Citation Nr: 21012053 Decision Date: 03/03/21 Archive Date: 03/03/21 DOCKET NO. 17-36 941 DATE: March 3, 2021 ORDER Entitlement to service connection for a traumatic brain injury (TBI) or residuals of a TBI is denied. Entitlement to service connection for a residual scar from a head laceration on the scalp is granted. FINDINGS OF FACT 1. The preponderance of evidence indicates the Veteran does not have a current diagnosis of a TBI or residuals of a TBI. 2. The medical evidence shows the Veteran has residual scarring from a head laceration on the scalp due to an in-service motor vehicle accident. CONCLUSIONS OF LAW 1. The criteria for service connection for a TBI or residuals of a TBI are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for a residual scar from a head laceration on the scalp are met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from August 1991 to March 2000. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a July 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Board remanded the appeal in October 2018 for further development. Service Connection Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Generally, service connection requires: (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. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004); see Caluza v. Brown, 7 Vet. App. 498, 506 (1995); 38 C.F.R. § 3.303. In determining whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). To do so, the Board must assess the credibility and weight of all the evidence, including the medical evidence, to determine its probative value, accounting for evidence that it finds to be persuasive or unpersuasive, and providing reasons for rejecting any evidence favorable to the Veteran. See Masors v. Derwinski, 2 Vet. App. 181 (1992). In making all determinations, the Board must fully consider the lay assertions of record. A layperson is competent to report on the onset and continuity of current symptomatology. See Layno v. Brown, 6 Vet. App. 465, 470 (1994). The Board notes that it has thoroughly reviewed the record in conjunction with this case. Although the Board has an obligation to provide reasons and bases supporting this decision, there is no need to discuss, in detail, the extensive evidence submitted by the Veteran or on his behalf. See Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) (the Board must review the entire record but does not have to discuss each piece of evidence). Rather, the Board's analysis below will focus specifically on what the evidence shows, or fails to show, on the claims. See Timberlake v. Gober, 14 Vet. App. 122, 129 (2000) (noting that the Board must analyze the credibility and probative value of the evidence, account for the evidence which it finds to be persuasive or unpersuasive and provide the reasons for its rejection of any material evidence favorable to the claimant). Entitlement to service connection for a traumatic brain injury (TBI) or residuals of a TBI. The Veteran contends that she is entitled to service connection for TBI. The Veteran’s service treatment records reflect that she sought treatment for a head injury from a fall in February 1992 causing a laceration. In December 1997, she was diagnosed with a tension headache after she reported hitting her head four months prior to the treatment date. However, service treatment records do not include a diagnosis of a TBI. The Veteran was afforded several VA examinations for residuals of a TBI. The April 2017 examination revealed no impairments in memory, judgment, social interaction, orientation, motor activity, visual spatial orientation, neurobehavioral effects, communication, or consciousness. The examiner noted the February 1992 head injury. The Veteran reported no subjective symptoms related to her purported TBI, though endorsed an occasional headache when stressed. The Veteran reported that, to date, the condition had not been formally diagnosed. The examiner concluded that the Veteran’s claimed condition was less likely than not proximately due to or the result of the Veteran’s service, as the condition has resolved. The November 2017 examination revealed no impairments in memory, judgment, social interaction, orientation, motor activity, visual spatial orientation, neurobehavioral effects, communication, or consciousness. The examiner noted the February 1992 and December 1997 head injuries. The Veteran reported no subjective symptoms related to her purported TBI, though endorsed an occasional headache when stressed or angry. The examiner concluded that the Veteran’s claimed condition was less likely than not due to her active duty service, as the condition has resolved. There is no evidence in the record of a concussion or TBI. The Veteran was afforded a December 2019 VA examination for residual scarring from the Veteran’s in-service laceration to the head. The examiner noted a December 1992 motor vehicle accident where the Veteran suffered a laceration to the back of the head. The examiner concluded that residual scarring was at least as likely as not incurred in or caused by the claimed in-service injury. The December 2020 examination revealed no impairments in memory, judgment, social interaction, orientation, motor activity, visual spatial orientation, neurobehavioral effects, communication, or consciousness. The examiner noted the February 1992 and December 1997 head injuries. The Veteran reported no subjective symptoms related to her purported TBI. The examiner concluded that the Veteran’s claimed condition was less likely than not due to her active duty service, as the Veteran has recovered from the injury. There is no evidence in the record of a cognitive disorder. The Veteran had two mild head injuries that have resolved. The Board acknowledges that the Veteran suffered multiple head injuries during service. However, after review of all the lay and medical evidence of record, the Board finds that the weight of the evidence is against finding that the Veteran currently has a TBI or residuals of TBI. As there is no current disability of a TBI or residuals of a TBI, the Board concludes that the criteria for service connection are not met. Although the Veteran asserts, she has a TBI or residuals of a TBI which is causally related to service, she is a lay person and does not have the requisite medical training or credentials to be able to diagnose a TBI. Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007). A TBI is a disorder diagnosed primarily on symptoms, clinical findings, and physiological testing. Thus, while the Veteran is competent to report symptoms she experiences, she is not competent to diagnose a TBI or residuals of a TBI because such a diagnosis requires specific medical knowledge and training. For these reasons, the Veteran's opinion that she has a TBI is of no probative value. Because a current disability of a TBI or residuals of a TBI is not demonstrated in this case, the appeal must be denied. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. However, as the Veteran has residual scarring from a head laceration on the scalp due to a 1992 MVA, service connection is warranted for this scar. TANYA SMITH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Edwin B. Esmenda, 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.