Citation Nr: 20021608 Decision Date: 03/26/20 Archive Date: 03/26/20 DOCKET NO. 20-00 947 DATE: March 26, 2020 REMANDED Entitlement to service connection for posttraumatic stress disorder (PTSD) is remanded. Entitlement to service connection for traumatic brain injury (TBI), to include as secondary to PTSD medications, is remanded. Entitlement to service connection for residuals of stroke under the provisions of 38 U.S.C. § 1151, and to include as secondary to TBI and PTSD medications, is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1974 to February 1975. He also served in the Reserves. These appeals arose to the Board of Veterans Appeals (Board) from an October 2018 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Board notes that the Veteran initially filed a claim compensation under the provisions of 38 U.S.C. § 1151 for stroke residuals. Although the Veteran's claim was denied in a December 2017 rating decision, and "reopening" of the claim was denied in October 2018, the Veteran submitted new and material evidence in March 2018, within one year of the December 2017 denial. As such, the December 2017 rating decision did not become final. 38 C.F.R. § 3.156 (b). Therefore, new and material evidence is not required to reopen the claim on appeal, regardless of the theory of entitlement set forth. Further, while the doctor in the March 2018 medical opinion stated that the Veteran mistakenly set forth a 1151 claim, the Veteran has yet to withdraw this theory of entitlement, accordingly, the Board has recharacterized this claim to consider all theories of entitlement for consideration. 1. Entitlement to service connection for PTSD is remanded. The Veteran contends he is entitled to service connection for PTSD. Specifically, the Veteran stated that sometime during July 1976, while serving in some capacity, he was physically and verbally assaulted by a white Marine; ever since that incident, the Veteran contends, he has suffered from PTSD. In March 2018, a former colleague of the Veteran’s submitted documentation stating that he witnessed the incident in question. In October 2018, a VA Compensation and Pension (C&P) examiner determined the Veteran suffered from PTSD related to that incident. To date, however, VA has not conducted any meaningful investigation as to whether the Veteran was engaged in active duty for training during the time period in question. Accordingly, a remand is necessary prior to adjudication. 2. Entitlement to service connection for TBI, to include as secondary to PTSD, is remanded. The Veteran contends that he is entitled to service connection for TBI. In February 2018, the Veteran submitted documentation from his treating practitioner indicating that the Veteran suffered from a TBI that was related to medication prescribed for his PTSD. Specifically, he stated that this medication, Prazosin, caused the Veteran to collapse and hit his head, resulting in TBI. As this issue is inextricably intertwined with the Veteran’s claim for service connection for PTSD, a remand is necessary prior to adjudication. See Tyrues v. Shinseki, 23 Vet. App. 166, 177 (2009) (en banc) (explaining that claims are inextricably intertwined where the adjudication of one claim could have a significant impact on the adjudication of another claim). 3. Entitlement to service connection for residuals of a stroke under the provisions of 38 U.S.C. § 1151, to include as secondary to TBI and PTSD, is remanded. The Veteran contends he is entitled to service connection for residuals of a stroke. In February 2018, the Veteran’s treating practitioner submitted a letter in which he stated that the Veteran’s stroke was caused by TBI, which in turn resulted from an incident in which he collapsed as a side effective of Prazosin, PTSD medication. As with the claimed TBI, this issue is inextricably intertwined with the Veteran’s claim for PTSD, a remand is necessary prior to adjudication. See id. 4. Entitlement to a TDIU is remanded. The Veteran contends he is entitled to TDIU in part due to impairment resulting from PTSD and TBI. Although these issues are not currently service-connected, the Board is remanding them for further development, as discussed above. The issue of entitlement to a TDIU is inextricably intertwined with the claims for service connection, and therefore must be remanded as well. See id. The matters are REMANDED for the following action: 1. Make appropriate attempts to verify whether the Veteran was on a period of ACDUTRA in July 1976 during his reported verbal and physical assault at the hands of a Marine. Please note that the record includes a corroborating statement from a fellow serviceman who claims he was “in the room” during the reported incident. 2. If, and only if, the Veteran’s PTSD is found to be service connected, schedule the Veteran for a VA examination by an examiner to determine the nature and etiology of the Veteran’s TBI. The examiner is asked to review the claims file and provide the following information: (a) State whether the criteria for a diagnosis are met. (b) Opine whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s TBI was caused or aggravated by the Veteran’s PTSD. Specifically discuss whether medication taken for PTSD, Prazosin, caused the Veteran to collapse and hit his head, resulting in TBI. (c) If it is determined that there is another likely etiology for the Veteran’s TBI, that should be stated. (d) The examiner is specifically asked to comment on the Veteran’s private physician’s February 2018 positive nexus that the Veteran’s TBI was due to side effects of his PTSD medication. The examiner should set forth all examination findings, with a clear rationale for the conclusions reached. 3. If, and only if, the Veteran’s PTSD is found to be service connected, schedule the Veteran for a VA examination by an examiner to determine the nature and etiology of the Veteran’s stroke residuals. The examiner is asked to review the claims file and provide the following information: (a) State whether the criteria for a diagnosis are met. (b) Opine whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s stroke was caused or aggravated by the Veteran’s PTSD. Specifically discuss whether medication taken for PTSD, Prazosin, caused the Veteran to collapse and hit his head, resulting in TBI, which then resulted in stroke. (c) If it is determined that there is another likely etiology for the Veteran’s stroke residuals, that should be stated. (d) The examiner is specifically asked to comment on the Veteran’s private physician’s February 2018 positive nexus that the Veteran’s stroke was related to his PTSD medication. The examiner should set forth all examination findings, with a clear rationale for the conclusions reached. 4. Re-adjudicate the Veteran’s claim for TDIU. LESLEY A. REIN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Ryan, Associate 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.