Citation Nr: 21023984 Decision Date: 04/21/21 Archive Date: 04/21/21 DOCKET NO. 15-39 077A DATE: April 21, 2021 REMANDED Service connection for transient ischemic attacks (mini strokes) is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1969 to January 1971. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a July 2014 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a video conference hearing before the undersigned in January 2019. In May 2019 and October 2020, the Board remanded this matter for further development. Service connection for transient ischemic attacks (mini strokes) is remanded. Unfortunately, another remand is necessary in this case. The Veteran is claiming service connection for transient ischemic attacks (mini strokes) as secondary to either exposure to herbicides in service or to his service-connected PTSD. The November 2020 etiology opinion indicated that “PTSD is not an established etiology of transient ischemic attacks in the medical literature” but did not address the medical article submitted by the Veteran in January 2019 that discusses the relationship between PTSD and cerebral vascular disease. Thus, the opinion regarding secondary service connection is inadequate. The matter is REMANDED for the following action: Obtain an addendum opinion from an appropriate clinician (other than the November 2020 clinician who provided the etiology opinion) regarding whether the Veteran’s transient ischemic attacks (TIAs) are at least as likely as not (a degree of probability of 50 percent or higher) caused or aggravated by service-connected PTSD. The clinician must address causation and aggravation separately. The clinician must address the significance, if any, of the article submitted by the Veteran in January 2019 that discusses the relationship between PTSD and cerebral vascular disease. M. HYLAND Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board B. Houbeck 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 This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.