Citation Nr: 1101495 Decision Date: 01/12/11 Archive Date: 01/20/11 DOCKET NO. 06-30 248 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Cleveland, Ohio THE ISSUES 1. Entitlement to service connection for the residuals of dental trauma. 2. Entitlement to service connection for a respiratory disorder. ATTORNEY FOR THE BOARD R. Erdheim, Associate Counsel INTRODUCTION The Veteran served on active duty from January 1981 to December 1985. This appeal to the Board of Veterans' Appeals (Board/BVA) is from a March 2006 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In July 2008, the Board remanded the claims to the RO via the Appeals Management Center (AMC) for further development and consideration, including to try and obtain additional treatment records and to have the Veteran examined for a medical nexus opinion. FINDINGS OF FACT 1. The Veteran's respiratory disorder, including his asthma and bronchitis, first manifested more than one year after his military service and has not been linked by probative (meaning competent and credible) evidence to his service. 2. The Veteran's dental disability, including loss of teeth #s 1, 3, 13, 14, 15, 19, 30, and 31, is not the result of combat wounds or service trauma, nor has service-connected tooth #12 caused or exacerbated his dental disability. 3. Periodontal disease and replaceable missing teeth secondary to periodontal disease, erosion, calcification, and bone loss, are not subject to service-connected compensation - only treatment, and only if the Veteran also meets the requirements of one of the classes of eligibility. CONCLUSIONS OF LAW 1. The Veteran's respiratory disorder was not incurred in or aggravated by his active military service. 38 U.S.C.A. §§ 1131, 1153, 5107 (West 2002); 38 C.F.R. §§ 3.303, 3.304, 3.306 (2010). 2. A dental disability involving teeth other than #12 also was not incurred in or aggravated by his active military service and is not proximately due to, the result of, or aggravated by this service-connected tooth #12. 38 U.S.C.A. §§ 1131, 1712, 5107 (West 2002 & Supp. 2010); 38 C.F.R. §§ 3.303, 3.310, 3.381, 17.161 (2010). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Duties to Notify and Assist the Appellant Upon receipt of a complete or substantially complete application, VA must notify the claimant and any representative of any information, medical evidence, or lay evidence not previously provided to VA that is necessary to substantiate the claim. This notice requires VA to indicate which portion of that information and evidence is to be provided by the claimant and which portion VA will attempt to obtain on the claimant's behalf. See 38 U.S.C.A. §§ 5103, 5103A, 5107 (West 2002 & Supp. 2010); 38 C.F.R. § 3.159 (2010). See also Quartuccio v. Principi, 16 Vet. App. 183 (2002); Charles v. Principi, 16 Vet. App. 370 (2002). These VCAA notice requirements apply to all five elements of a claim: (1) Veteran status; (2) existence of a disability; (3) a connection between service and the disability; (4) degree of disability; and (5) effective date of the disability. If, as here, the claim is for service connection, this notice should include information concerning the downstream disability rating and effective date elements of the claim. Dingess/Hartman v. Nicholson, 19 Vet. App. 473 (2006), aff'd sub nom. Hartman v. Nicholson, 483 F.3d 1311 (2007). Ideally, this VCAA notice also should be provided prior to initially adjudicating the claim. Pelegrini v. Principi, 18 Vet. App. 112 (2004). If for whatever reason it was not, however, or the notice provided was inadequate or incomplete, this timing error can be effectively cured by providing any necessary notice and then readjudicating the claim, such as in a statement of the case (SOC) or supplemental SOC (SSOC), such that the intended purpose of the notice is not frustrated and the Veteran is given an opportunity to participate effectively in the adjudication of the claim. Mayfield v. Nicholson, 499 F.3d 1317 (Fed. Cir. 2007); Prickett v. Nicholson, 20 Vet. App. 370 (2006). A reviewing court, in considering the rule of prejudicial error, is precluded from applying a mandatory presumption of prejudice rather than assessing whether, based on the facts of each case, the error was outcome determinative. All VA notice errors are not presumptively prejudicial. That would impose an unreasonable evidentiary burden on VA to rebut the presumption and require VA to demonstrate why any error is harmless, rather than requiring the appellant, as the pleading party, to show the error was harmful. Shinseki v. Sanders, 129 S. Ct. 1696 (2009). Here, the RO sent correspondence in April 2005, November 2005, February 2006, March 2006, September 2006, August 2007, November 2007, August 2008, and September 2009 discussing the type of evidence and information needed to substantiate the claims and apprising the Veteran of his and VA's respective responsibilities in obtaining this supporting evidence. And although all of those letters were not sent prior to initially adjudicating the claims, so were not issued in the preferred sequence, the AMC's remand and rating development team at the RO in Huntington, West Virginia, has readjudicated the claims in the September 2010 SSOC, so since the provision of even the additional VCAA notices that did not precede the initial adjudication of the claims. So the claims have been reconsidered since providing all necessary VCAA notice. The timing error in the provision of the post- adjudicatory notice therefore has been rectified ("cured"). See again Mayfield and Prickett, supra. In addition, all relevant, identified, and available evidence has been obtained, and VA has notified the appellant of any evidence that could not be obtained. 