Citation Nr: 21027846 Decision Date: 05/07/21 Archive Date: 05/07/21 DOCKET NO. 18-09 889 DATE: May 7, 2021 REMANDED Entitlement to an initial disability rating in excess of 10 percent for traumatic brain injury (TBI) is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from June 2002 to June 2006. During his period of service, he earned the Army Commendation with Valor Device, Army Commendation Medal, Army Achievement Medal (3rd Award), Army Good Conduct Medal, National Defense Service Medal, Iraq Campaign Medal, Global War on Terrorism Service Medal, Korea Defense Service Medal, Army Service Ribbon, Overseas Service Ribbon (2nd Award), Combat Infantryman Badge (2nd Award), Expert Infantryman Badge, and Parachutist Badge. The issue of entitlement to an initial disability rating in excess of 10 percent for traumatic brain injury (TBI) were previously before the Board in February 2020. In that decision, the Board denied entitlement to an increased rating for the aforementioned disability. In a January 2021 Joint Motion for Remand (Joint Motion), the United States Court of Appeals for Veterans Claims (Court) indicated that the Board erred when it relied on the 2017 Compensation and Pension (C&P) examination, which was inadequate because it did not provide a rationale for its opinion. The parties agreed that the Board's decision finding that the Veteran was not entitled to an increased rating for TBI should be vacated and the appeal remanded to the Board for actions consistent with the Joint Motion. Entitlement to a higher rating for TBI The Veteran appeared for a VA TBI examination in February 2017. The Veteran reported that he had been dazed while doing combat training during basic training, and that he hit his head and lost consciousness during airborne school. While in Iraq, he was exposed to numerous improvised explosive devices (IEDs) and vehicle-borne improvised explosive devices (VBIEDs) and had been knocked out on more than one occasion. He also sustained many concussions from firing his mortar. He reported frequent headaches associated with his duties, as well as mood swings, decreased concentration, and frustration. The examiner opined that the Veteran's reported neurobehavioral effects, which included irritability, impulsivity, unpredictability, lack of motivation, verbal aggression, physical aggression, belligerence, lack of empathy, moodiness, lack of cooperation, and inflexibility, related to his service-connected PTSD. Unfortunately, the Board the February 2017 examination to be inadequate for adjudication purposes. While the examiner attributed the Veteran's reported symptoms to his service-connected PTSD, the examiner failed to offer an adequate rationale in support of his opinion. In order to properly adjudicate this appeal, a remand is warranted to obtain a new examination to ascertain the severity of the Veteran's service connected TBI. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). The matters are REMANDED for the following action: Schedule the Veteran for a VA examination with the appropriate examiner to address the current nature and severity of his service connected TBI. The claims folder must be made available to the examiner for review in connection with the examination. The examination report must reflect that such a review was conducted. All appropriate tests and studies should be conducted. (a) The examiner is asked to include all subjective complaints and objective symptoms of the Veteran's service-connected TBI residuals. The examiner must address the degree to which the service-connected disability is manifested by facets of cognitive impairment including: memory, attention, concentration, executive functions; judgment; social interaction; orientation; motor activity; visual spatial orientation; subjective symptoms; neurobehavioral effects; communication; and consciousness. (Continued on the next page) (b) The examiner should state whether it is possible to distinguish the Veteran's PTSD symptoms from his TBI symptoms, and if so, he or she must clearly state which symptoms are attributed to each disability. If it is not possible to distinguish the PTSD symptoms from the TBI symptoms, the examiner must so state and explain why. Rationale for all requested opinions shall be provided. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation stating why this is so. In so doing, the examiner shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question(s). A. S. CARACCIOLO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Tracy O. Joseph, 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.