Citation Nr: 20021267 Decision Date: 03/25/20 Archive Date: 03/25/20 DOCKET NO. 11-08 343 DATE: March 25, 2020 ORDER Service connection for a disability manifested by impairment of concentration and memory is denied. FINDING OF FACT The Veteran does not have a current disability manifested by impairment of concentration and memory. See VA Examinations dated July 2019. CONCLUSION OF LAW The criteria for service connection for a disability manifested by impairment of concentration and memory are not met. 38 U.S.C. §§ 1110, 1111, 1131, 1132, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the Army from September 1983 to January 1984, from February to June 2003, and from December 2003 to March 2005. The Veteran has additional periods of Reserve service. This case is before the Board of Veterans’ Appeals (Board) on appeal from an October 2008 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Pittsburgh, Pennsylvania. 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). The Veteran’s claim for service connection for a disability manifested by impairment of concentration and memory arose out of two separate claims for service connection for posttraumatic stress disorder (PTSD) and for residuals of a traumatic brain injury (TBI). The Veteran’s PTSD claim was finally denied in a March 2014 Board decision, and his TBI claim in a September 2016 Board decision. However, the latter decision also remanded the claim now on appeal, for a VA examination to determine whether the Veteran’s claimed concentration and memory impairment may have an etiology other than PTSD or a TBI, to include a Gulf War undiagnosed or medically unexplained chronic multisymptom illness. See 38 C.F.R. § 3.317. The Veteran has been afforded two VA examinations since the September 2016 Board remand, and one additional VA medical nexus opinion. A January 2017 VA examination noted that “the Veteran does not have any conditions that are undiagnosable. The Veteran has either conditions that are clearly diagnosable with clear and specific etiology or has not had any evaluation to determine diagnosis.” Thus, the Board concludes that the Veteran is not entitled to service connection for the claimed condition pursuant to the provisions of 38 C.F.R. § 3.317. However, the January 2017 examination report did not include any mention of the Veteran’s complaints of concentration and memory impairment, nor did it “determine the nature and etiology” of these complaints, per the Board’s remand instructions. For these reasons, the Board found the January 2017 VA examination to be inadequate, and remanded the issue again in April 2018 for another VA examination to comply with the Board’s prior remand directives. A July 2019 VA examination noted no mental diagnosis or any cognitive impairment. The examiner noted that the Veteran’s memory, intellect, attention, and concentration were all within normal limits. She stated that his subjective complaints were related to mild social anxiety and possibly to distraction caused by tension headaches. A subsequent July 2019 VA medical opinion (without examination) reached a similar conclusion, noting that cognitive testing of the Veteran in May 2014 and January 2017 had both yielded results within normal limits. The examiner further opined that any current cognitive complaints were unlikely to be related to the Veteran’s active duty service fourteen years ago, since his cognitive functioning was shown to be normal during the intervening period. The findings and opinions of the July 2019 VA examination and medical opinion are competent, credible, and entitled to significant weight. Moreover, there is no probative evidence to the contrary. Therefore, the Board finds that the Veteran does not have a current disability manifested by impairment of concentration and memory. Accordingly, service connection for a disability manifested by impaired concentration and memory is not warranted. S.C. KREMBS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board P. Timmerman 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.