38 C.F.R. § 3.159(c), (e). This included trying to obtain the additional records cited in the Board's July 2008 remand and apprising the Veteran of any of these records that were not obtained. In his most recent statement in support of claim (VA Form 21-4138) and response to the September 2010 SSOC, the Veteran indicated he had more information or evidence to submit in support of his appeal. He therefore asked VA to wait the full 30-day period to give him a chance to submit this information or evidence. He also indicated that he understood that, if this evidence was not submitted within the 30-day period, his case would be returned to the Board. He did not submit any additional evidence within the required 30 days, so the Board is proceeding with the adjudication of his claims since there was substantial compliance with the Board's July 2008 remand directives - both in terms of obtaining (or trying to obtain) the additional treatment records mentioned and having him examined for a medical nexus opinion concerning his dental claim. See Dyment v. West, 13 Vet. App. 141, 146-47 (1999); Stegall v. West, 11 Vet. App. 268, 271 (1998). See also Chest v. Peake, 283 Fed. App. 814 (Fed. Cir. 2008). The Board has not requested or obtained a medical examination for an additional nexus opinion concerning his claim for service connection for a respiratory disorder because there is no competent and credible evidence associating this disorder with his military service. See McLendon v. Nicholson, 20 Vet. App. 79 (2006); 38 U.S.C.A. § 5103A(d); 38 C.F.R. § 3.159(c)(4). When determining whether a VA examination is required under 38 U.S.C.A. § 5103A(d)(2), the law requires competent evidence of a disability or symptoms of a disability, but does not require competent evidence of a nexus, only that the evidence indicates an association between the disability and service or another service-connected disability. See Waters v. Shinseki, 601 F.3d 1274 (Fed. Cir. 2010). However, where the Board makes a finding that lay evidence regarding an in-service event or injury is not credible, a VA examination is not required. See Bardwell v. Shinseki, 24 Vet. App. 36 (2010). Thus, the duty to assist the Veteran in developing his claims also has been satisfied. Service Connection Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active military service. 38 U.S.C.A. § 1131; 38 C.F.R. § 3.303(a). Stated somewhat differently, to establish entitlement to direct service connection for the claimed disability, there must be: (1) medical evidence of current disability; (2) medical, or in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus or link between the claimed in-service disease or injury and the current disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004), citing Hansen v. Principi, 16 Vet. App. 110, 111 (2002). Certain diseases are chronic, per se, meaning permanent, and therefore will be presumed to have been incurred in service if manifested to a compensable degree (generally of at least 10- percent disabling) within one year after service. This presumption, however, is rebuttable by probative evidence to the contrary and does not include any of the conditions specifically at issue in this appeal, including the bronchitis and/or asthma the Veteran says comprise his respiratory disorder. 38 U.S.C.A. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309(a). So service connection may be established either by showing direct service incurrence or aggravation or by using applicable presumptions, if applicable. Combee v. Brown, 34 F.3d 1039, 1043 (Fed. Cir. 1994). Other diseases initially diagnosed after service also may be service connected if the evidence, including that pertinent to service, shows the diseases were incurred in service. 38 C.F.R. § 3.303(d). But if chronicity of disease or injury in service is not shown, or legitimately questionable, then a showing of continuity of symptomatology following service is required to support the claim. 38 C.F.R. § 3.303(b). Establishing continuity of symptomatology under 38 C.F.R. § 3.303(b) is an alternative method of satisfying the second and third Shedden requirements. See also Clyburn v. West, 12 Vet. App. 296, 302 (1999). For the showing of chronic disease in service, there is a required combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time, as distinguished from merely isolated findings or a diagnosis including the word "chronic." Id. Evidence relating a current disorder to service must be medical unless it concerns a disorder that may be competently demonstrated by lay observation. Savage v. Gober, 10 Vet. App. 488, 494-97 (1997). When a condition may be diagnosed by its unique and readily identifiable features, the presence of the disorder is not a determination "medical in nature" and is capable of lay observation. In such cases, the Board is within its province to weigh that testimony and to make a credibility determination as to whether that evidence supports a finding of service incurrence and continuity of symptomatology sufficient to establish service connection. See Barr v. Nicholson, 21 Vet. App. 303 (2007). Lay evidence can be competent and sufficient to establish a diagnosis of a condition when: (1) a layperson is competent to identify the medical condition, (2) the layperson is reporting a contemporaneous medical diagnosis, or (3) lay testimony describing symptoms at the time supports a later diagnosis by a medical professional. Davidson v. Shinseki, 581 F.3d. 1313 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Service connection also may be granted on a secondary basis for disability that is proximately due to or the result of a service- connected disease or injury. 