Citation Nr: 21040399 Decision Date: 07/03/21 Archive Date: 07/03/21 DOCKET NO. 18-53 900 DATE: July 3, 2021 ORDER Entitlement to service connection for a seizure disorder is denied. FINDING OF FACT The Veteran's seizure disorder did not manifest in service, and is not otherwise shown to be related to service, or any service-connected disability. CONCLUSION OF LAW The criteria for entitlement to service connection for a seizure disorder have not been met. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from November 1959 to August 1963. In January 2020, the Veteran withdrew his hearing request. While testimony was taken on the matter at an October 2019 hearing, this issue was not actually before the presiding Veterans Law Judge at the time. Thus, the hearing withdraw request is allowed. The Veteran's claim was previously before the Board in February 2021. At that time, the Board determined that the Veteran should be afforded a new VA examination. That development having been completed, the Veteran's claim is once again before the Board and will be adjudicated below. Service Connection Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. See 38 U.S.C. §§ 1110, 1131 (2012); 38 C.F.R. § 3.303(a) (2019). "To establish a right to compensation for a present disability, a Veteran must show: "(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"- the so-called "nexus" requirement." Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2010) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Certain chronic diseases, including arthritis, may be presumed to have been incurred in or aggravated by service if manifest to a compensable degree within one year of discharge from service, even though there is no evidence of such disease during service. 38 U.S.C. §§ 1101, 1112 (2012); 38 C.F.R. §§ 3.307, 3.309(a) (2018). When, after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding service origin, the degree of disability, or any other point, such doubt will be resolved in favor of the claimant. By reasonable doubt is meant one which exists because of an approximate balance of positive and negative evidence which does not satisfactorily prove or disprove the claim. It is a substantial doubt and one within the range of probability as distinguished from pure speculation or remote possibility. See 38 C.F.R. § 3.102. 1. Entitlement to an increased rating for a seizure disorder The Veteran contends that his seizure disorder is due to his service. The Veteran contends that his seizure disorder was related to his motor vehicle accident in service. The Veteran testified that he was seen for a laceration on his forehead while on active duty. He testified that seizures did not run in his family. At the outset, the Veteran's medical records confirm that the Veteran has a current seizure disorder. In addition, there is also evidence of an in-service event, insofar as the Veteran was involved in an automobile accident while in service; his separation examination noted scars on his scalp and forehead. As such, the remaining question for the Board is whether the Veteran's current seizure condition is related to his in-service accident. The Veteran was afforded a VA examination in April 2021. The Veteran reported that he did not recall many details of his motor vehicle accident in service. The examiner noted that the Veteran did have a history of migraines, which the Veteran believed began soon after service. The examiner opined that the Veteran's seizure condition was less likely than not incurred in or caused by the Veteran's in-service incident. The examiner reasoned that it was unlikely that the Veteran's seizure disorder was due to any seizure disorder during service. The examiner explained that this was simply due to the fact that there was no seizure disorder during the Veteran's active duty. The Veteran's first seizure was reported to be in 2014, and another in 2016. The examiner noted that the Veteran's first seizure was 54 years after his accident in service, and 51 years after his separation from service. It is very common that there is no specific cause for seizures found. The examiner pointed to the Veteran's work up performed after his 2016 seizure; the work up ruled out some causes such as intracranial mass, or intracranial bleeding. Blood work was also drawn in 2016 and did not show any abnormalities that could have caused the seizures. There was no indication in the records available that the Veteran was diagnosed with epilepsy. The examiner concluded that in this case, the cause of the Veteran's seizures is not known, which is not terribly uncommon. The likelihood that the disorder was related to any head injury in service 50 years ago was determined to be quite remote. Although possible, it was certainly very unlikely in the examiner's professional opinion. The examiner also opined that the Veteran's seizure disorder was less likely than not related to any of his service-connected conditions, including his tinnitus and hearing loss. Despite a review of literature online, the examiner was unable to find evidence showing that tinnitus or hearing loss could cause or increase the risk of seizure activity. The Board finds that the April 2021 VA opinion is competent and credible as the examiner considered all relevant evidence in the claims file and provided a thorough rationale. The examiner carefully considered the record and drew conclusions despite there being no documentation of a TBI in service, ultimately finding that the Veteran's injury in service did occur. Nonetheless, the examiner determined that the injury that the Veteran suffered in service was not very likely to be the cause of the Veteran's current seizure disorder. As the examiner provided an adequate, detailed opinion and rationale, the opinion is afforded high probative weight regarding the issue of direct nexus between the Veteran's seizure disorder and service, to include a motor vehicle accident in service. With respect to the Veteran's contention that his seizure disorder was caused by service, the preponderance of the evidence is against that claim. The April 2021 VA examiner opined that the Veteran's seizure disorder was less likely than not related to service. There is no other medical evidence in the Veteran's file to the contrary. The Board has considered the Veteran's lay statements asserting a nexus between his seizure disorder and service. As a lay person, however, the Veteran does not have the requisite medical knowledge, training, or experience to be able to render a competent medical opinion regarding the cause of a seizure disorder. The Board instead places great weight upon the April 2021 VA examiner's opinion. Significantly, the service treatment records show no indication of a seizure disorder. The service treatment record that documented the Veteran's involvement in a motor vehicle accident did not indicate any abnormality of the head or head trauma. There additionally is no indication of a continuity of symptoms since service, as the first seizure occurred decades following service separation. The Veteran has not alleged continuous seizures since service. Finally, the 2021 VA examiner found that it was less likely than not that his current seizures were related to service. This opinion was based upon the record as described above which did not evidence a head injury in service or indication of seizures for many decades following service. The opinion was also based upon the Veteran's clinical history and pattern of symptoms. Given such, the Board finds that the VA examination is of greater probative value than the Veteran's statements, which are not competent on the matter. The medical evidence of record indicates that the Veteran's seizure disorder is less likely than not due to service. As such, the Board finds that the preponderance of the evidence weighs against finding that the Veteran's seizure disorder was due to his period of service. R. Erdheim Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E. Vosburgh, 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.