Citation Nr: 21065695 Decision Date: 10/27/21 Archive Date: 10/27/21 DOCKET NO. 12-18 391 DATE: October 27, 2021 REMANDED Entitlement to service connection for a disability manifested by near syncopal episodes is remanded. REASONS FOR REMAND The Veteran served on active duty in the Unites States Air Force from September 1980 to September 2000; the Veteran had over eight years of foreign service. For his meritorious service, the Veteran was awarded (among other decorations) the Defense Meritorious Service Medal, the Meritorious Service Medal, the Air Force Commendation Medal, the Joint Service Achievement Medal, and the Air Force Achievement Medal. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 2008 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In March 2017, the Board issued a decision which, in pertinent part, denied the Veteran's claim seeking service connection for a disability manifested by near syncopal episodes. The Veteran appealed the denial to the United States Court of Appeals for Veterans Claims (Court). In August 2018, the Court granted a Joint Motion for Partial Remand, which set aside this portion of the March 2017 Board decision and remanded the matter for further adjudication consistent with the Joint Motion. In February 2019, the Board remanded this matter for additional development. In May 2020, the Board issued a decision which denied the Veteran's claim. The Veteran timely appealed this denial to the Court. In April 2021, the Court granted a Joint Motion for Remand, which set aside the Board's May 2020 decision and remanded the matter for further adjudication consistent with the Joint Motion. 1. Entitlement to service connection for a disability manifested by near syncopal episodes is remanded. Pursuant to the March 2021 Joint Motion, the Veteran should be given a final opportunity to attend a VA examination to determine the nature and etiology of his claimed near syncopal episodes. This examination is needed to determine if a current disability exists, and if so, whether it is related to the Veteran's military service. The Board notes that the Veteran has previously failed to report for the same examination now being sought. When entitlement to a benefit cannot be established without a current VA examination or reexamination and a claimant, without good cause, fails to report for such examination or reexamination, an original claim for compensation is to be decided based on the evidence of record. 38 C.F.R. § 3.655(b). Examples of good cause include, but are not limited to, the illness or hospitalization of the claimant, or death of an immediate family member. 38 C.F.R. § 3.655(a). The Veteran is advised that failure to attend the upcoming examination to be scheduled regarding this issue, without good cause, will likely result in the denial of his claim. The matters are REMANDED for the following action: 1. Ask the Veteran to provide the names and addresses of all medical care providers who have recently treated him during the course of this appeal for his near syncopal episodes. After securing any necessary releases, request any relevant records identified. In addition, obtain updated VA treatment records. If any requested records are unavailable, the Veteran should be notified of such. 2. Thereafter, schedule the Veteran for a new examination by an appropriate clinician to determine the nature and etiology of his near syncopal episodes. The examiner must review the claims file. The VA examiner must obtain and record a detailed history of the Veteran's claimed near syncopal episodes, both during and after his military service. After examination of the Veteran, and considering the medical evidence and the Veteran's reports as to the nature and associated symptomatology of his near syncopal episodes, the examiner must diagnose this disability. If a diagnosis for the near syncopal episodes cannot be rendered, the examiner must provide an opinion as to whether it is at least as likely as not that the episodes and/or associated symptoms cause functional impairment sufficient to be considered disability. If the near syncopal episodes and/or associated symptoms at least as likely as not demonstrate a disability, the examiner must opine whether it is at least as likely as not the disability is related to service, including the multiple noted instances of left-sides numbness, dizziness, absence spells, etc., noted in the Veteran's service treatment records. In providing these opinions, the examiner must address the Veteran's statements describing his symptomatology, and his reports of suffering from near syncopal episodes approximately every six months since his separation from service. The examiner should also consider post service treatment records, dated in February 2013, August 2013, January 2014, April 2014, May 2014, May 2019, June 2019, and August 2019, which reflect that the Veteran denied any problems with loss of consciousness or incidents of vertigo. If there is any medical reason to accept or reject the proposition that the Veteran's reported injury and symptoms in service and thereafter represented the onset of his current disability, this should be noted. Stated another way, do the Veteran's reports about his symptoms align with how the currently diagnosed disability is known to develop or are the Veteran's reports generally inconsistent with medical knowledge or implausible? Evan M. Deichert Veterans Law Judge Board of Veterans' Appeals Attorney for the Board W. Yates, 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.