38 C.F.R. § 3.310(a). This includes situations where a service-connected disability has aggravated a non-service-connected condition, but in this latter instance the Veteran is only compensated for the degree of disability over and above that existing prior to the aggravation. 38 C.F.R. § 3.303(b); Allen v. Brown, 7 Vet. App. 439 (1995). To establish entitlement to service connection on this secondary basis, there must be: (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) medical evidence establishing a nexus (i.e., link) between the service- connected disability and the current disability - either in the way of causation or aggravation. See Wallin v. West, 11 Vet. App. 509, 512 (1998); McQueen v. West, 13 Vet. App. 237 (1999); Velez v. West, 11 Vet. App. 148, 158 (1998). Respiratory Conditions As explained, the first and indeed perhaps most fundamental requirement for any service-connection claim is that the Veteran must first establish he has current disability on account of the alleged condition. Boyer v. West, 210 F.3d 1351 (Fed. Cir. 2000); Brammer v. Derwinski, 3 Vet. App. 223 (1992). There then needs to be competent and credible evidence linking this current disability to his military service, including, if applicable by way of a service-connected disability. See Watson v. Brown, 4 Vet. App. 309, 314 (1993) ("A determination of service connection requires a finding of the existence of a current disability and a determination of a relationship between that disability and an injury or a disease incurred in service."). See, too, Maggitt v. West, 202 F.3d 1370, 1375 (Fed. Cir. 2000); D'Amico v. West, 209 F.3d 1322, 1326 (Fed. Cir. 2000); Hibbard v. West, 13 Vet. App. 546, 548 (2000); and Collaro v. West, 136 F.3d 1304, 1308 (Fed. Cir. 1998). The Veteran contends that, while in service, he was hospitalized twice for a breathing disorder, once while stationed in San Antonio, Texas, in 1981, and again while stationed in Wiesbaden, Germany, in 1984. He says that, while hospitalized, he was administered treatment with a breathing machine and that ever since he has experienced asthmatic symptoms and bronchitis requiring an inhaler. The Veteran's service treatment records (STRs) show two instances in which he was either hospitalized or received treatment for viral illnesses. In February 1981, he was treated for an upper respiratory infection that included a sore throat, nasal congestion, and cough. There was post-nasal drainage, but with no exudates or adenopathy. His lungs also were clear. The diagnosis was upper respiratory infection. He was prescribed throat lozenges and cough medicine. On follow-up examination in March 1981, he was still experiencing congestion. He was prescribed a different cold medicine. Nearly three years later, in January 1984, he was hospitalized when he began experiencing cramps, chills, and sweats. He also had been vomiting. His lungs were still clear. The diagnosis was viral syndrome. He developed a sore throat and antibiotics were prescribed. He was hospitalized for four days until, on discharge, he reported that he was feeling better. When subsequently examined in November 1985 for separation from service, he denied having asthma, sinusitis, or ear, nose, or throat trouble, and no respiratory condition was diagnosed or otherwise noted. His military service ended in December 1985. As chronicity (permanency) in service has not been established, or is at least legitimately questionable, a showing of continuity of symptoms after discharge is required to support the claim for service connection for a respiratory disorder. 38 C.F.R. § 3.303(b). In Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006), the Federal Circuit Court recognized lay evidence as potentially competent to support presence of disability, including during service and since, even where not corroborated by contemporaneous medical evidence such as treatment records. But the Federal Circuit Court also indicated in Buchanan that the Board retains the discretion to make credibility determinations and otherwise weigh the evidence submitted, including lay evidence. One of the reasons for remanding this claim in July 2008 was to try and obtain records (documentary evidence) concerning treatment the Veteran purportedly had received since service for respiratory problems, including from D.G.P., M.D. And although it was requested on remand that the Veteran complete and submit the authorization form (VA Form 21-4142) needed to request and obtain this private physician's records, the Veteran did not respond to this request. The duty to assist him in developing his claim is not a "one-way street." If he wishes help, he cannot passively wait for it in circumstances where he may or should have information that is essential in obtaining putative evidence. Wood v. Derwinski, 1 Vet. App. 190, 193 (1991). As an unfortunate consequence, the only post-service record concerning a respiratory disorder is