Citation Nr: 21040541 Decision Date: 07/05/21 Archive Date: 07/05/21 DOCKET NO. 06-24 975A DATE: July 5, 2021 REMANDED Entitlement to service connection for a disability manifested by seizures or seizure-like symptoms is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1951 to March 1953. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2010 rating decision from a Department of Veterans Affairs (VA) Regional Office. In April 2015, the Veteran testified during a Board hearing before the undersigned Veterans Law Judge. A transcript of the hearing is included in the claims file. In July 2015, the Board remanded the issue on appeal to the agency of original jurisdiction (AOJ) for additional development. The case has since returned to the Board. The Board notes that when this case was previously before the Board, the Board also remanded the issue of entitlement to service connection for a bilateral eye disability, to include chalazion of the right eyelid. The Veteran has requested an additional hearing in this matter and the issue will be addressed in a separate Board decision. 1. Entitlement to service connection for a disorder manifested by seizures or seizure-like symptoms is remanded. In the July 2015 remand, the Board notes that the Veteran had not been provided an examination to determine the nature and etiology of the claimed seizure disorder, which the Veteran contends was incurred in service. The examiner was instructed to provide an opinion as to whether it was at least as likely as not that any current seizure disability began in service, was caused by service, or was otherwise related to service. The Veteran was afforded a VA examination in April 2019, at which time the Veteran reported episodes of shaking, urinary incontinence, tongue biting, and blacking out. The examiner noted that previous workup for seizures was negative and the Veteran symptoms instead were attributed to sleep paralysis and hypnopompic hallucinations. After examination and review of the record, the examiner concluded that there was no objective evidence of a seizure disorder. The examiner indicated that the claimed condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness, as there was no objective evidence to support a diagnosis of a seizure disorder. No other rationale was provided. A claim of service connection encompasses all pertinent symptomatology, regardless of how that symptomatology is diagnosed. See Clemons v. Shinseki, 23 Vet. App. 1, 5, 9 (2009). This is because a claimant is not expected to have medical expertise and generally "is only competent to identify and explain the symptoms that he observes and experiences." See id. Therefore, the Board has expanded the Veteran's claim to include consideration of a disability manifested by seizures or seizure-like symptoms. Moreover, given the foregoing, the April 2019 VA examination and opinion is inadequate, as it provided a negative nexus opinion based solely on the examiner's finding that the Veteran did not have a seizure disorder. The examiner failed to address whether the Veteran's sleep paralysis, hypnopompic hallucinations, or other disorder productive of the claimed seizure-like symptomatology as described by the Veteran and noted in treatment records, is related to service. Accordingly, remand for another examination and opinion is warranted. The matter is REMANDED for the following action: 1. Schedule the Veteran for a VA examination to address the nature and etiology of the claimed disability manifested by seizures or seizure-like symptoms. Any indicated tests should be accomplished. The examiner should review the record prior to examination, and elicit from the Veteran a detailed medical history. The examiner should identify any and all disorder(s) productive of the seizure-like symptoms and manifestations as described by the Veteran, to include consideration of whether diagnosis of sleep paralysis and hypnopompic hallucinations is warranted. The examiner should address whether it is at least at likely as not (50 percent probability or more) that any disorder productive of the seizure-like symptomatology as described by the Veteran and noted in treatment records began in service, was caused by service, or is otherwise related to service, or had its onset within one year of discharge. In providing the requested opinion, the examiner should specifically consider and address the Veteran's report as to onset of symptoms and seizure activity in service. The examiner is also advised that the Veteran is competent to report symptoms and treatment and that his reports, including his reports as to the onset and nature of his symptoms in service, must be taken into account, along with the other evidence of record, in formulating the requested opinions. The examiner should set forth all examination findings, along with the complete rationale for any conclusions reached. ROBERT C. SCHARNBERGER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board G. E. Wilkerson, 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.