EPILEPSY

Summary

The Veteran, an Army Veteran who served from May 1963 to May 1966, appeals the denial of service connection for epilepsy. The Veteran contends his epilepsy is related to a motor vehicle accident in 1966 during service, which resulted in a concussion. The Board found that the Veteran has a current diagnosis of epilepsy and that the service treatment records documented an in-service event, specifically a concussion from a 1966 motor vehicle accident. The Board reviewed multiple VA medical opinions. An April 2023 VA opinion found the epilepsy less likely than not related to service due to a lack of chronicity and treatment history, but the Board found this opinion inadequate for failing to address the extensive evidence of symptoms from 1970 onwards. A January 2026 VA opinion also found the condition not related to service, but was similarly found inadequate for failing to address the long history of symptoms and the positive opinion. A July 2025 VA opinion found the Veteran's psychomotor epilepsy to be at least as likely as not related to the 1966 concussion, citing medical literature supporting a link between TBI and increased risk of epilepsy. The Board found the evidence to be in equipoise regarding the relationship between the epilepsy and the in-service accident. Applying the benefit of the doubt, service connection for epilepsy was granted.

Rationale

Favorable finding of current epilepsy; Favorable finding of in-service concussion from MVA; Equipoise between current epilepsy and in-service concussion; Benefit of the doubt applied in favor of Veteran

Full Decision Text

Citation Nr: A26032056
Decision Date: 04/08/26	Archive Date: 04/08/26

DOCKET NO. 260306-634849
DATE: April 8, 2026

ORDER

Entitlement to service connection for epilepsy is granted.

FINDING OF FACT

Resolving reasonable doubt in favor of the Veteran, the evidence is at least in relative equipoise as to whether the Veteran's epilepsy is due to an in-service head injury incurred during a 1966 motor vehicle accident.

CONCLUSION OF LAW

The criteria for entitlement to service connection for epilepsy have been met.  38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty in the United States Army from May 1963 to May 1966.  

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a February 2026 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). 

Within the framework of the Appeals Modernization Act (AMA), in March 2026, the Veteran submitted a VA Form 10182, Decision Review Request Board Appeal (Notice of Disagreement (NOD)) in response to the February 2026 rating decision and elected Direct Review by a Veterans Law Judge.  38 C.F.R. § 19.2(d).  

By way of procedural background, in March 2023, the Veteran filed a VA Form 20-0995 Supplemental Claim Application for the current service connection claim for loss of memory (diagnosed as epilepsy).  In a May 2023 rating decision, the Agency of Original Jurisdiction (AOJ) denied entitlement to service connection for epilepsy due to motor vehicle accident (MVA).  In response, in May 2024, the Veteran submitted a timely VA Form 20-0996, Decision Review Request: Highter-Level Review (HLR).  In May 2025, the AOJ again denied service connection for epilepsy due to MVA.  The Veteran submitted a VA Form 10182 NOD in response to the May 2025 HLR decision.  Thereafter, in June 2025, the Board determined the April 2023 VA opinion was inadequate and remanded the claim to obtain an adequate VA etiological opinion.  

After additional VA examination and opinion were obtained in July 2025, the claim was again denied in a September 2025 rating decision.  Subsequently in September 2025, the Veteran submitted a VA Form 20-0996, Decision Review Request: HLR, requesting a review of the September 2025 rating decision.  In December 2025, the AOJ identified a duty to assist error during HLR for the epilepsy due to MVA claim, additional development was conducted.  

In February 2026, the AOJ issued the rating decision on appeal, which considered the entire evidence of record at the time.  Therefore, under the direct review option, no additional evidence received after the appealed rating decision is to be considered; rather, review is limited to the evidence on record at the time of the February 2026 decision.  It may consider argument, but not evidence, that was received at any time after the February 2026 decision.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence.  38 C.F.R. § 3.2501.  If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered.  Id.  Specific instructions for filing a Supplemental Claim are included with this decision.

The Board notes the Veteran has the right to select a different Board review option by submitting a new VA Form 10182 within one year from the date the AOJ mailed the decision on appeal, or within 60 days of the date the Board received the VA Form 10182, whichever date is later.  38 C.F.R. § 20.202(c)(2); see Williams v. McDonough, 37 Vet. App. 305 (2024).  Although the period to change dockets per 38 C.F.R. § 20.202(c)(2) has not elapsed, this decision constitutes a full grant of the benefits sought on appeal, and therefore, there is no prejudice to the Veteran in proceeding to adjudicate the appeal.

