Citation Nr: 18160358
Decision Date: 12/27/18	Archive Date: 12/26/18

DOCKET NO. 16-63 251
DATE:	December 27, 2018
REMANDED
Entitlement to service connection for asthma (claimed as due to exposure to herbicides) is remanded.
Entitlement to service connection for traumatic brain injury (TBI) is remanded.
Entitlement to service connection for headaches is remanded.
Entitlement to a compensable rating for psoriasis is remanded.
REASONS FOR REMAND
The Veteran served on active duty in the Army from April 1962 to April 1965, September 1965 to February 1967, and June 1982 to July 1983, which included service in the Republic of Vietnam.
This matter came to the Board of Veterans’ Appeals (Board) on appeal from a June 2015 rating decision by the Department of Veterans Affairs (VA), Regional Office (RO).
1. Asthma 
The Veteran contends that his asthma had its onset in service.  
In a July 2014 statement, the Veteran asserted that he developed asthma while serving in the military.  In a December 2016 statement, he reported that he started having shortness of breath and breathing problems after his 18 months at Fort Lewis, Washington, while going to the 91C Specialist course.  He indicated that he experienced shortness of breath problems years later while serving in Germany, and he was told to watch the condition, and if it became worse, to report to the hospital.  The Veteran noted that his breathing problems continued until he retired from service, and that he is still having shortness of breath.        
The evidence of record indicates that the Veteran has been diagnosed with asthma.  The evidence further suggests asthma symptoms in and since service.  The Veteran has not been afforded a VA examination in conjunction with his asthma claim.  As the evidence indicates that the Veteran has current disability that may be associated with service, to include his presumed herbicide agent exposure, a VA examination should be conducted and opinion obtained as to the etiology of the Veteran’s asthma disability.  38 U.S.C. § 5103A(d); McLendon v. Nicholson, 20 Vet. App. 79 (2006).  
2. TBI and Headache
The Veteran contends that he suffered a TBI in service and currently has headaches and other residuals that are related to the TBI.
In a December 2016 statement, the Veteran reported that in 1964, he was in a convoy in Germany, when a tire blew, causing the jeep he was in to flip.  He stated that he woke up in a military hospital the next day, and had received numerous lacerations on his head and face, as well as road burn on his left arm and head.  The Veteran asserted that he started having headache and eye problems throughout the rest of his military career.  He further noted that he presently is still having a lot of problems with headache, and gets very upset yelling at his family for no reason, which is not his normal manner.
In a January 2018 statement, the Veteran reiterated that he suffered a traumatic brain injury while serving in Germany, which caused problems throughout his military career to the present day.  He also reported that while serving in Vietnam, he was helping to unload wounded personnel from the back of a truck and fell off the truck onto his head.  The Veteran stated that he was knocked out for 15 to 20 minutes, and had cuts on his forehead.  He indicated that he was placed on a ward for the next three days for the head injury, and had light duty for the next 15 days.  The Veteran noted having problems with massive headaches, blurred vision, and that he was placed on Magnesium, which he is still taking as of this date, 50 years later.  He further noted that he has mood swings, migraine headaches, memory loss, confusion, loss of concentration, and loneliness associated with his in-service TBI.  
Service treatment records (STR) reflect complaints and treatment for headaches.  At his September 1965 reenlistment examination, the Veteran reported treatment for a 1964 car wreck while serving in Germany.  At a November 1971 periodic examination, he reported a car accident involving a head injury. 
The evidence of record indicates that the Veteran has been diagnosed with tension-type headache and also that headaches were noted in service.  The evidence, including the Veteran’s competent and credible lay statements, further suggests a head injury in service and symptoms including headaches in and since service.  The Veteran has not been afforded a VA examination in conjunction with his TBI and headache claims.  As the evidence indicates that the Veteran has current disability that may be associated with service, a VA examination should be conducted and opinion obtained as to the etiology of the Veteran’s headaches and claimed TBI.  38 U.S.C. § 5103A(d); McLendon v. Nicholson, 20 Vet. App. 79 (2006).  
3. Psoriasis
The Veteran seeks an initial compensable rating for his service-connected psoriasis disability.  He reports that the rating currently assigned does not reflect the severity of his disability.
In a November 2017 lay statement, the Veteran’s wife reported that she knew him when he was stationed in Kentucky, and that he had a serious time with psoriasis, which was on a large part of his body.  She stated that after retirement, he obtained some relief from the dermatologist, and that it was a lot better, but the psoriasis is still there, and sometimes gets worse.  In a January 2018 statement, the Veteran reported that he still has problems with his psoriasis, and the medication seems to help a little, but he still has psoriasis.  
The Veteran was last afforded a VA medical examination in connection with this claim in June 2015.  As it appears that the severity of the Veteran’s service-connected psoriasis may have materially changed since he was last examined for VA compensation purposes, an additional VA medical examination is necessary to ensure that the Veteran’s disability is appropriately evaluated.  See 38 C.F.R. § 3.159 (c)(4); see also Olsen v. Principi, 3 Vet. App. 480, 482 (1992), citing Proscelle v. Derwinski, 2 Vet. App. 629, 632 (1992) (where a Veteran claim that a service-connected disability is worse than when originally rated, and the available evidence is too old to adequately evaluate the current state of the condition, VA must provide a new examination).
The matters are REMANDED for the following action:
1. Schedule the Veteran for a VA examination to determine the nature and etiology of his asthma disability.  The claims file, including a copy of this remand should be reviewed by the examiner to become familiar with the Veteran’s relevant medical history.
The examiner is to provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that asthma had its onset during service or is otherwise related to military service, or any incident therein, to include his presumed exposure to herbicide agents.   
The fact that the Veteran may not have a disease presumed service connection in veterans exposed to Agent Orange should not be used as a reason for finding that this Veteran’s asthma is not related to exposure to an herbicide agent.
A complete rationale should accompany any opinion provided. 
The examiner is advised that the Veteran is competent to report symptoms and treatment, and that his reports must be taken into account in formulating the requested opinions.
2. Schedule the Veteran for a VA examination to determine the nature and etiology of his headaches and any TBI.  The claims file, including a copy of this remand should be reviewed by the examiner.
The examiner should provide an opinion as to whether the Veteran’s current headaches are related to service, to include both the headaches noted in service and the injuries he described.  The examiner should also indicate whether the Veteran suffered a TBI in service and currently has residuals of a TBI.
3. The Veteran should be scheduled for a VA medical examination to determine the severity of his service-connected psoriasis.  Access to records in the Veteran’s electronic VA claims files and copy of the remand must be made available to the examiner for review in conjunction with the examination. 

The examination should be conducted in accordance with the current disability benefits questionnaire.
[ 
Jonathan Hager
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	R. Walker, Associate Counsel

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