Citation Nr: 20072815 Decision Date: 11/12/20 Archive Date: 11/12/20 DOCKET NO. 12-05 026 DATE: November 12, 2020 REMANDED Entitlement to service connection for cavernous hemangioma with brain hemorrhage is remanded. INTRODUCTION The record reflects that the appellant served on active duty from May 1991 to July 1991, with subsequent periods of service in the Air Force and Army Reserves and National Guards. In June 2020, the United States Court of Appeals for Veterans Claims (Court) granted a joint motion for remand and returned the above-noted issue to the Board for action consistent with the joint motion. REASONS FOR REMAND In the course of the June 2020 joint motion for remand, the Court indicated the Board should consider seeking an independent medical opinion (IMO) to address the complex matters associated with this case. The Board agrees. The Veteran seeks service connection for a cavernous hemangioma malformation with brain hemorrhage that she alleges is directly related to service. In sum, the evidence indicates the Veteran entered the Air Force National Guard in May 1991. She underwent a pre-entrance examination in March 1991 at which time the examiner found the Veteran’s head and neurologic system to be normal. The Veteran also denied ever experiencing a head injury or headaches at that time. During her period of active duty, the Veteran asserts she fell while participating in an obstacle course and sustained an injury to her head. A review of her service treatment records shows the Veteran reported experiencing a thumping pain in her head and headaches on several occasions. She was prescribed Fioricet at that time. In November 2009 the Veteran was diagnosed with the above-noted disability. She has asserted that her head injury in basic training may have caused her cavernous hemangioma malformation with brain hemorrhage, and that her headaches in service may have been an early manifestation of the condition. Based on the complexities of this matter, the Board finds an independent medical opinion from a Neurologist specializing in cavernous hemangioma malformations would be of great assistance. Accordingly, the case is REMANDED for the following actions: Obtain a VA medical opinion from a Board-Certified Neurologist with sufficient expertise in cavernous hemangioma malformations, who has not previously examined this Veteran or provided a medical opinion in this matter, to address the etiology of the Veteran’s claimed disability. All pertinent evidence of record must be made available to and reviewed by the examiner. Another examination of the Veteran must be performed only if deemed necessary by the physician providing the opinion. Following a review of the relevant records and lay statements, the examiner should state an opinion with respect to whether the Veteran’s cavernous hemangioma malformation with brain hemorrhage at least as likely as not (a 50 percent probability or greater): a) was caused by the Veteran’s head trauma resulting from a fall in basic training on the obstacle course; or b) whether the Veteran’s in-service headaches were related to, or an early manifestation of her subsequently diagnosed cavernous hemangioma with brain hemorrhage. A discussion of the facts and the medical principles involved will be of considerable assistance to the Board. The examiner must specifically address the Veteran’s reports relative to the etiology of the claimed disability. If the examiner is unable to provide any required opinion, he or she should explain why. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation as to why this is so. T. REYNOLDS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board G. Fraser, Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.