Citation Nr: 21073022 Decision Date: 12/07/21 Archive Date: 12/07/21 DOCKET NO. 18-49 978A DATE: December 7, 2021 ORDER Entitlement to service connection for a seizure disability is granted. FINDING OF FACT It is at least as likely as not that the Veteran's seizure disability was incurred in service. CONCLUSION OF LAW The criteria for service connection for a seizure disability have been met. 38 U.S.C. § 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Navy from July 1978 to August 1986. Service Connection Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303 (a). To establish entitlement to service-connected compensation benefits, a Veteran must show: "(1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service-the so-called "nexus" requirement." Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2010) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). The United States Court of Appeals for the Federal Circuit (Federal Circuit) has held that "[l]ay evidence can be competent and sufficient to establish a diagnosis of a condition when (1) a layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional." Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007); see also Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006) ("[T]he Board cannot determine that lay evidence lacks credibility merely because it is unaccompanied by contemporaneous medical evidence"). Service connection must be considered on the basis of the places, types, and circumstances of his service as shown by his service records, the official history of each organization in which he served, his medical records, and all pertinent medical and lay evidence. See 38 C.F.R. § 3.303(a); see also Jandreau v. Nicholson, supra; and Buchanan v. Nicholson, supra. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107(b).). Entitlement to service connection for a seizure disability At the onset, the Board observes that there is no dispute that the Veteran has a current seizure disability as noted in a September 2011 private treatment report. Similarly, there is no dispute that the Veteran had dramatic episode in service which included a cluster of psychiatric and physical ailments which caused him to be airlifted off a naval vessel he was stationed on. These ailments took the form of confusion, depression, suicidal ideation and anorexia as documented in a March 1982 service treatment record. The only remaining element for service connection and the focus of this analysis is whether this incident aboard the naval vessel and the Veteran's later diagnosis of a seizure disability are related, i.e. a nexus. Turning the issue of nexus, the Board observes that the Veteran has provided two private medical opinions which have tied his symptoms in service to his current seizure disability as early manifestation of his seizure disability. The Veteran has also provided lay statements from his wife which document the continued symptoms the Veteran experienced during service and along with his daughter, his symptoms continuing after service up until the point he was diagnosed with a seizure disability and provided seizure medication, which alleviated some of the symptoms. The Board will address each in turn. On reviewing the private medical opinions provided to the Veteran, the Board finds that they are probative on the issue of nexus. In particular, the September 2011 private treatment record from the Veteran's neurologist accurately described the Veteran's symptoms of confusion, memory loss, depression and anxiety in service in March 1982. He unequivocally concludes that these symptoms were caused by his seizure disability, and the Board finds that his basis for this conclusion, the fact that these symptoms largely abated once the Veteran was placed on the appropriate medication, to be compelling evidence of a relationship. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008) (Most of the probative value of a medical opinion comes from its reasoning and the Board must be able to conclude that a medical expert has applied valid medical analysis to the significant facts of the particular case in order to reach the conclusion submitted in the medical opinion). More recently, the Veteran provided an October 2019 correspondence from a private treating physician who, more equivocally, stated that he believed that the Veteran service may have played a role. While the Board finds that this evidence is less probative, it does provide support the Veteran's contention of a relationship as it places the possibility of such a relationship within the realm of possibility. Last, the Board observes that the Veteran provided lay evidence in the form of September 2011 correspondence from the Veteran's daughter and a March 2014 statement from the Veteran's wife. Both the statements describe the nature of the Veteran's illness and the symptoms which they observed and the abrupt end of these symptoms once the Veteran's seizure disability was identified and appropriately treated. The Board finds that these statements are credible and that both the Veteran's spouse and daughter are competent to observe dramatic changes in behavior. Moreover, the Board finds that these lay statements further bolster the relationship between the Veteran's symptoms in service and his current diagnosis. In sum, the Veteran has provided two private opinion which related the Veteran's service to his current disability and two lay statements from people who were close enough to observe the Veteran of the course of his disease and ultimate treatment. Considering there is no negative opinion of record and the quality of the evidence above, the Board finds that there is a nexus between the Veteran's seizure disability and his symptoms in service, and as such, all the elements of service connection have been satisfied. Entitlement to service connection for a seizure disability is warranted. GAYLE E. STROMMEN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Acosta, 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.