Citation Nr: 20022080 Decision Date: 03/30/20 Archive Date: 03/30/20 DOCKET NO. 10-31 777 DATE: March 30, 2020 REMANDED Entitlement to service connection for a dementia disorder, to include Alzheimer’s disease is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1951 to February 1953. He died in April 2009 and the Appellant is his surviving spouse. In October 2010, the Agency of Original Jurisdiction (AOJ) determined that the Veteran’s surviving spouse qualified as a substitute party. As the record shows that the Veteran has diagnoses for dementia and Alzheimer’s disease, the claim has been expanded and recharacterized as indicated above. Clemons v. Shinseki, 23 Vet. App. 1, 5 (2009). Entitlement to service connection for a dementia disorder, to include Alzheimer’s disease is remanded. In May 2014, July 2016, and September 2016, the AOJ procured VA medical opinions regarding the etiology of the Veteran’s Alzheimer’s disease. All of the VA examiners rendered negative nexus opinions as to whether the Veteran’s Alzheimer’s disease was etiologically related to his in-service cold exposure. Significantly, however, the VA medical records indicate that there may be some correlation between the Veteran’s dementia and his service-connected Parkinson’s disease. See June 2005 VA Treatment records. The Appellant also suggested that the Veteran’s dementia/Alzheimer’s was caused by his Paget’s disease. See December 2010 Board Hearing Transcript. None of the VA examiners specifically addressed whether the Veteran’s dementia and/or Alzheimer’s disease was caused or aggravated by his service-connected disorders, to include Parkinson’s disease and Paget’s disease. As such, the Board finds that the current evidence of record is insufficient to adequately adjudicate the claim. Accordingly, a remand is warranted for a new VA medical opinion consistent with the directives herein. The matter is REMANDED for the following actions: 1. Obtain a VA medical opinion from an appropriate examiner to determine the nature and etiology of the Veteran’s dementia disorder, to include Alzheimer’s disease. The claims folder (including a copy of this remand) must be provided to and reviewed by the examiner as part of the examination. All indicated tests should be accomplished and all clinical findings reported in detail. The examiner must provide an opinion as to whether it is at least as likely as not (i.e., 50 percent or greater probability) that the Veteran’s dementia disorder, to include Alzheimer’s disease was caused or aggravated by his service-connected disorders, to include Parkinson’s disease and Paget’s disease. A rationale for all requested opinions shall be provided. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation stating why this is so. In so doing, the examiner shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question. M. Mac Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board P. E. Metzner, 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.