RESIDUALS OF TRAUMATIC BRAIN INJURY (TBI)

LESLEY A. REIN · 2026 · Case ID: A26037018

GRANTED

Summary

The Veteran, who served in the U.S. Navy from October 1993 to October 1996, appeals the denial of service connection for a head injury with concussion and asthma. The Board reviewed new and relevant evidence submitted after the prior denials, including VA treatment records, hearing testimony, and a private nexus opinion. For the head injury claim, VA treatment records from May 2018 diagnosed post-concussive syndrome, and a February 2025 private opinion from Dr. R.P. also diagnosed this condition, linking it to the in-service head injury. The Veteran's service treatment records documented a closed head injury in February 1995 and another head injury in April 1996, with ongoing symptoms reported post-service. The Board found the private opinion persuasive, establishing a nexus to service. For the asthma claim, the Veteran testified to exposure to asbestos on board the U.S.S. Halyburton and hazardous materials, including proximity to a burn pit. Service treatment records showed an inhaler prescription for wheezing in September 1996. A February 2025 article confirmed asbestos use on the U.S.S. Halyburton, and Dr. R.P.'s private opinion concluded the asthma was as likely as not connected to service, citing the asbestos exposure and lack of pre-service respiratory issues. The Board found both claims warranted service connection, granting both the head injury with concussion and asthma claims.

Rationale

New and relevant evidence submitted post-denial; VA treatment records show post-concussive syndrome diagnosis; Private nexus opinion establishes link to in-service head injury; Veteran testimony corroborates in-service injury and continuity of symptoms

Service Branch

NAVY

Special Benefit

NO SPECIAL BENEFIT

Docket No.

210127-136521

Full Decision Text

Citation Nr: A26037018
Decision Date: 04/21/26 Archive Date: 04/21/26

DOCKET NO. 210127-136521
DATE: April 21, 2026

ORDER

New and relevant evidence having been received, readjudication of the claim of entitlement to service connection for a head injury with concussion is warranted.

New and relevant evidence having been received, readjudication of the claim of entitlement to service connection for asthma (including as due to in-service asbestos exposure) is warranted.

Entitlement to service connection for a head injury with concussion is granted.

Entitlement to service connection for asthma (including as due to in-service asbestos exposure) is granted.

FINDINGS OF FACT

1. New evidence received since the August 2003 rating decision tends to prove or disprove a matter at issue with respect to the claim of entitlement to service connection for a head injury with concussion.

2. New evidence received since the August 2018 rating decision tends to prove or disprove a matter at issue with respect to the claim of entitlement to service connection for asthma.

2. The evidence of record demonstrates that the Veteran's head injury with concussion began during, and is etiologically related to, his active duty service.

3. The evidence of record demonstrates that the Veteran's asthma began during, and is etiologically related to, his active duty service.

CONCLUSIONS OF LAW

1. The criteria to readjudicate the claim of entitlement to service connection for a head injury with concussion have been met. 38 U.S.C. § 5108; 38 C.F.R. §§ 3.156(d), 3.2501.

2. The criteria to readjudicate the claim of entitlement to service connection for asthma have been met. 38 U.S.C. § 5108; 38 C.F.R. §§ 3.156(d), 3.2501.

3. The criteria for entitlement to service connection for a head injury with concussion have been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303.

4. The criteria for entitlement to service connection for asthma have been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from October 1993 to October 1996.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a January 2021 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO).

In January 2021, the Veteran submitted a timely VA Form 10182: Appeal to the Board of Veterans' Appeals and elected to have a hearing before a Veterans Law Judge (VLJ). The Veteran was afforded a hearing before the undersigned VLJ in November 2024 and a transcript of the hearing is of record. Therefore, the Board may only consider the evidence of record at the time of the agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or his representative at the hearing or within 90 days of the hearing. 38 C.F.R. § 20.302 (a).

