Citation Nr: 0915571 Decision Date: 04/24/09 Archive Date: 04/29/09 DOCKET NO. 04-43 155 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in St. Louis, Missouri THE ISSUES 1. Entitlement to service connection for loss of taste, to include as secondary to a service-connected disability. 2. Entitlement to service connection for loss of smell, to include as secondary to a service-connected disability. REPRESENTATION Appellant represented by: The American Legion ATTORNEY FOR THE BOARD David S. Ames, Associate Counsel INTRODUCTION The veteran served on active duty from September 1966 to August 1968. This matter comes properly before the Board of Veterans' Appeals (Board) on appeal from a rating decision by the Department of Veterans Affairs (VA) Regional Office in St. Louis, Missouri (RO). This case was remanded by the Board in September 2008 for additional development. FINDINGS OF FACT 1. The medical evidence of record shows that the currently diagnosed loss of taste disorder is related to a service-connected disability. 2. The medical evidence of record shows that the currently diagnosed loss of smell disorder is related to a service-connected disability. CONCLUSIONS OF LAW 1. A loss of taste disorder is proximately due to a service-connected disability. 38 U.S.C.A. §§ 1110, 5103A, 5107 (West 2002); 38 C.F.R. §§ 3.303, 3.310 (2008). 2. A loss of smell disorder is proximately due to a service-connected disability. 38 U.S.C.A. §§ 1110, 5103A, 5107 (West 2002); 38 C.F.R. §§ 3.303, 3.310 (2008). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS In November 2000, the Veterans Claims Assistance Act of 2000 (VCAA) was signed into law. See 38 U.S.C.A. §§ 5100, 5102, 5103, 5103A, 5106, 5107, 5126 (West 2002 & Supp. 2007). VA has issued regulations implementing the VCAA. 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326 (2008). Without deciding whether the notice and development requirements of the VCAA have been satisfied in the present case, this law does not preclude the Board from adjudicating the issue involving the veteran's claim for service connection for loss of taste and loss of smell as the Board is taking action favorable to the veteran by granting service connection for these disorders. As such, this decision poses no risk of prejudice to the veteran. See, e.g., Bernard v. Brown, 4 Vet. App. 384 (1993); see also Pelegrini v. Principi, 17 Vet. App. 412 (2004). Generally, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military service. 38 U.S.C.A. § 1110; 38 C.F.R. § 3.303(a). In addition, service connection may be granted for any disease diagnosed after discharge, when all the evidence including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Service connection may be established on a secondary basis for a disability which is shown to be proximately due to or the result of a service connected disease or injury. 38 C.F.R. § 3.310(a). Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists and (2) that the current disability was either (a) caused by a service connected disability or (b) aggravated by a service connected disability. Id.; Allen v. Brown, 7 Vet. App. 439, 488 (1995) (en banc). The determination as to whether these requirements are met is based on an analysis of all the evidence of record and the evaluation of its credibility and probative value. See Baldwin v. West, 13 Vet. App. 1, 8 (1999). The veteran's service treatment records show repeated diagnoses of and treatment for partial facial paralysis and respiratory issues. Service connection was subsequently granted for residuals, left facial nerve palsy and chronic bronchitis with chronic obstructive pulmonary disease and history of vasomotor rhinitis. After separation from military service, in a January 1971 VA ear, nose, and throat examination report, the veteran reported some disturbance of his ability to taste. In a March 1975 VA ear, nose, and throat examination report, the veteran reported that there was a loss of taste in the anterior two-thirds of his tongue on the left side. A May 2003 VA cranial nerves examination report stated that the veteran's claims file had been reviewed. The veteran reported that his smell and taste had progressively diminished over the previous 10 years. On physical examination, the veteran was unable to smell coffee, but was able to taste sugar. The examiner stated that the veteran's "decreased smelling acuity is most likely secondary to his current allergic rhinitis complaints." In a March 2006 VA outpatient medical report, the veteran stated that he had not had a sense of smell since his Bell's Palsy began. In a July 2006 VA neurological disorders examination report, the veteran stated that he could not taste food except for some sweetness. An October 2008 VA smell and taste examination report stated that the veteran's claims file had been reviewed. After a review of the veteran's medical history and a physical examination, the diagnoses were partial loss of smell and partial loss of taste. The examiner stated that the basis for these disabilities could not be determined and that I cannot without mere speculation determine if the partial loss of taste and smell is related to military service or to any of the [Veteran's] service connected disabilities[.] The onset of taste and smell problems is not noted in [the] medical records. Among multiple other causes, Bell's Palsy and rhinitis can lead to problems with taste. Common causes of changes in the sense of smell can be affected by allergies, which the veteran had in service, viral rhinitis accounts for 31% of changes in smell. He also has been a tobacco use[r] and has depression. These can add to the loss of these senses. There [is] not enough evidence to determine the cause. The preponderance of the medical evidence of record shows that the currently diagnosed loss of taste and loss of smell disorders are related to a service-connected disability. The October 2008 VA smell and taste examination report provides specific diagnoses of loss of taste and loss of smell disorders. The etiological evidence regarding these disorders is limited to the May 2003 VA cranial nerves examination report and the October 2008 VA smell and taste examination report. The former specifically stated that the veteran's loss of taste was "most likely" related to his allergic rhinitis. As service connection for a respiratory disorder, including vasomotor rhinitis is currently in effect, the May 2003 opinion relates the veteran's loss of smell disorder to a service-connected disability. In addition, while the October 2008 VA smell and taste examination report stated that the cause of the veteran's loss of taste and loss of smell disorders could not be determined, it also stated that "Bell's Palsy and rhinitis can lead to problems with taste," that allergies such as those the veteran experienced during military service could cause a loss of sense of smell, and that "viral rhinitis accounts for 31% of changes in smell." When combined with the May 2003 etiological opinion, this qualifies as medical evidence relating the veteran's loss of taste and loss of smell disorders to his service-connected facial palsy and rhinitis. Accordingly, applying the doctrine of reasonable doubt, the Board finds that the veteran's loss of taste and loss of smell disorders are related to a service-connected disability and therefore, service connection is warranted for a loss of taste disorder and a loss of smell disorder disorder. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). ORDER Service connection for loss of taste is granted. Service connection for loss of smell is granted. _________________________________________________ JOY A. MCDONALD Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs