Citation Nr: 21068036 Decision Date: 11/08/21 Archive Date: 11/08/21 DOCKET NO. 18-28 134 DATE: November 8, 2021 ORDER Entitlement to service connection for neurocognitive disorder unspecified (claimed as residuals of traumatic brain injury (TBI)), secondary to service-connected other specified trauma and stressor-related disorder, on a causation basis, is granted. FINDING OF FACT The evidence is at least evenly balanced as to whether the Veteran's neurocognitive disorder unspecified is caused by his service-connected other specified trauma and stressor-related disorder. CONCLUSION OF LAW With reasonable doubt resolved in favor of the Veteran, the criteria for service connection for neurocognitive disorder unspecified, as secondary to other specified trauma and stressor-related disorder, on a causation basis, are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from May 1987 to February 1992. This matter initially came before the Board of Veterans' Appeals (Board) from a July 2016 rating decision. The Veteran testified before the undersigned Veterans Law Judge (VLJ) at a November 2019 hearing and a transcript of the hearing has been associated with his claims file. In January 2020, the Board remanded this matter for further development. As a final preliminary matter, the Board points out that the Veteran had also perfected an appeal with regard to the issue of entitlement to service connection for psychiatric disability, and the Board remanded this issue in January 2020 for further development. A Decision Review Officer awarded service connection for other specified trauma and stressor-related disorder (manifested by anxiety and depression, among other symptoms) by way of an April 2020 decision, and thereby resolved the appeal as to this issue. Entitlement to service connection for neurocognitive disorder unspecified (claimed as residuals of TBI), secondary to service-connected other specified trauma and stressor-related disorder Service connection will be granted if the evidence demonstrates that current disability resulted from an injury suffered or disease contracted in active military, naval, air, or space service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Establishing service connection generally requires competent evidence of three things: (1) current disability; (2) in-service injury or disease; and (3) a relationship between the two. Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018). Consistent with this framework, service connection is warranted for a disease first diagnosed after service when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Service connection is also warranted for disability which is proximately due to or the result of service-connected disease or injury. 38 C.F.R. § 3.310. In this case, the Veteran contends that he has current disability manifested by memory loss that is related to TBI sustained in service. The Board finds, for the following reasons, that the Veteran has current neurocognitive disorder unspecified, and that the evidence is at least evenly balanced as to whether this disability is caused by his service-connected other specified trauma and stressor-related disorder. Medical records, including a March 2020 VA mental health telephone encounter note, indicate that the Veteran has been diagnosed as having neurocognitive disorder unspecified. Therefore, current disability manifested by memory loss has been demonstrated. In November 2019, the Veteran underwent a neuropsychological evaluation due to progressive cognitive difficulty with memory loss. The examination findings were suggestive of mild deficient verbal learning and reduced executive skills, and the Veteran was diagnosed as having mild cognitive impairment of undetermined etiology. The clinical neuropsychologist who conducted the evaluation explained that the etiology of the Veteran's deficiencies was not clear, but that given the indication of inconsistent engagement during the examination, "anxiety/depression may account for the below expected performances on certain measures." The Veteran was afforded a VA TBI examination in July 2020, during which he reported that he experienced memory loss, but no other impairments. The physiatrist who conducted the examination concluded that the Veteran did not have any residuals of TBI and opined that his claimed disability was not likely ("less likely than not"/"less than 50 percent probability") incurred in or caused by service. He reasoned, in pertinent part, that neuropsychological testing suggested that the Veteran experienced "mild cognitive impairment likely related to depression and anxiety." Overall, while there is no clear and direct opinion that the Veteran's neurocognitive disorder unspecified is caused by his service-connected other specified trauma and stressor-related disorder, the findings noted above in essence support the conclusion that his current neurocognitive disorder unspecified is caused by his service-connected psychiatric disability. There is no medical opinion contrary to this conclusion. With reasonable doubt resolved in favor of the Veteran, service connection for neurocognitive disorder unspecified, secondary to service-connected other specified trauma and stressor-related disorder, on a causation basis, is warranted. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. Jonathan Hager Veterans Law Judge Board of Veterans' Appeals Attorney for the Board B. Elwood, 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.