a September 2006 statement from Dr. D.G.P., a family practitioner, indicating the Veteran has suffered from respiratory conditions in the past that have required him to use inhalers to help control some of his asthmatic complaints. But this historical reference does not date these complaints back to his military service or attribute his complaints to those he had in service. So there is not the required confirmation of continuous symptoms since service or of a relationship or correlation between the complaints and symptoms he has had since service and those he had in service. Moreover, since there was no discussion or clarification of just how long "in the past" he had suffered from respiratory conditions, the Board is only left to wonder just how much time potentially elapsed between the conclusion of his military service in December 1985 and the eventual recurrence of any respiratory disorder or related complaints. See Maxon v. West, 12 Vet. App. 453, 459 (1999), affirmed sub nom. Maxon v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000) (ruling that a prolonged period without medical complaint can be considered, along with other factors, as evidence of whether an injury or a disease was incurred in service resulting in any chronic or persistent disability). Asthma and bronchitis are not the type of conditions that are readily amenable to lay diagnosis or comment on their etiology. See Woehlaert v. Nicholson, 21 Vet. App. 456, 462 (2007) (unlike varicose veins or a dislocated shoulder, rheumatic fever is not a condition capable of lay diagnosis). And while the Veteran is competent, even as a layman, to proclaim having experienced respiratory-related complaints since service, he is not also competent to ascribe these complaints to a specific condition or diagnosis like asthma or bronchitis. Washington v. Nicholson, 19 Vet. App. 363 (2005). Furthermore, his lay testimony, even if competent, also must be credible to ultimately have probative value. See Rucker v. Brown, 10 Vet. App. 67 (1997) and Layno v. Brown, 6 Vet. App. 465, 469 (1994) (distinguishing between competency ("a legal concept determining whether testimony may be heard and considered") and credibility ("a factual determination going to the probative value of the evidence to be made after the evidence has been admitted")). And, here, given the lapse of so many years following service with no documented complaints of a respiratory disorder, much less objective clinical findings such as a pertinent diagnosis, the Veteran's lay testimony of having purportedly had respiratory related complaints and symptoms continuously since service is not credible - again, also considering that Dr. D.G.P. did not define the parameters of just what he meant by his reference to the Veteran having experienced respiratory conditions "in the past". This statement was not tantamount to saying the Veteran necessarily had experienced these conditions since service. For these reasons and bases, the preponderance of the evidence is against the claim, so there is no reasonable doubt to resolve in the Veteran's favor, and his claim accordingly must be denied. 38 U.S.C.A. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Dental Disability Dental conditions will be service connected under the following circumstances: (a) Treatable carious teeth, replaceable missing teeth, dental or alveolar abscesses, and periodontal disease will be considered service-connected solely for the purpose of establishing eligibility for outpatient dental treatment as provided in 38 C.F.R. § 17.161. (b) Each defective or missing tooth and each disease of the teeth and periodontal tissues will be considered separately to determine whether the condition was incurred or aggravated in line of duty during active service. When applicable, it will be determined whether the condition is due to combat or other in-service trauma, or whether the Veteran was interned as a prisoner of war. (c) In determining service connection, the condition of teeth and periodontal tissues at the time of entry into active duty will be considered. Treatment during service, including filling or extraction of a tooth, or placement of a prosthesis, will not be considered evidence of aggravation of a condition that was noted at entry, unless additional pathology developed after 180 days or more of active service. (d) The following principles apply to dental conditions noted at entry and treated during service: (1) Teeth noted as normal at entry will be service-connected if they were filled or extracted after 180 days or more of active service. (2) Teeth noted as filled at entry will be service-connected if they were extracted, or if the existing filling was replaced, after 180 days or more of active service. (3) Teeth noted as carious but restorable at entry will not be service-connected on the basis that they were filled during service. However, new caries that developed 180 days or more after such a tooth was filled will be service-connected. (4) Teeth noted as carious but restorable at entry, whether or not filled, will be service connected if extraction was required after 180 days or more of active service. (5) Teeth noted at entry as non-restorable will not be service connected, regardless of treatment during service. (6) Teeth noted as missing at entry will not be service connected, regardless of treatment during service. (e) The following will not be considered service-connected for treatment purposes: (1) Calculus; (2) Acute periodontal disease; (3) Third molars, unless disease or pathology of the tooth developed after 180 days or more of active service, or was due to combat or in- service trauma; and (4) Impacted or malposed teeth, and other developmental defects, unless disease or pathology of these teeth developed after 180 days or more of active service. (f) Teeth extracted because of chronic periodontal disease will be service connected only if they were extracted after 180 days or more of active service. 