Citation Nr: 21063699 Decision Date: 10/15/21 Archive Date: 10/15/21 DOCKET NO. 15-29 246 DATE: October 15, 2021 REMANDED The issue of service connection for a disability manifested by dizziness is remanded. REASONS FOR REMAND The Veteran had active service from December 1969 to December 1971 and from January 1981 to January 1984. This matter was before the Board of Veterans' Appeals (Board) in April 2021 when the claim was remanded for a VA addendum opinion. Pursuant to the April 2021 Board remand, a VA addendum opinion was provided in August 2021. However, the opinion is not adequate and the matter must again be remanded. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). The issue of service connection for a disability manifested by dizziness is remanded. The matter is REMANDED for the following action: 1. BACKGROUND FOR THE RO ADJUDICATOR: During the October 2020 VA evaluation of residuals of traumatic brain injury (TBI) examination, the examiner did not note dizziness as a symptom attributable to the Veteran's service-connected TBI. The examiner stated that the Veteran had dizziness after a 1981 concussion, which is a symptom of his concussion/TBI, but that the dizziness has since resolved. However, the examiner did not address whether the dizziness is a separate and distinct disability or a symptom of TBI. Pursuant to the April 2021 Board remand, a VA addendum opinion was provided in August 2021. The examiner was asked to address the following: 1) whether dizziness was present during the appeal period, reconciling any findings with October 2020 VA examination and; 2) whether the dizziness was caused by or chronically worsened by the Veteran's service-connected TBI or merely a symptom. The examiner noted dizziness/vertigo as a symptom attributable to the Veteran's service-connected TBI. On the first question, the examiner simply opined that it is less likely than not. No supporting rationale was provided, and the opinion is inconsistent with the examiner's notation that the Veteran has dizziness/vertigo as a symptom attributable to his service-connected TBI. On the second question, the examiner stated that the records do not show that the Veteran has a separate and distinct disability manifested by dizziness that was caused by or chronically worsened by his in-service cerebral concussion/TBI; the examiner opined "[t]hus it is less likely than not." Again, no supporting rationale was provided. For these reasons, the August 2021 VA addendum opinion is inadequate. Barr, 21 Vet. App. at 311. Therefore, a further VA addendum opinion is necessary. THE REMAND DIRECTIVES FOLLOW. 2. RETURN THIS CASE TO THE AUGUST 2021 VA EXAMINER and request a further addendum. If that examiner is no longer available, schedule the Veteran for a VA examination with an appropriate VA examiner regarding the etiology of any disability manifested by dizziness. All evidence and a copy of this remand will be made available to the examiner, who will acknowledge receipt and review of these materials. The examiner must respond to the following: (a.) The examiner MUST provide an opinion as to the onset of any disability manifested by dizziness, to include the symptom of dizziness noted in the August 2021 VA TBI examination. (b.) The examiner MUST provide an opinion as to whether the Veteran has a separate and distinct disability manifested by dizziness that was caused by or chronically worsened by his in-service cerebral concussion/TBI; OR, if it is merely a symptom of his service-connected cerebral concussion/TBI. (c.) If the examiner determines that the Veteran has dizziness that is a symptom attributable to his service-connected cerebral concussion/TBI, provide a complete and full explanation for the determination. (d.) The examiner MUST provide a complete and full explanation for the opinions provided. (e.) The examiner is ADVISED that an opinion without a complete and full explanation is not adequate. The examiner must review the entire record in conjunction with rendering the requested opinions. In addition to any records that are generated because of this Remand, the VA examiner's attention is drawn to the following: * The Veteran is service-connected for cerebral concussion/mild TBI. * During the September 2013 VA examination, the Veteran complained of dizziness/vertigo, which the examiner opined is less likely as not caused by or related to mild TBI and more likely related to other medical conditions. * A September 2013 VA medical record shows a diagnosis of mild TBI, resolved without residuals. The VA psychiatrist noted current subjective symptoms that are less likely as not caused by or related to mild TBI, and more likely related to other medical conditions. * In June 2014, the Veteran reported intermittent dizziness and frequent insomnia. * In August 2015, the Veteran reported experiencing dizziness, headaches, and insomnia. * During the December 2019 VA examination, the examiner noted a diagnosis of chronic insomnia. The Veteran reported dizziness, nausea, and sleep disturbance. The examiner associated the Veteran's symptoms to mental, physical, or neurological conditions, or residuals attributable to a TBI. However, the examiner was unable to differentiate the Veteran's TBI and insomnia. * The October 2020 VA examination. * The August 2021 VA TBI examination. * The August 2021 VA addendum opinion. A thorough explanation must be provided for the opinions rendered. If the examiner cannot provide the requested opinions without resorting to speculation, s/he should expressly indicate this and provide supporting rationale as to why the opinions cannot be made without resorting to speculation. The examiner is advised that by law, the mere statement that the claims folder was reviewed, and/or the examiner has expertise is not sufficient to find the examination/opinion sufficient. 3. Following the review and any additional development deemed necessary, re-adjudicate the claim. Should the claim not be granted in its entirety, issue an appropriate supplemental statement of the case (SSOC), and forward the claim to the Board for adjudication. The Veteran has the right to submit additional evidence and argument on the matter the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board of Veterans' Appeals or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C. §§ 5109B, 7112. Vito A. Clementi Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Timothy T. Emmart The Board's decision is only binding on this case. This action is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.