If evidence was associated with the claims file during a period of time when additional evidence was not allowed, the Board has not considered it in its decision. 38 C.F.R. § 20.300. If the Veteran would like VA to consider any evidence that was added to the claims file 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.

Duties to Notify and Assist.

With respect to the Veteran's claim, VA has met all statutory and regulatory notice and duty to assist provisions. See 38 U.S.C. §§ 5100, 5102, 5103, 5103A; 38 C.F.R. § 3.159. Neither the Veteran nor his representative have advanced any procedural arguments in relation to VA's duty to notify and assist; therefore, the Board will proceed with appellate review. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015).

NEW AND RELEVANT EVIDENCE

A claimant or his or her authorized representative, if
this decision.

Duties to Notify and Assist.

NEW AND RELEVANT EVIDENCE

A claimant or his or her authorized representative, if any, who disagrees with a prior VA decision may file a supplemental claim by submitting in writing or electronically a complete application on a form prescribed by the Secretary any time after the agency of original jurisdiction issues notice of a decision, regardless of whether the claim is pending or has become finally adjudicated. 38 C.F.R. § 3.2501. If new and relevant evidence is presented or secured with respect to the supplemental claim, the agency of original jurisdiction will readjudicate the claim taking into consideration all of the evidence of record. 38 C.F.R. §§ 3.156(d); 3.2501.

If new and relevant evidence is not presented or secured, the agency of original jurisdiction will issue a decision finding that there was insufficient evidence to readjudicate the claim. In determining whether new and relevant evidence is presented or secured, VA will consider any VA treatment records reasonably identified by the claimant and any evidence received by VA after VA issued notice of a decision on the claim and while the evidentiary record was closed. 38 C.F.R. § 3.2501.

New evidence is evidence not previously part of the actual record before agency adjudicators. Relevant evidence is information that tends to prove or disprove a matter at issue in a claim. Relevant evidence includes evidence that raises a theory of entitlement that was not previously addressed. 38 C.F.R. § 3.2501(a)(1).

The evidentiary record for a supplemental claim includes all evidence received by VA before VA issues notice of a decision on the supplemental claim. For VA to readjudicate the claim, the evidentiary record must include new and relevant evidence that was not of record as of the date of notice of the prior decision. 38 C.F.R. § 3.2501(b).

Under the AMA, a claimant may continuously pursue a claim or issue by filing a supplemental claim following notice of a decision by the AOJ or the Board. 38 C.F.R. § 3.2500(c).

1. New and relevant evidence having been received, readjudication of the claim of entitlement to service connection for a head injury with concussion is warranted.

2. New and relevant evidence having been received, readjudication of the claim of entitlement to service connection for asthma (including as due to in-service asbestos exposure) is warranted.

The Veteran contends that new and relevant evidence has been submitted to warrant reopening and readjudicating his claim for entitlement to service connection for a head injury with concussion, and asthma, to include as due to in-service exposures.

In August 2003, the RO last denied entitlement to service connection for a head injury with concussion because there was no evidence demonstrating that the Veteran had any post-concussion residuals that could be compensated.

In August 2018, the RO last denied entitlement to service connection for asthma because there was no evidence of a link between asthma and military service. The RO found that service treatment records did not contain complaints, treatment, or diagnosis for asthma, and the evidence did not show an event, disease or injury in service.

The question in this case is whether new evidence was submitted or obtained after the August 2003 and August 2018 rating decisions and, if so, whether that evidence is relevant to the Veteran's claims for service connection herein.

Regarding the Veteran's claim for service connection for a head injury with concussion, evidence received since the August 2003 rating decision includes May 2018 VA treatment records demonstrating that the Veteran was diagnosed with post-concussive syndrome and provided with educational literature for recovery; November 2024 hearing testimony regarding his in-service head injury and the continuity of his symptoms since service; and a February 2025 private nexus opinion from Dr. R.P. diagnosing the Veteran with post-concussive syndrome and establishing a nexus between his diagnosis and his in-service head injuries.