38 C.F.R. § 3.381. Outpatient dental treatment may be authorized by the Chief of Dental Service for beneficiaries defined in 38 U.S.C. 1712(b) and 38 CFR 17.93 to the extent prescribed and in accordance with the applicable classification and provisions set forth in this section. (a) Class I: Those having a service-connected compensable dental disability or condition may be authorized any dental treatment indicated as reasonably necessary to maintain oral health and masticatory function. There is no time limitation for making application for treatment and no restriction as to the number of repeat episodes of treatment. (b) Class II: (1)(i) Those having a service-connected noncompensable dental condition or disability shown to have been in existence at time of discharge or release from active service, which took place after September 30, 1981, may be authorized any treatment indicated as reasonably necessary for the one-time correction of the service-connected noncompensable condition, but only if: (A)\ They served on active duty during the Persian Gulf War and were discharged or released, under conditions other than dishonorable, from a period of active military, naval, or air service of not less than 90 days, or they were discharged or released under conditions other than dishonorable, from any other period of active military, naval, or air service of not less than 180 days; (B) Application for treatment is made within 90 days after such discharge or release; (C) The certificate of discharge or release does not bear a certification that the veteran was provided, within the 90-day period immediately before such discharge or release, a complete dental examination (including dental X-rays) and all appropriate dental treatment indicated by the examination to be needed, and (D) Department of Veterans Affairs dental examination is completed within six months after discharge or release, unless delayed through no fault of the veteran. (ii) Those veterans discharged from their final period of service after August 12, 1981, who had reentered active military service within 90 days after the date of a discharge or release from a prior period of active military service, may apply for treatment of service-connected noncompensable dental conditions relating to any such periods of service within 90 days from the date of their final discharge or release. (iii) If a disqualifying discharge or release has been corrected by competent authority, application may be made within 90 days after the date of correction. (2)(i) Those having a service-connected noncompensable dental condition or disability shown to have been in existence at time of discharge or release from active service, which took place before October 1, 1981, may be authorized any treatment indicated as reasonably necessary for the one-time correction of the service-connected noncompensable condition, but only if: (A) They were discharged or released, under conditions other than dishonorable, from a period of active military, naval or air service of not less than 180 days. (B) Application for treatment is made within one year after such discharge or release. (C) Department of Veterans Affairs dental examination is completed within 14 months after discharge or release, unless delayed through no fault of the veteran. (ii) Those veterans discharged from their final period of service before August 13, 1981, who had reentered active military service within one year from the date of a prior discharge or release, may apply for treatment of service-connected noncompensable dental conditions relating to any such prior periods of service within one year of their final discharge or release. (iii) If a disqualifying discharge or release has been corrected by competent authority, application may be made within one year after the date of correction. (c) Class II (a): Those having a service-connected noncompensable dental condition or disability adjudicated as resulting from combat wounds or service trauma may be authorized any treatment indicated as reasonably necessary for the correction of such service-connected noncompensable condition or disability. (d) Class II(b): Those having a service-connected noncompensable dental condition or disability and who had been detained or interned as prisoners of war for a period of less than 90 days may be authorized any treatment as reasonably necessary for the correction of such service- connected dental condition or disability. (e) Class II(c): Those who were prisoners of war for 90 days or more, as determined by the concerned military service department, may be authorized any needed dental treatment. (f) Class IIR (Retroactive): Any veteran who had made prior application for and received dental treatment from the Department of Veterans Affairs for noncompensable dental conditions, but was denied replacement of missing teeth which were lost during any period of service prior to his/her last period of service