Citation Nr: 22012173 Decision Date: 03/02/22 Archive Date: 03/02/22 DOCKET NO. 15-29 813 DATE: March 2, 2022 REMANDED Entitlement to service connection traumatic brain injury (TBI), to include headaches and seizures residuals, is remanded. Entitlement to special monthly compensation (SMC) based on the need for the regular aid and attendance is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1967 to February 1970. The Veteran served in Vietnam and was awarded the Combat Infantry Badge, Army Commendation Medal, and the Vietnam Service Medal. These matters come before the Board of Veteran's Appeals (Board) from a January 2014 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Jackson, Mississippi. In June 2017, the Veteran testified via videoconference before the undersigned Veterans Law Judge (VLJ). A transcript of the hearing has been associated with the record. 1. Entitlement to service connection TBI, to include headaches and seizures residuals, is remanded. The Veteran is seeking to establish service connection for TBI with residuals including headaches and seizures. The Veteran contends he suffered a TBI in service during combat. Specifically, he believes blast explosions caused by firefights and bombs caused his claimed TBI. Alternatively, the Veteran believes he suffered a TBI after being hit in the head near the eye by shrapnel and/or after he sustained a laceration to the forehead while cleaning a road wheel. The Veteran believes his epilepsy, seizures, and headaches are evidence he had a TBI in service. This matter has been remanded by the Board several times for additional development. Most recently, in September 2021, the Board determined that the latest June 2021 VA opinion was inadequate for adjudicative purposes and remanded the issue for a new VA opinion. Regrettably, the Board finds there was not substantial compliance with the September 2021 remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998) (holding veterans are entitled to compliance with Board remand instructions). In its September 2021 remand, the Board directed the RO to obtain a VA addendum opinion which specifically addressed evidence that supported the Veteran's claim. Unfortunately, the December 2021 VA opinion does not substantially comply with the Board's remand directives and thus, remand for a new opinion is warranted. 2. Entitlement to SMC based on the need for the regular aid and attendance is remanded. The Veteran is seeking SMC based on the need for aid and attendance. Specifically, he contends that he needs aid and attendance due to his seizure disorder, anxiety, and DJD. See November 2012 Statement for Aid & Attendance. As noted above the Veteran's claim for service connection for a TBI is being remanded for additional development. The outcome of such development would impact the claim entitlement to SMC. Therefore, the Board finds these issues to be inextricably intertwined and must remand the claim. See Harris v. Derwinski, 1Vet. App.180, 183 (1991) The matters are REMANDED for the following action: 1. Obtain an addendum opinion from a new VA examiner, if possible, regarding the nature and etiology of the Veteran's claimed TBI. The record, to include a copy of this remand, must be made available to and be reviewed by the examiner. If an opinion cannot be obtained without an examination, then a VA examination should be afforded to the Veteran. The examiner is asked to respond to the following: a) Does the Veteran have a diagnosis of TBI? In making his or her determination, the examiner is asked to address the following: i) the Veteran's contention, including medical literature to support this contention submitted in April 2019, that gunfire and bombs during combat in Vietnam caused blast-induced neurotrauma; ii) the Veteran's contention that he sustained a TBI in December 1969 after sustaining a laceration to the forehead while cleaning a road wheel; iii) the Veteran's contention made during a December 2013 VA examination that he was hit in the face near his eye with shrapnel; and iv) the Veteran's contention that his headaches, seizures, and aggravated epilepsy are evidence that indicate he suffered a TBI in service. b) If the Veteran has a confirmed diagnosis of TBI, is it as least as likely as not (i.e., a 50 percent or greater probability) that his TBI is related to active duty service? c) If the Veteran does not have a confirmed diagnosis of TBI, please reconcile this finding with the February 2018 VA examiner's recognition of post traumatic epilepsy as a result of closed head non-impact blast-induced TBI. The February 2018 examiner opined that the Veteran's epilepsy was as least as likely as not related to service. The examination report must include a complete rationale for all opinions expressed. If the examiner feels that a requested opinion cannot be rendered without resorting to speculation, the examiner must state whether the need to speculate is caused by a deficiency in the state of general medical knowledge (i.e., no one could respond given medical science and the known facts) or by a deficiency in the record or the examiner (i.e., additional facts are required, or the examiner does not have the needed knowledge or training). (Continued on the next page) 2. After completing the above, and any other development as may be indicated by any response received as a consequence of the actions taken in the preceding paragraphs, the Veteran's claims should be readjudicated based on the entirety of the evidence. If any benefit sought remains denied, furnish the Veteran and his representative a supplemental statement of the case (SSOC) and return the case to the Board. KRISTI L. GUNN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board L. Silverblatt, 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.