Regarding the Veteran's claim for service connection for asthma, evidence received since the August 2018 rating decision includes November 2024 hearing testimony regarding his in-service exposures to hazardous materials and the continuity of his asthma symptoms since service; an article uploaded in February 2025 listing the
3 rating decision includes May 2018 VA treatment records demonstrating that the Veteran was diagnosed with post-concussive syndrome and provided with educational literature for recovery; November 2024 hearing testimony regarding his in-service head injury and the continuity of his symptoms since service; and a February 2025 private nexus opinion from Dr. R.P. diagnosing the Veteran with post-concussive syndrome and establishing a nexus between his diagnosis and his in-service head injuries.

The above listed records are both new and relevant to the Veteran's claim. These records are new as they were not a part of the Veteran's claims file at the time of the August 2003 and August 2018 denials. These records are highly relevant, as the VA medical records establish the existence of a current diagnosis of post-concussive syndrome; the Veteran's testimony provides corroborating evidence of in-service injuries and exposures, as well as a continuity of symptoms since service; the February 2025 article establishes in-service exposures to asbestos on board the U.S.S. Halyburton; and the private nexus opinion prepared by Dr. R.P. provides evidence of a nexus between the Veteran's current head and asthma disabilities and service.

This evidence above tends to prove or disprove critical matters at issue which are necessary to establish claims for service connection under 38 C.F.R. § 3.303 (d). Therefore, readjudication of the claims of entitlement to service connection for a head injury with concussion and asthma are warranted. 38 C.F.R. § 3.156 (d).

SERVICE CONNECTION

Service connection may be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred or aggravated during active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303 (a). In general, service connection requires: (1) evidence of a current disability; (2) medical, or in certain circumstances, lay evidence of an in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the current disability. See Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004).

Service connection may be granted for any disease diagnosed after discharge when all evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d).

With respect to the Veteran's assertion that he was exposed to asbestos in service, there are no statutes specifically dealing with asbestos and service connection for asbestos related diseases, and the Secretary of VA has not promulgated any specific regulations. An opinion by VA's Office of General Counsel discussed the development of asbestos claims. See VAOPGCPREC 4-2000.

VA has acknowledged that a relationship exists between asbestos exposure and the development of certain diseases, which may occur 10 to 45 years after exposure. When considering VA compensation claims, rating boards have the responsibility of ascertaining whether or not military records demonstrate evidence of asbestos exposure in service and of ensuring that development is accomplished to ascertain whether or not there was pre-service and/or post-service evidence of occupational or other asbestos exposure. A determination must then be made as to the relationship between asbestos exposure and the claimed diseases, keeping in mind the latency and exposure information noted above.

Asbestos particles have a tendency to break easily into tiny dust particles that can float in the air, stick to clothes, and may be inhaled or swallowed. Inhalation of asbestos fibers can produce fibrosis and tumors. The most common disease is interstitial pulmonary fibrosis (asbestosis).

Occupations involving asbestos exposure include mining and milling, shipyard and insulation work, demolition of old buildings, construction, manufacture and servicing of friction products such as clutch products and brake linings, manufacture and insulation of roofing and flooring materials, sheet and pipe products, and so forth. High exposure to asbestos and the high prevalence of disease have been noted in insulation and shipyard workers. The clinical diagnosis of asbestosis requires a history of asbestos exposure and radiographic evidence of parenchymal lung disease.

When the evidence is evenly balanced or approximately so with regard to whether service connection is warranted, VA shall resolve reasonable doubt in favor of the claim
produce fibrosis and tumors. The most common disease is interstitial pulmonary fibrosis (asbestosis).