Service Connection

Entitlement to service connection for epilepsy.

The Veteran contends his epilepsy is related to his in-service MVA.
 AOJ mailed the decision on appeal, or within 60 days of the date the Board received the VA Form 10182, whichever date is later.  38 C.F.R. § 20.202(c)(2); see Williams v. McDonough, 37 Vet. App. 305 (2024).  Although the period to change dockets per 38 C.F.R. § 20.202(c)(2) has not elapsed, this decision constitutes a full grant of the benefits sought on appeal, and therefore, there is no prejudice to the Veteran in proceeding to adjudicate the appeal.

Service Connection

Entitlement to service connection for epilepsy.

The Veteran contends his epilepsy is related to his in-service MVA.  The Board finds service connection is warranted.

Generally, service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service.  38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303.  The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury.  Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004).

In rendering this decision, the Board has reviewed all evidence of record.  See Newhouse v. Nicholson, 497 F.3d 1298, 1302 (Fed. Cir. 2007) (holding the Board must only discuss the evidence which is relevant to the issues on appeal).  To the extent the evidence is found in "approximate balance," the Board will afford the benefit of the doubt in favor of the Veteran.  Lynch v. McDonough, 21 F. 4th 776 (Fed, Cir. 2021) (holding that exact equipoise is not required for the benefit of the doubt to be applied, but rather the Veteran is entitled to the benefit of the doubt when the evidence is in approximate balance or "nearly equal").

The AOJ favorably found in the February 2026 decision on appeal that the Veteran has a current diagnosis of epilepsy.  The Board is bound by this favorable finding.  See 38 U.S.C. § 5104A; 38 C.F.R. § 3.104(c).  

Regarding in-service incurrence, the Veteran has contended that he was involved in a motor vehicle accident in 1966 that is related to his current epilepsy.  A review of the service treatment records (STRs) shows that in February 1966, the Veteran had been driving his vehicle in Germany when he lost control of it and was forced off the road by another car and hit a tree head-on.  The record noted the Veteran had a short period of unconsciousness, complained of headaches, dizziness, and pain in anterior chest.  The Veteran was diagnosed with concussion, cerebral, and contusion, sternum.  The AOJ also favorably found in the February 2026 decision on appeal that the evidence showed a qualifying event, injury, or disease had its onset during service, specifically, that the Veteran's STRs in February 1966 documented a hospital stay for a concussion.  The Board is bound by this favorable finding as well.  See 38 U.S.C. 5104A; 38 C.F.R. § 3.104(c).  

Accordingly, the only remaining question for the Board is whether the Veteran's current epilepsy is related to service, to include the 1966 accident.  There are opinions in favor of and against this claim.

Regarding evidence against the claim, in an April 2023 opinion, a VA examiner found that it was less likely than not that the Veteran's epilepsy was caused by his in-service 1966 motor vehicle accident which resulted in a concussion  The examiner's rationale was that there was no pattern of chronicity from 1966 to the present, and no pattern of evaluation and treatment from 1966 to the present.  The examiner noted the Veteran had a concussion during service in 1966, reported an auto accident in 1970, had head trauma in 1972 while boxing, was diagnosed with a seizure disorder in 1973, was diagnosed with temporal lobe seizure activity in September 1976, and in 1979 reported 9 years of headaches beginning in 1970.  The examiner also noted additional symptoms and diagnoses continuing to the present.  In the April 2023 VA seizure disorders (epilepsy) disability benefits questionnaire (DBQ) examination, the examiner noted the Veteran's diagnosis of psychomotor epilepsy and noted the
6 to the present, and no pattern of evaluation and treatment from 1966 to the present.  The examiner noted the Veteran had a concussion during service in 1966, reported an auto accident in 1970, had head trauma in 1972 while boxing, was diagnosed with a seizure disorder in 1973, was diagnosed with temporal lobe seizure activity in September 1976, and in 1979 reported 9 years of headaches beginning in 1970.  The examiner also noted additional symptoms and diagnoses continuing to the present.  In the April 2023 VA seizure disorders (epilepsy) disability benefits questionnaire (DBQ) examination, the examiner noted the Veteran's diagnosis of psychomotor epilepsy and noted the condition impacted his ability to work, specifically that he had decreased ability to drive certain commercial vehicles and had decreased ability to work on heights or around dangerous equipment and machinery.  The Board agrees with its June 2025 determination that the April 2023 VA opinion is inadequate since the examiner did not adequately address the extensive evidence of symptoms from at least 1970 to the present.  Thus, the Board affords low probative weight to the April 2023 VA negative etiological opinion.   

