Citation Nr: A21019175 Decision Date: 12/02/21 Archive Date: 12/02/21 DOCKET NO. 201204-124069 DATE: December 2, 2021 ORDER New and relevant evidence having been received, the claim of entitlement to service connection for a neurocognitive disorder, including memory loss and dementia, may be readjudicated. REMANDED Entitlement to service connection for a neurocognitive disorder, including memory loss and dementia, is remanded. FINDING OF FACT New and relevant evidence has been received, regarding the Veteran's claim of entitlement to service connection for a neurocognitive disorder, since the September 2018 rating decision and March 2020 Statement of the Case. CONCLUSION OF LAW As new and relevant evidence has been received, the requirements to readjudicate the claim of entitlement to service connection for a neurocognitive disorder, including memory loss and dementia, have been met. 38 U.S.C. §§ 5108, 7105; 38 C.F.R. §§ 3.156, 3.2501. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January 1963 to January 1966. This case comes to the Board of Veterans' Appeals (Board) from a July 2020 rating decision of the Department of Veterans Affairs Regional Office. In December 2020, he submitted a VA Form 10182 Notice of Disagreement requesting a Hearing with a Veterans Law Judge. This issue has therefore been validly appealed under the Appeals Modernization Act (AMA). On June 2, 2021, the Veteran requested to withdraw his hearing request. He therefore had 90 days from that date to submit additional evidence in this case. 38 C.F.R. §§ 20.302(b), 20.704(e). New and Relevant Evidence The Veteran's prior claim for service connection for dementia/memory loss was denied in a September 2018 rating decision. The Veteran submitted a Notice of Disagreement with the decision in November 2018, and a Statement of the Case was issued in March 2020. The Veteran did not appeal this decision to the Board by submitting a Form 9 substantive appeal, and the September 2018 rating decision is therefore final. In June 2020, the Veteran submitted a Supplemental Claim requesting service connection for dementia/memory loss. A Supplemental Claim under the AMA must be accompanied by new and relevant evidence. 38 C.F.R. § 3.2501. A claimant may reopen a finally adjudicated claim by submitting new and relevant evidence, and VA will then readjudicate the claim taking into consideration all of the evidence of record. New evidence means existing evidence not previously submitted to agency decisionmakers. The term "relevant evidence" means evidence that tends to prove or disprove a matter in issue. Id. The standard shall not be construed to impose a higher evidentiary threshold than the "new and material" evidence standard that was in effect prior to the date of the enactment of the AMA. In May 2021, the Veteran was afforded a new VA psychiatric examination which diagnosed him with unspecified neurocognitive disorder and adjustment disorder with anxiety. This is new evidence that had not previously been before VA adjudicators, and it is relevant, as it pertains to the presence of current psychiatric and cognitive diagnoses, and is therefore evidence which tends to prove the claim. The Board therefore finds that new and relevant evidence has been received since the prior final disallowance of the claim for service connection memory loss and dementia. The claim is reopened, and is granted to this extent only. REASONS FOR REMAND The Veteran attended a VA examination with a psychologist in February 2020. He reported that he had been a paratrooper in the military, and he also boxed and played football during service. He was diagnosed with unspecified neurocognitive disorder. The examiner wrote that it was less likely as not that his unspecified neurocognitive disorder was incurred in or was caused by an in-service injury or event. She did not provide any rationale whatsoever for her findings. Most of the probative value of a medical opinion comes from its rationale, and this opinion is, unfortunately, entirely missing one. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). The Regional Office did then afford the Veteran additional VA examination in May 2021, and the examining psychologist noted that the Veteran reported that he had been a boxer and football player in service and experienced a lot of head blows, and that he also had been a parachutist. She diagnosed the Veteran with unspecified neurocognitive disorder and adjustment disorder with anxiety, and found that he had total occupational and social impairment. Despite finding these diagnoses, and marking "anxiety" as one of the symptoms of the Veteran's diagnoses, in the Remarks section, she wrote that for the claimant's claimed condition of anxiety, there is no diagnosis because there are no findings, signs, and/or symptoms to support a diagnosis, and that there was also no depression diagnosis because there were no findings, signs, or symptoms to support a diagnosis. This finding seems totally inconsistent to the Board, and it is not clear whether she even intended this statement to apply to this Veteran. In a separate medical opinion form, she wrote that the conditions were less likely than not incurred in or caused by service, because his anxiety was secondary to his dementia, which leads him to worry about his memory. The examiner did not, however, address the etiology of the Veteran's dementia and memory loss, and therefore the record is still lacking an adequate medical opinion regarding this issue. The Board finds that this constitutes a pre-decisional error in the duty to assist, and the issue is remanded so that an adequate medical examination and opinion can be obtained. The matters are REMANDED for the following action: Schedule the Veteran for a VA examination with a neurologist regarding the etiology of his neurocognitive disorder, including dementia and memory loss. The examination may be held via telehealth during social distancing restrictions. The examiner must be provided access to the Veteran's entire claims file and must specify in the report that the claims file has been reviewed. The examiner should then: Identify all current diagnoses, including any neurocognitive impairment or dementia. For every diagnosed disorder, state whether it is as likely as not (a 50/50 probability, or greater) the disorder had its onset during or is related to the Veteran's service. The examiner should discuss the Veteran's reports that he had may suffered head injuries from boxing, playing football, and working as a parachutist in service, which he believes have led to his current dementia and memory loss. The Board notes that an August 1964 treatment record did indicate that the Veteran was a football player. A complete, well-reasoned rationale must be provided for all conclusions and opinions. If the requested opinions cannot be rendered without resorting to speculation, the examiner must explain why. DELYVONNE M. WHITEHEAD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Mary E. Rude, 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.