Citation Nr: 21023305 Decision Date: 04/20/21 Archive Date: 04/20/21 DOCKET NO. 15-31 263 DATE: April 20, 2021 REMANDED Entitlement to service connection for Bell’s palsy is remanded. Entitlement to service connection for epilepsy is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1973 to February 1974. These matters come to the Board of Veterans’ Appeals (Board) from a November 2012 rating decision. In that decision, a Department of Veterans Affairs (VA) Regional Office (RO) denied reopening of a previously denied claim for service connection for Bell’s palsy, on the basis that new and material evidence had not been received. The RO also denied service connection for seizures. In January 2019 the Veteran had a Travel Board hearing before the undersigned Veterans Law Judge. In a June 2019 decision, the Board found that new and material evidence had been received and granted reopening of a claim for service connection for Bell’s palsy. The Board then considered that reopened claim on its merits and denied service connection. In the same decision, the Board denied service connection for epilepsy. The Veteran appealed the Board’s denials of service connection for both disorders to the United States Court of Appeals for Veterans Claims (Court). In June 2020 the Veteran and VA (the parties) submitted to the Court a joint motion for partial remand (JMPR), requesting that the Court vacate the parts of the June 2019 Board decision that denied service connection for Bell’s palsy and service connection for epilepsy, and remand those parts to the Board for specified actions and then readjudication. In June 2020 order, the Court granted the JMPR. In July 2020 the Veteran submitted arguments regarding his Bell’s palsy and epilepsy service connection claims. In a July 2020 letter, the Board informed the Veteran that he could, if desired, submit additional argument and evidence to the Board. The Board told the Veteran that, if he submitted new evidence, he had the right to have that evidence considered by the agency of original jurisdiction (AOJ) (in this case, the RO), or he could waive that right and have the evidence considered directly by the Board. In August 2020 the Veteran submitted additional evidence, including private and VA medical records. He asked the Board to remand the case for the RO to consider the new evidence. In December 2020 the Board remanded the Bell’s palsy and epilepsy service connection claims to the RO for additional action. 1. Service connection for Bell’s palsy The Board is remanding this issue to the RO for additional medical examination and opinion. The Veteran reports that he had onset of Bell’s palsy soon after his separation from service. He contends that that his Bell’s palsy is attributable to injury, disease, or other events during his service. After the December 2020 Board remand, the Veteran had a VA cranial nerves diseases examination. He reported that, beginning in 1974, and through the present, he experienced difficulty chewing and episodes of difficulty speaking. The examiner found that the Veteran had mild paresthesias and/or dysesthesias in his right mid and lower face, mild numbness in his right mid face, lower face, mouth, and throat, mild difficulty chewing, and mild difficulty speaking. Sensory examination showed decreased sensation to light touch in the right mid face. The examiner found that the right cranial nerve VII had incomplete, moderate paralysis. The examiner did not explain why the symptoms described by the Veteran and the examination findings regarding his face do not support a diagnosis of Bell’s palsy. The examination therefore was not adequate. The Board is remanding the case again for a new examination with findings and explanations addressing the nature and likely etiology of any current disorder affecting the Veteran’s face, mouth, and/or throat. 2. Service connection for epilepsy The Board is remanding this issue to the RO for additional medical examination and opinion. The Veteran reports that he began to have epileptic seizures soon after his separation from service. He contends that that his epilepsy is attributable to injury, disease, or other events during his service. In VA treatment in December 1992, the Veteran reported having right eye spasm and then losing consciousness. In treatment in May 2016, he stated that his head was spinning. In treatment in January 2017, the Veteran reported that he felt his right eye rolling, experienced blurring of his vision, and thought that he was going to pass out. In the January 2019 Board hearing, the Veteran indicated that he experienced seizures soon after his separation from service and continued to have seizures through the present. After the December 2020 Board examination, he had a VA epilepsy examination. He reported that after his service he had seizures. He stated that the seizures stayed the same thereafter. The examiner found that the Veteran had not had any findings, signs, or symptoms attributable to epilepsy or a seizure disorder. The examiner did not explain why the symptoms, including seizures, that the Veteran has described do not support a diagnosis of epilepsy or other seizure disorder. The examination therefore was not adequate. The Board is remanding the case again for a new examination with findings and explanations addressing the nature and likely etiology of any current disorder manifested by seizures. (Continued on the next page) The matters are REMANDED for the following action: 1. For the VA examinations requested below, schedule the examinations when, in the opinion of the Veteran, and in the opinion of an appropriate official at a VA medical facility near the Veteran, it is reasonably safe, in light of local conditions with regard to the COVID pandemic, to perform in-person examinations. 2. Schedule the Veteran for a VA neurological examination as to the nature and likely etiology of: (1) claimed Bell’s palsy or other neurological disorder affecting his face, mouth, and/or throat, and (2) claimed epilepsy or other seizure disorder. Provide the Veteran’s claims file to a neurologist for review. Ask the examiner to review the claims file and examine the Veteran. Ask the examiner to state specifically whether the Veteran has each of the following: (1) Bell’s palsy, (2) epilepsy. Ask the examiner to provide a diagnosis for any and all disorders manifested by (1) neurological findings involving the Veteran’s face, mouth, and/or throat, (2) seizures, or episodes of dizziness of sudden loss of consciousness. Ask the examiner, for each condition with any of the manifestations listed above, to provide opinion as to whether it is at least as likely as not that the disorder began during the Veteran’s October 1973 to February 1974 service, or is otherwise causally related to injury, disease, or other events during that service. Ask the examiner to explain conclusion and opinion. 3. Then review the expanded claims file and review the remanded claims. If any of those claims remain denied, issue a supplemental statement of the case and afford the Veteran and his representative an opportunity to respond. Then return the case to the Board for appellate review, if otherwise in order. K. PARAKKAL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. J. Kunz, 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.