Citation Nr: 18152714 Decision Date: 11/27/18 Archive Date: 11/23/18 DOCKET NO. 14-23 488 DATE: November 27, 2018 ORDER Service connection for burn scars on the face and neck is denied. Service connection for traumatic brain injury (TBI) is granted. FINDINGS OF FACT 1. The Veteran experienced a burn injury to his face and arms during service in July 1963 when a military training device was triggered while he was holding it. 2. No visible scars are observable on his face and neck at present, and no other skin disability of the face and neck is diagnosed. 3. Resolving all reasonable doubt in favor of the Veteran, a currently diagnosed traumatic brain injury, or the residuals thereof, is shown to be etiologically related to the July 1963 event during service. CONCLUSIONS OF LAW 1. The criteria to establish service connection for burn scars on the face and neck have not been met. 38 U.S.C. §§ 1110,1154, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2017). 2. Resolving reasonable doubt in the Veteran’s favor, the criteria to establish service connection for traumatic brain injury have been met. 38 U.S.C. §§ 1110,1154, 5107 (2012); 38 C.F.R. §§ 3.102, 3.303 (2017). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served in the Army National Guard, with a period of active duty from July 27, 1963 to August 11, 1963, based upon injuries incurred during that period that resulted in service-connected disabilities. This appeal was subject to a prior remand by the Board in July 2017 to ensure compliance with due process requirements. Regarding the claim of service connection for scars, the evidentiary record has been adequately developed in substantial compliance with all prior Board remand instructions and has been returned to the Board for further appellate review. Stegall v. West, 11 Vet. App. 268 (1998). Although there may not have been adequate compliance with all remand directives on the claim of service connection for TBI, there can be no prejudice to the Veteran in proceeding as a full grant of service connection for TBI is issued herein. Service Connection Service connection generally requires (1) evidence of a current disability; (2) medical, or in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) competent evidence of a causal relationship, or nexus, between the claimed in-service event, injury, or disease and the current disability. 38 C.F.R. § 3.303; see Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). 1. Service connection for burn scars on the face and neck On July 31, 1963, the Veteran sustained injuries when a military training device, variously described as a smoke bomb or artillery simulator was triggered while in the Veteran’s hand. The resulting included burns to his upper extremities and to his face according to contemporaneous documentation. Burn scars to both arms have previously been granted service connection. It is undisputed that an in-service injury occurred in this instance. However, upon examination in January 2018, the examiner could not identify any visible scars or other disfigurement of the head, face, or neck. Although the Veteran’s spouse described that the Veteran sometimes experienced sensitive skin when he shaves, the Veteran’s medical treatment records, including those where his skin was examined reflect no complaint of sensitivity and find no wounds or other skin problems present. A skin examination in conjunction with an initial primary care assessment in October 2017 found the Veteran’s skin to be warm and dry without lesions or dermatoses present. Occasionally sensitive skin, with no underlying diagnosis, no resulting functional impairment, and no appreciable scarring present is not found to constitute a disability for which compensation may be paid. In the absence of a current disability, there can be no valid claim of service connection. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). 2. Service connection for traumatic brain injury (TBI) As discussed above, the occurrence of an in-service injury has been conceded. A January 2018 VA examination by a neurology specialist also specifically identified the 1963 injury to the Veteran as a traumatic brain injury. This examiner identified the ordnance in question as an artillery simulator as opposed to a smoke bomb, and stated the Veteran’s symptoms at the time of injury included loss of consciousness (LOC) and confusion. The identified current residuals of TBI primarily included subjective symptoms of mental disorder that could not be differentiated from the Veteran’s co-existing posttraumatic stress disorder (PTSD) for which service connection is already in effect. Although the same examiner then stated a contradictory opinion in an April 2018 addendum that the medical records do not support a finding of loss of consciousness or amnesia, the examiner does not offer a rationale or provide the medical basis for the change in his own thinking on this matter, and does not resolve the conflict in his own findings. In sum, the in-service event or injury is known to have occurred, and the examiner diagnosed a TBI as resulting from that event. Although there is conflict in the evidentiary record, the examiner also appears to have linked the current TBI symptoms to the in-service event in 1963 at least in the initial January 2018 examination report. When an approximate balance of positive and negative evidence exists on any matter, including the element of nexus as here, the Board must resolve reasonable doubt in the Veteran’s favor. As such, the Board resolves reasonable doubt in this manner and finds that service connection is warranted for TBI in this instance. 38 C.F.R. § 3.303. K. J. ALIBRANDO Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD K. McDonald