Citation Nr: 21075643
Decision Date: 12/21/21	Archive Date: 12/21/21

DOCKET NO. 16-25 745
DATE: December 21, 2021

REMANDED

Entitlement to service connection for unspecified neurocognitive disorder (claimed as residuals of a traumatic brain injury) is remanded.

REASONS FOR REMAND

The Veteran served on active duty from July 1968 to August 1968.  

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a November 2014 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a hearing before the undersigned Veterans Law Judge in July 2019; a transcript of the hearing is of record.

This matter was previously before the Board in November 2019, January 2021 and July 2021, wherein the Board remanded the issue to obtain VA medical opinions. The matter has returned to the Board for adjudication.

1. Entitlement to service connection for unspecified neurocognitive disorder (claimed as residuals of a traumatic brain injury) is remanded.

When this matter was last before the Board, it was remanded, in pertinent part, to obtain an addendum VA medical opinion to determine whether the unspecified neurocognitive disorder pre-existed service and, if not, whether the disorder was as due to service.

Unfortunately, the Board finds that the prior remand directives of the July 2021 Board decision have not been substantially complied with.

The requested addendum opinion was obtained in August 2021, wherein the examiner found that the Veteran's unspecified neurocognitive disorder did not clearly and unmistakably pre-exist service and thus was not clearly and unmistakably aggravated by service.  The Board accepts this opinion and finds that the Veteran was sound upon entry into service.  In finding that the Veteran's disability did not pre-exist service, the examiner was then asked to opine on whether the disability began in service, manifested within one year after discharge from service, or was noted during service with continuity of the same symptomatology since service.  The examiner rendered his negative opinion on the above questions but failed to discuss the specifics requested in the remand directives in rendering his opinion.

As the August 2021 VA examination is inadequate, the Board finds that that the claim must be remanded to comply with the previous remand instructions.

The matter is REMANDED for the following actions:

1. Obtain an addendum opinion from an appropriate clinician regarding the Veteran's currently diagnosed unspecified neurocognitive disorder. The examiner is asked to provide a response to the following:

2. Is it at least as likely as not that the unspecified neurocognitive disorder (1) began during active service, (2) manifested within one year afterdischarge from service, or (3) was noted during service with continuity of the same symptomatology since service?

The examiner must presume that the Veteran is competent and credible to describe the head injury sustained during basic training.

The examiner must presume that the Veteran was sound upon entry into service.

In rendering the above opinions, the examiner should also address the following and indicate how this information was addressed in the opinion:

i. The Veteran's reports of continued symptoms of a head injury following service, although he didn't consistently seek treatment.

ii. The Veteran's wife's testimony regarding differing behavior prior to service and following separation from service.

iii. The Veteran's reports of seeking treatment immediately following service for acting irrationally and erratically.

iv. The Veteran's reported history of tremors and vision and memory impairment following service.

 

 

MARJORIE A. AUER

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Kelsey Love, Associate 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.