When the evidence is evenly balanced or approximately so with regard to whether service connection is warranted, VA shall resolve reasonable doubt in favor of the claimant. 38 U.S.C. § 5107; 38 C.F.R. §§ 3.102; Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (en banc). To deny a claim on its merits, the evidence must persuasively weigh against the claim. Id.) (only when the evidence persuasively favors one side or another is the benefit of the doubt doctrine not for application).

1. Entitlement to service connection for a head injury with concussion is granted.

The Veteran asserts that service connection is warranted for residuals of an in-service head injury with concussion.

Specifically, the Veteran testified that during active duty service, he was serving as a "mess specialist" and he sustained a head and back injury when he slipped in the galley. The Veteran testified that since this incident, he has experienced dizziness and pain shooting down from head to his neck and spine. The Veteran stated that he did not seek consistent care in service for these symptoms because it was very difficult to obtain medical care while at sea. See November 2024 Hearing Transcript.

As an initial matter, the Veteran was diagnosed with post-concussive syndrome by a VA provider in May 2018. See May 21, 2018 VA Treatment Record. Additionally, in February 2025, the Veteran submitted a private opinion from Dr. R.P., who also diagnosed the Veteran with post-concussive syndrome. See February 2025 Dr. R.P. Treatment Record.

As such, the first element of service connection is met.

The question before the Board is therefore whether the Veteran's head injury with concussion (post-concussive syndrome) is etiologically related to his active-duty service.

Turning to the Veteran's Service Treatment Records (STRs), in February 1995, the Veteran was weightlifting and while pulling down the overhead bar, he hit himself in the head with the bar. The Veteran passed out, and while this was not directly witnessed, the Watch found him and called in an unconscious patient. The Veteran regained consciousness after 5 to 10 minutes. The Veteran did not report any memory loss, or vision changes, but was noted to have a 1.5 inch by 1.5 inch scalp hematoma. See February 12, 1995 Service Treatment Record. The Veteran was subsequently diagnosed with a concussion placed on light duty for 72 hours. See February 13, 1995 Service Treatment Record.

In April 1996, the Veteran again reported to sick call stating that he slipped on the deck in moderately heavy seas and struck the right side of his head. The examining physician noted that the Veteran had a closed head injury in January 1996 which "resolved without incident" The Veteran did not lose consciousness, lose bladder or bowel control, or report any focal or radicular symptoms. See April 30, 1996 Service Treatment Record.

In November 2016, the Veteran reported to his VA provider that he had been experiencing memory loss and recurrent headaches for the past 20 years. The Veteran attributed these symptoms to the incident during service in which he slipped and fell on in the galley and hit his head and back. The Veteran stated that he blacked out for a minute and came back to consciousness, but he was given two weeks of light duty before he was released to go back to work. See November 23, 2016 VA Treatment Record.

As demonstrated above, the Veteran's STRs reflect multiple in-service head injuries requiring prolonged treatment. Additionally, following service, the Veteran consistently reported that he sustained head trauma in service, and has experienced head and neck pain and dizziness since these injuries occurred. The Board notes that the Veteran is competent to report observable symptomatology of his condition, such as pain and dizziness, and when these symptoms began. Layno v. Brown, 6 Vet. App. 465
and hit his head and back. The Veteran stated that he blacked out for a minute and came back to consciousness, but he was given two weeks of light duty before he was released to go back to work. See November 23, 2016 VA Treatment Record.

Therefore, the second element of service connection is met.

With the first and second elements of service connection met, the remaining question becomes whether the Veteran's residuals of a head injury with concussion are related to his active duty service.

