented medical history and assertions.
The examiner should offer comments, an opinion and a supporting rationale that addresses whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s seizure and blackouts are etiologically related to his service-connected neck disability.  In providing this opinion, the examiner should address whether pain or other symptoms from the Veteran’s neck disability cause episodes of seizures or blackouts. See August 2017 VA Examination, p. 5.
The examiner is advised that the Veteran is competent to report his symptoms and history, and such reports must be considered.  If the examiner rejects the Veteran’s reports, the examiner must provide a reason for doing so.

 
A. S. CARACCIOLO
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	W.V. Walker, Associate Counsel