Citation Nr: 21028208 Decision Date: 05/10/21 Archive Date: 05/10/21 DOCKET NO. 10-23 237 DATE: May 10, 2021 REMANDED Entitlement to service connection for residuals of a neck injury, including as secondary to a service-connected right knee disability is remanded. Entitlement to service connection for a disability manifested by loss of balance is remanded. REASONS FOR REMAND The Veteran had active service from January 1970 to September 1973 and additional service in the Air Force Reserve. This matter comes to the Board of Veterans' Appeals (Board) from an August 2011 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In December 2013, the Veteran testified before the undersigned Veterans Law Judge at a Board hearing at the RO/Agency of Original Jurisdiction (AOJ). This case was previously remanded by the Board in September 2014 and January 2017. In May 2019, the Board, in pertinent part, denied service connection for residuals of a neck injury; and remanded the issues of entitlement to service connection for a disability manifested by loss of balance. The Veteran appealed the Board's decision to the U.S. Court of Appeals for Veterans Claims (Court), and pursuant to a March 2020 Joint Motion for Partial Remand (JMPR), the Court, in April 2020, vacated the Board's May 2019 decision, insofar as it denied service connection for residuals of a neck injury. In June 2020, the Board remanded the service connection claim for a disability manifested by loss of balance as the AOJ had not completed the development previously directed in the May 2019 Board remand. The Board also remanded the service connection claim for residuals of a neck injury, pursuant to the March 2020 JMPR. In September 2020, the Board sent the Veteran an erroneous hearing notice letter noting that he had elected to participate in (another) Board hearing. The Veteran elected to participate in a Board virtual hearing in November 2020. Thus, in January 2021, the Veteran testified at a Board virtual hearing with the same Veterans Law Judge. 1. Entitlement to service connection for residuals of a neck injury, including as secondary to a service-connected right knee disability is remanded. The AOJ has not yet completed the directives of the Board's previous June 2020 remand, pursuant to the JMPR. Thus, this matter must go back to the AOJ. The Veteran offered additional testimony at the Board hearing in January 2021 that his neck injury in service actually happened in 1972 during active duty service, rather than during his reserve service in 1975, though it was not recorded until the later date. See January 2021 Board virtual hearing, pp. 6-7. He also stated that when the neck injury incident was recorded, he was on active duty for training in November 1975. Id. at 7. 2. Entitlement to service connection for a disability manifested by loss of balance is remanded. The Board remanded the service connection claim for disability manifested by loss of balance in May 2019 so that it could be determined whether the Veteran had a disability manifested by the claimed symptom, and also whether it was related to his service-connected head injury. It was noted that service treatment records demonstrated a history of falls and that a VA examiner in December 2015 had related to the Veteran's loss of balance to his service-connected foot drop disability. A VA medical opinion was provided in November 2019 that the Veteran's loss of balance was not caused or aggravated by his service-connected TBI. The question remains, however, whether the Veteran has a diagnosed disability related to his loss of balance related to his military service given that he has a history of falls in service. The matters are REMANDED for the following action: 1. Complete the remand directives of the Board's June 2020 remand with respect to the claim of entitlement to service connection for residuals of a neck injury. The AOJ should note in readjudicating the Veteran's claim that he offered additional testimony at a Board hearing in January 2021 that his head injury in service actually happened in 1972 during active duty service, rather than during his reserve service in 1975, though it was not recorded until the later date. See January 2021 Board virtual hearing, pp. 6-7. He also stated that when the incident was recorded, he was on active duty for training in November 1975. Id. at 7. Of note, the service treatment records also show a history of falls including a fall in 1970 when he lost consciousness. 2. Obtain an addendum VA opinion to determine the etiology of the Veteran's claimed disability manifested by loss of balance. If the examiner is unable to respond to the Board's inquiry without an examination of the Veteran, he should be scheduled for an examination. The examiner must review the claims file. Please state whether the Veteran has a diagnosis to explain his loss of balance symptoms. If a diagnosis cannot be provided but the Veteran's condition manifests in symptoms that cause functional impairment, then the examiner should consider such symptoms a "disability" for the purpose of providing the requested opinion(s) below. The examiner is asked to provide a response to whether any disability manifested by loss of balance is at least as likely as not related to service, including the falls the Veteran experienced in service. Provide a rationale to support the opinion(s). In providing the requested opinion, consider the Veteran's description of his in-service falls and symptoms as well as his post-service symptoms. If there is any medical reason to accept or reject the proposition that the Veteran's reported falls and symptoms in service and thereafter represented the onset of his current disability, this should be noted. Stated another way, do the Veteran's reports about his symptoms align with how the currently diagnosed disability is known to develop or are the Veteran's reports generally inconsistent with medical knowledge or implausible? S. L. Kennedy Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Sarah B. Richmond, 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.