The Veteran has not been afforded a VA opinion for a traumatic brain injury (TBI) or TBI residuals. However, in February 2025, the Veteran submitted a private opinion prepared by Dr. R.P. Here, Dr. R.P. noted that he reviewed the Veteran's in-service and post-service treatment records, as well as Cleveland Clinic literature concerning post-concussive syndrome. Based on this review, Dr. R.P. opined that the Veteran's head injury with concussion is at least as likely as not connected to his service. Dr. R.P. reasoned that the Veteran's in-service medical records clearly document that the Veteran sustained a closed head injury when he slipped and fell on his back, hitting his head on the kitchen floor on board the U.S.S. Halyburton. Despite lingering symptoms such as headaches from the incident, the Veteran did not receive subsequent treatment during service because he was discharged from service shortly thereafter in October 1996. As such, Dr. R.P. concluded that it is this head injury which caused his concussion, leading to his current post-concussive syndrome. See February 2025 Dr. R.P. Private Opinion.

Based on the above, the Board finds that the evidence weighs in favor of the Veteran's claim for service connection for residuals of a head injury with concussion. The Board finds that the private nexus opinion prepared by Dr. R.P. is highly probative. This nexus opinion is supported by a review of the Veteran's STRs, post-service medical records, statements, and medical literature, recognizes the Veteran's current symptomatology, and provides an opinion establishing a nexus between the current symptomatology and service. Therefore, the Board concludes that the February 2025 opinion by Dr. R.P. is persuasive and affords it probative weight. See Stefl v. Nicholson, 21 Vet. App. 120; Nieves-Rodriquez v. Peake, 22 Vet. App. 295; Dalton v. Nicholson, 21 Vet. App. 23, 40. There is no evidence to the contrary and the Court of Appeals for Veterans Claims (Court) has cautioned VA against seeking a medical opinion where favorable evidence in the record is unrefuted. See Mariano v. Principi, 17 Vet. App. 305, 312 (2003).

Accordingly, the Board finds that service connection for residuals of a head injury with concussion is warranted. Therefore, the Veteran's appeal is granted. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102; Lynch, 999 F.3d at 1391.

2. Entitlement to service connection for asthma (including as due to in-service asbestos exposure) is granted.

The Veteran asserts that service connection is warranted for asthma.

Specifically, during his November 2024 hearing, the Veteran testified that during active duty service, he first worked on board the U.S.S. Hoist which was a rescue and salvage ship initially built in WWII. The Veteran testified that he then served on board the U.S.S. Halyburton. The Veteran testified that he believed the older ships were built using asbestos, and he was therefore exposed in the course of his duties. The Veteran also testified that he had to wear gas masks with respirators while sailing in the Persian Gulf. The Veteran stated that around the end of 1994, his ship sailed within five miles of a burn pit. The Veteran further testified that following service, he started experiencing shortness of breath around 1997, but was not officially diagnosed with asthma until 2000. See November 2024 Hearing Transcript.

Based on a careful review of all the subjective and clinical evidence below, and resolving all reasonable doubt in favor of the Veteran, the Board finds that direct service connection for asthma as due to in-service hazardous
Veteran testified that he believed the older ships were built using asbestos, and he was therefore exposed in the course of his duties. The Veteran also testified that he had to wear gas masks with respirators while sailing in the Persian Gulf. The Veteran stated that around the end of 1994, his ship sailed within five miles of a burn pit. The Veteran further testified that following service, he started experiencing shortness of breath around 1997, but was not officially diagnosed with asthma until 2000. See November 2024 Hearing Transcript.

As an initial matter, the Veteran was first diagnosed with asthma in November 1999. See November 30, 1999 VA Treatment Record.

As such, the first element of service connection is met.

The question before the Board is therefore whether the Veteran's asthma is etiologically related to his active-duty service.

Turning to the Veteran's STRs, in September 1996, shortly before his discharge, the Veteran was prescribed a Proventil inhaler and was instructed to administer two puffs every 4-6 hours daily for wheezing. See September 6, 1996 Service Treatment Record.

The Veteran's service records reflect that he served on board the U.S.S. Hoist from January 1993 to December 1993, and on board the U.S.S. Halyburton from October 1994 to October 1996. See Abstract of Service and Medical History.

