Citation Nr: 21005055 Decision Date: 01/28/21 Archive Date: 01/28/21 DOCKET NO. 10-20 788 DATE: January 28, 2021 REMANDED The claim of entitlement to service connection for seizure disorder is remanded. REASONS FOR REMAND The Veteran had active service from July 1978 to February 1985. This matter comes before the Board of Veterans’ Appeals (Board) from an August 2007 rating decision by the Agency of Original Jurisdiction (AOJ). The appeal was remanded by the Board in November 2017. At that time, the Board also remanded the issues of entitlement to service connection for residuals of a head injury and for a psychiatric disorder. It concluded that the instant issue was inextricably intertwined with the claim of entitlement to service connection for residuals of a head injury, as the Veteran claimed compensation for seizures as secondary to head injury residuals. In October 2020, the AOJ granted service connection for residuals of a head injury and for an acquired psychiatric disorder. As the award of service connection constitutes a full grant of the benefits sought on appeal, these issues are no longer in appellate status. The remaining issue, entitlement to service connection for seizures, must again be remanded. VA treatment records indicate that the Veteran is prescribed medication that is noted to be for seizures or mood. On VA neurological examination in August 2020, the diagnosis was tonic clonic seizures or grand mal epilepsy. The examiner, noted to be an emergency medicine physician, concluded that the Veteran’s seizures, which clearly and unmistakably preexisted service, were clearly and unmistakably not aggravated beyond natural progression by an in-service injury, event, or illness. He stated that chart review showed a history of grand mal seizures, and that the Veteran had a history of scars on his nose. He indicated that the facial scars did not affect brain activity and therefore would not affect seizure activity. Notably, a VA traumatic brain injury examination was conducted in September 2020. The examiner indicated the Veteran’s report of an assault in 1983. Based on the Veteran’s report, the examiner concluded that the Veteran’s head injury residuals were related to the assault during service. Because the reported in-service assault has been accepted as the incident that resulted in the Veteran’s service-connected head injury residuals, and as there is no indication that seizures preexisted service, the Board finds that the August 2020 examination and opinion are not adequate for the purpose of deciding the instant claim. An additional examination is necessary to determine the etiology of the Veteran’s claimed seizures. The matter is REMANDED for the following action: 1. Schedule the Veteran for an examination to determine the nature and etiology of his claimed seizures. The evidentiary record, including a copy of this remand, must be made available to and reviewed by the examiner. The examination report must include a notation that this record review took place. After the record review and examination of the Veteran, the examiner should provide an opinion regarding whether it is at least as likely as not that the Veteran’s seizures are related to active service, to include the reported assault therein. The examiner should also provide an opinion with respect to whether it is at least as likely as not that seizures were caused or aggravated (worsened beyond normal progression) by the Veteran’s service-connected head injury residuals and/or acquired psychiatric condition. In rendering these opinions, the examiner is advised that the Veteran is competent to report his symptoms and history. Such reports must be acknowledged and considered in formulating any opinion. If the examiner rejects the Veteran’s reports, he or she must provide an explanation for such rejection. The examiner is not to improperly discount the Veteran’s lay statements or mistakenly rely on an absence of medical evidence in the record to support his or her conclusions. The complete rationale for all opinions should be set forth and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. If an opinion cannot be provided without resorting to mere speculation, the examiner must provide a complete explanation for why an opinion cannot be rendered. In so doing, the examiner must 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. 2. Then, readjudicate the Veteran’s claim, with application of all appropriate laws, regulations, and case law, and consideration of any additional information obtained as a result of this remand. If the decision remains adverse to the Veteran, he and his representative should be furnished a supplemental statement of the case (SSOC) and afforded an appropriate period within which to respond thereto. DONNIE R. HACHEY Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Department of Veterans Affairs 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.