Citation Nr: 18159966 Decision Date: 12/21/18 Archive Date: 12/20/18 DOCKET NO. 12-34 670 DATE: December 21, 2018 REMANDED Entitlement to an initial rating higher than 40 percent for traumatic brain injury (TBI) is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1980 to June 1984. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a December 2016 rating decision, which granted service connection for traumatic brain injury, rated as 10 percent disabling, effective November 24, 2009. The Veteran appealed the assigned rating via a February 2017 notice of disagreement. An October 2017 rating decision granted a higher rating of 40 percent for the entire appeal period. This was not a full grant of the benefit sought, and the appeal continues. The Veteran’s November 2017 substantive appeal indicates that the Veteran requested a Board hearing. Nevertheless, in October 2018, the Veteran informed VA that he did not want a hearing of any kind. See 10/24/2018, VA 119 Report of Contact. As such, the Veteran’s hearing request is deemed withdrawn.   Entitlement to an initial rating higher than 40 percent for traumatic brain injury (TBI) is remanded. The Veteran asserts that his service-connected traumatic brain injury (TBI), currently rated as 40 percent disabling, meets the criteria for a rating of 70 percent. The Veteran last underwent a VA examination for his TBI in October 2017. A mental status examination resulted in a score indicative of moderate impairment. The VA examiner, however, stated that this score was inconsistent with the Veteran’s ability to discuss certain topics and understand instructions on one telling. The examiner concluded that these inconsistencies prevented a clear diagnosis and opinion, and strongly recommended that the Veteran undergo a full neuropsychiatric examination, conducted by an individual with the appropriate expertise, to evaluate his mental status. See 10/19/2017, C&P Exam, at 5; see also 11/16/2018 Appellate Brief (contending a remand is warranted based on the statement by the 2017 VA examiner). In view of the above, the Board finds that a new VA examination is warranted. On remand, the RO should schedule the Veteran for a neuropsychiatric examination. Finally, VA treatment records were last associated with the claims file in October 2017. On remand, the RO should obtain any outstanding VA treatment records. The matter is REMANDED for the following actions: 1. Obtain the Veteran’s VA treatment records for the period from October 2017 to the Present. 2. Thereafter, schedule the Veteran for a **neuropsychiatric** examination, conducted by an appropriate clinician, to determine the current severity of any cognitive impairment related to the Veteran’s service-connected traumatic brain injury (TBI). (As noted by the October 2017 VA physician, a neuropsychiatric examination is needed due to inconsistencies with the MOCA score.) The neuropsychiatric examiner is to provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability under the rating criteria. The examiner must attempt to elicit information regarding the severity, frequency, and duration of symptoms. To the extent possible, the examiner should identify any symptoms and social and occupational impairment due to his service-connected TBI alone. Paul Sorisio Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD P. López, Associate Counsel