In June 2017, the Veteran submitted a VA Form 21-4138: Statement in Support of Claim, in which he asserted that the U.S.S. Hoist was decommissioned due to old age and asbestos, rust, and mold. The Veteran stated that he believed this exposure led to his asthma diagnosis.

In February 2025, the veteran submitted an article titled "Asbestos on Frigates - Find Out Where Asbestos Was Used," which listed the U.S.S. Halyburton as a ship on which servicemembers were exposed to asbestos. See February 2025 Correspondence.

As demonstrated above, the Veteran's STRs reflect the in-service prescription of an inhaler due to breathing issues. Additionally, the Veteran's service records reflect service on board the U.S.S. Halyburton, which is recognized as a ship on which Veterans were exposed to asbestos. Following service, the Veteran consistently reported difficulty breathing and was diagnosed with asthma only three years following his discharge with no childhood or family history of asthma. The Board notes that the Veteran is competent to report observable symptomatology of his condition, such as difficulty breathing, and when these symptoms began. Layno, 6 Vet. App. 465, 470 (1994).

Therefore, the second element of service connection is met.

With the first and second elements of service connection met, the remaining question becomes whether the Veteran's asthma is related to his active duty service.

The Veteran has not been afforded a VA opinion for asthma. However, in February 2025, the Veteran submitted a private opinion prepared by Dr. R.P. Here, Dr. R.P. noted that he reviewed the Veteran's in-service and post-service treatment records, as well as the article submitted by the Veteran demonstrating that servicemembers were exposed to asbestos on board the U.S.S. Halyburton. Based on this review, Dr. R.P. concluded that The Veteran's asthma is as likely as not connected to service. Dr. R.P. reasoned that the Veteran served in the United States Navy on board the U.S.S. Halyburton and the U.S.S. Hoist and was exposed to asbestos. Dr. R.P. further reasoned that the Veteran had no respiratory issues prior to service but was diagnosed with asthma only a few years following his discharge and his period of exposure. Therefore, Dr. R.P. concluded that it is as likely as not that the Veteran's service on board these older Naval vessels contributed to or caused his current respiratory condition (asthma). See February 2025 Dr. R.P Private Opinion.

Based on the above, the Board finds that the evidence weighs in favor of the Veteran's claim for service connection for asthma. The Board finds that the private nexus opinion prepared by Dr. R.P. is highly probative. This nexus opinion is supported by a review of the Veteran's STRs, post-service medical records, statements and testimony, and research articles, Dr. R.P. recognizes the Veteran's current symptomatology, and Dr. R.P. provides an opinion establishing a nexus between the current symptomatology and service. Therefore, the Board concludes that the February 2025 opinion by Dr. R
older Naval vessels contributed to or caused his current respiratory condition (asthma). See February 2025 Dr. R.P Private Opinion.

Based on the above, the Board finds that the evidence weighs in favor of the Veteran's claim for service connection for asthma. The Board finds that the private nexus opinion prepared by Dr. R.P. is highly probative. This nexus opinion is supported by a review of the Veteran's STRs, post-service medical records, statements and testimony, and research articles, Dr. R.P. recognizes the Veteran's current symptomatology, and Dr. R.P. provides an opinion establishing a nexus between the current symptomatology and service. Therefore, the Board concludes that the February 2025 opinion by Dr. R.P. is persuasive and affords it probative weight. See Stefl, 21 Vet. App. 120; Nieves-Rodriquez, 22 Vet. App. 295; Dalton, 21 Vet. App. 23, 40. There is no evidence to the contrary and the Board reiterates that the Court has cautioned VA against seeking a medical opinion where favorable evidence in the record is unrefuted. See Mariano v, 17 Vet. App. 305, 312 (2003).

Accordingly, the Board finds that service connection for asthma is warranted. Therefore, the Veteran's appeal is granted. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102; Lynch, 999 F.3d at 1391.

LESLEY A. REIN

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board Breslin, Jenna D.

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.

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