Citation Nr: 21074962 Decision Date: 12/16/21 Archive Date: 12/16/21 DOCKET NO. 14-42 668 DATE: December 16, 2021 REMANDED 1. Entitlement to an initial compensable rating prior to November 25, 2019 for fainting spells or vasovagal episodes of syncope is remanded. 2. Entitlement to a rating in excess of 10 percent beginning November 25, 2019 for fainting spells or vasovagal episodes of syncope is remanded. REASONS FOR REMAND The Veteran had active service from August 1973 to August 1982. The Veteran died in September 2021. The appellant, the Veteran's surviving spouse, is substitute for the claim. In November 2018, the Veteran testified before the undersigned Veterans Law Judge (VLJ) at a Travel Board hearing. A transcript of this hearing is of record. In August 2019, the Board remanded the case for further development by the originating agency. Thereafter, in an August 2020 Board decision, the Board denied the increased rating claims. The Veteran appealed that decision to the U.S. Court of Appeals for Veterans Claims (Court). In July 2021, the Court issued an Order that vacated the Board's August 2020 decision, and remanded the matters on appeal for adjudication consistent with the instructions outlined in the July 2021 Joint Motion for Remand. Entitlement to Increased Ratings for Fainting Spells or Vasovagal Episodes of Syncope is Remanded. In its Joint Motion for Remand (JMR), the parties to the appeal noted that the Veteran's June 2016 examiner stated that he was diagnosed with psychomotor epilepsy beginning in 1976, and that there was no change in the Veteran's diagnosis. At his November 2019 examination, however, the Veteran was only examined for paralysis of the tenth cranial nerve, rather than epilepsy. In the vacated Board decision, the Board rated the Veteran's condition by analogy under diagnostic code 8210, for paralysis of the tenth cranial nerve. In the JMR, the parties to the appeal asserted that the Board's August 2020 decision was inadequate because it did not more thoroughly discuss whether the Veteran's condition should be rated by analogy as psychomotor epilepsy under diagnostic code 8911. Diagnostic code 8210 for paralysis of the tenth cranial nerve provides schedular ratings based upon the level of paralysis, incomplete and moderate, incomplete and severe, or complete. In contrast, diagnostic code 8911 provides schedular ratings based on the number of major or minor seizures the Veteran has in a specific period. When a particular service-connected disability is not listed in the rating schedule, the disability is rated by analogy under a diagnostic code for a closely related disability that affects the same anatomical functions and has closely analogous symptomatology. 38 C.F.R. § 4.20. In this case, the evidence demonstrates that the Veteran has had a number of strokes and treatment records include diagnoses of a seizure disorder as result of stroke. Thus, at present, it is unclear whether seizures were due to the Veteran's service-connected fainting condition or whether they were are unrelated to it. This determination is a medical one and cannot be made by the Board. Colvin v. Derwinski, 1 Vet. App. (1991). Thus, the Board seeks a medical opinion from a neurologist, to determine which of the Veteran's symptoms should be attributed to the service-connected fainting and syncope disorder. In so doing, the Board notes that if it is not possible to separate the effects of the Veteran's service-connected disorder and symptoms due to a stroke, such signs and symptoms will be attributed to the service-connected disability. Mittleider v. West, 11 Vet. App. 181 (1998). Further, the opining neurologist may find it helpful to review the disability benefit questionnaire (DBQ) forms, to include the DBQs for seizure disorders and cranial nerve conditions. The matters are REMANDED for the following action: Obtain an opinion from a neurologist in order to describe the symptoms which are related to his service-connected condition following a complete review of the claims file. If it is not possible to distinguish the Veteran's service-connected symptoms from those of seizure or another unrelated disorder, he or she must so state. KELLI A. KORDICH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board G. Slovick, 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.