In January 2026, a different VA examiner provided a negative etiological opinion, finding that there was no historical evidence to support diagnosis of epilepsy and that the medical records are silent for complaints, diagnosis and/or treatment of epilepsy while on active duty and post-separation 'til date.  The Board also finds the January 2026 VA opinion inadequate as the examiner similarly failed to address the extensive evidence of symptoms from at least 1970 to the present, failed to address the current functional impairment noted in both of the April 2023 and July 2025 VA seizure disorders (epilepsy) DBQ examination reports related to the Veteran's confirmed diagnosis of psychomotor epilepsy, and failed to adequately address the July 2025 VA positive etiological opinion in support of the claim.  Thus, the Board also affords low probative weight to the January 2026 VA opinion.  

In the July 2025 VA examination, the examiner noted the Veteran's diagnosis of psychomotor epilepsy.  Regarding functional impact, the examiner noted the Veteran's memory issues and that he was prone to blacking out.  After examination, the examiner opined that the Veteran's psychomotor epilepsy is at least as likely as not related to the 1966 concussion during active-duty service.  In support of the rationale, the examiner considered the Veteran's symptomatology and referenced numerous medical literature that showed that a history of concussion or traumatic brain injury can lead to an increased risk of developing epilepsy in the future, with risk magnitude depending on injury severity, recurrence, age, and other clinical factors.  The examiner highlighted that the research shows multiple large cohort and meta-analytic studies that demonstrate that a history of concussion or traumatic brain injury (TBI), even when mild, is associated with a significantly increased risk of developing epilepsy later in life, with risk rising further with repeated or more severe injuries.  The examiner indicated that the relative risk of epilepsy after a single mild TBI concussion is approximately 2-3 times that of the general population, and this risk increases with injury severity, presence of skull fracture, or intracranial hemorrhage, and that recurrent TBIs further amplify the risk, with hazard ratios exceeding 4 for individuals with multiple injuries.  The examiner further noted that the risk of post-traumatic epilepsy is highest in the first few years after injury and remained elevated for decades.  The examiner also noted that recent studies highlighted the risk of epilepsy is higher in those with early post-traumatic seizures, certain injury patterns (e.g., hemorrhagic temporal lobe injury), and in those with additional neurological or psychiatric comorbidities.  

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?

Reading the April 2023, July 2025, and January 2026 VA etiological opinions as a whole and in the context of the evidence of record, and as the reviewing examiners explained the reasons for the conclusion based on the available evidence of record, the opinions are entitled to some probative weight.  Acevedo v. Shinseki, 25 Vet. App. 286, 294 (2012) (medical reports must be read as a whole and in the context of the evidence of record); Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008) (most of the probative value of a medical opinion comes from its reasoning).

Based on the foregoing, the Board finds the evidence to at least be in equipoise as to whether the Veteran's psychomotor epilepsy was incurred during his period of active service, as due to the in-service head injury incurred during a 1966 motor vehicle accident. 
 opinions are entitled to some probative weight.  Acevedo v. Shinseki, 25 Vet. App. 286, 294 (2012) (medical reports must be read as a whole and in the context of the evidence of record); Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008) (most of the probative value of a medical opinion comes from its reasoning).

Based on the foregoing, the Board finds the evidence to at least be in equipoise as to whether the Veteran's psychomotor epilepsy was incurred during his period of active service, as due to the in-service head injury incurred during a 1966 motor vehicle accident.  As the reasonable doubt created by this relative equipoise in the evidence must be resolved in favor of the Veteran, entitlement to service connection for epilepsy is warranted.  38 U.S.C. § 5107(b); 38 C.F.R. § 3.102.

 

 

T. Raymond

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	J.C., 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.