Citation Nr: 21006381 Decision Date: 02/04/21 Archive Date: 02/04/21 DOCKET NO. 14-19 640 DATE: February 4, 2021 REMANDED Entitlement to service connection for a seizure disorder, including as secondary to service-connected PTSD, is remanded. REASONS FOR REMAND The Veteran had over 20 years of active military service, including from May 1962 to December 1969 and August 1974 to November 1984, when he retired from service. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an October 2012 rating decision by a Department of Veterans Affairs (VA) Regional Office/Agency of Original Jurisdiction (RO/AOJ). The claim on appeal was previously before the Board and was remanded in March 2018 and January 2020 for further development (the January 2020 Board decision also granted an increased initial 70 percent rating for posttraumatic stress disorder (PTSD), a total disability rating based on individual unemployability (TDIU) due to PTSD alone and, from December 5, 2011, special monthly compensation (SMC) under 38 U.S.C. § 1114(s) and 38 C.F.R. § 3.350(i)(1)). As a preliminary matter, the Board notes that the appellant entered into a representation agreement with J. Michael Woods of Woods and Woods LLP in May 2015. Prior to the return of this claim to the Board, in November 2020, Mr. Woods submitted notice to the RO that he was withdrawing as the Veteran’s representative. This notice also indicated that the Veteran had been notified by Mr. Woods of the withdrawal of representation. Under VA regulations, prior to certification of an appeal to the Board, a claimant’s representative may withdraw from representation before an agency of original jurisdiction at any time, “if such withdrawal would not adversely impact the claimant’s interest.” 38 C.F.R. § 14.631; see also 38 C.F.R. § 20.6. The undersigned grants the November 2020 motion to withdraw representation before the Board. The January 2020 Board remand directed the AOJ to afford the Veteran a VA examination and obtain opinions as to whether his seizure disorder was related to service or whether it was secondary to (due to or aggravated by) his service-connected PTSD. Although VA seizure disorders examination and opinions were obtained in October 2020 and an addendum opinion was obtained in November 2020, the opinion as to whether the seizure disorder is aggravated by the Veteran’s service-connected PTSD is insufficient for rating purposes. The rationale for finding no aggravation also concludes with the finding that the Veteran’s seizure disorder is less likely than not related to his “active duty service or any incident therein.” In addition, the November 2020 addendum opinion explained that “[t]here is no research to support seizure disorders are associated with that of PTSD.” An opinion that a disability is not related to or associated with another disability is not adequate to address the aggravation factor. El-Amin v. Shinseki, 26 Vet. App. 136, 140-41 (2013). As such, these opinions are insufficient for rating purposes and remand is necessary to obtain adequate opinions as to the nature and cause of the Veteran’s seizure disorder. Stegall v. West, 11 Vet. App. 268, 271 (1998). The matters are REMANDED for the following action: 1. Please secure for the record copies of complete updated clinical records (any not already of record) of all VA and/or private mental health treatment the Veteran has received. 2. After the action requested in paragraph 1 above is complete, please forward the Veteran’s claims file to an appropriate clinician for preparation of an addendum opinion. If another examination is deemed necessary to answer the questions below, one should be scheduled (or telehealth interview, if an in-person examination is not feasible). Following a review of the record, the examiner should provide responses to the following: a) Is it at least as likely as not (50 percent or better probability) that any diagnosed seizure disorder was aggravated by the Veteran’s service-connected PTSD? In responding to the above, the examiner should consider as necessary the VA and private treatment records showing the diagnosis of a seizure disorder and VA treatment records noting “seizure disease stable on Keppra.” The clinician is informed that aggravation here is defined as any increase in disability. If the Veteran’s PTSD aggravated his seizure disorder, the clinician should indicate, to the extent possible, the approximate level of disability (baseline) before the onset of the aggravation. The clinician must provide complete rationales for all opinions and conclusions reached, citing the objective medical findings leading to the conclusions. If an opinion cannot be provided without resort to speculation, the examiner should provide an explanation as to why   this is so and note what, if any, additional evidence would permit such an opinion to be made. M. C. GRAHAM Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Kshama Hughes 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.