may be authorized such previously denied benefits under the following conditions: (1) Application for such retroactive benefits is made within one year of April 5, 1983. (2) Existing Department of Veterans Affairs records reflect the prior denial of the claim. All Class IIR (Retroactive) treatment authorized will be completed on a fee basis status. (g) Class III: Those having a dental condition professionally determined to be aggravating disability from an associated service-connected condition or disability may be authorized dental treatment for only those dental conditions which, in sound professional judgment, are having a direct and material detrimental effect upon the associated basic condition or disability. (h) Class IV: Those whose service-connected disabilities are rated at 100% by schedular evaluation or who are entitled to the 100% rate by reason of individual unemployability may be authorized any needed dental treatment. (i) Class V: A veteran who is participating in a rehabilitation program under 38 U.S.C. Chapter 31 may be authorized such dental services as are professionally determined necessary for any of the reasons enumerated in Sec. 17.47(g). (j) Class VI: Any veterans scheduled for admission or otherwise receiving care and services under chapter 17 of 38 U.S.C. may receive outpatient dental care which is medically necessary, i.e., is for dental condition clinically determined to be complicating a medical condition currently under treatment. 38 C.F.R. § 17.161. The RO (Veterans Benefits Administration (VBA)) determines whether a Veteran is entitled to service connection for a dental disability, whereas the local VA medical center (Veterans Health Administration (VHA)) determines whether he is eligible for VA dental treatment. The Veteran in this case contends that, while in service, he fell while walking up some stairs and bit down on a drumstick causing trauma to tooth #12 and the surrounding teeth, including #s 1, 3, 13, 14, 15, 19, 30, and 31. The regulations governing dental claims make a fundamental distinction between "replaceable missing teeth", see 38 C.F.R. § 3.381(a), and teeth lost as a result of loss of substance of body of maxilla or mandible due to trauma or disease such as osteomyelitis, and not loss of the alveolar process as a result of periodontal disease. See 38 C.F.R. § 4.150; Simington v. West, 11 Vet. App. 41, 44 (1998). Absent a demonstration of dental trauma, service connection may be considered solely for the purpose of determining entitlement to dental examinations or outpatient dental treatment. See also Woodson v. Brown, 8 Vet. App. 352, 354 (1995). Here, although the Veteran contends that his fall in service caused trauma to many other teeth (that is, aside from tooth #12 that is already service connected), the VA examiner that evaluated the Veteran in August 2008, on remand, determined that any further dental trauma the Veteran sustained at the time of that fall did not result in his current dental condition, including the loss of the additional teeth mentioned. In providing this opinion, this VA examiner reviewed the Veteran's service dental records and did not find evidence of any dental trauma due to a fall. Rather, the records revealed he had several missing teeth upon entering service, including teeth #s 1, 13, and 19, and that teeth #s 3, 14, 15, 30, and 31 were noted on entrance X-ray to have been severely eroded, decalcified, and abscessed prior to service and were extracted due to a natural progression of these conditions. Further, tooth #20 was rotated prior to service and was unchanged during service. In August 2010, a different VA dental examiner also reviewed the claims file for the pertinent history and determined the February 1981 entrance dental X-ray examination in fact revealed teeth that were already fractured, including tooth #12, with carious root tips in #s 2, 3, 13, 14, 30, and 31. This examiner further noted that, although in October 1981, the Veteran had tooth #12 repaired due to a fracture, fractures could occur from caries and were not necessarily due to dental trauma. Accordingly, this examiner determined the fracture to tooth #12 most likely occurred prior to service, and that there was no evidence the Veteran experienced further trauma to this tooth or to any other teeth from a fall during service. Accordingly, because this evidence - especially in combination, does note indicate the Veteran sustained dental trauma in service due to loss of substance of body of maxilla or mandible due to trauma or disease such as osteomyelitis, rather, has been shown to suffer from replaceable missing teeth due to fracture and periodontal disease, he does not have a Class I service- connectable dental disorder and is eligible for service connection for replaceable missing teeth for treatment purposes only. In this additional consideration of whether the Veteran is entitled to service connection for treatment purposes only, the Board sees that he was discharged from service in December 1985 and did not file a claim for service connection for a dental disability until nearly 20 years later, in March 2005. Because he did not file a claim for service connection for a dental disability within one year of his separation from service, his claim is untimely, and he is not entitled to service connection for treatment purposes under Class II. 38 C.F.R. § 17.161(f). He also does not quality for treatment under Classes IIA, IIB, and IIC, as he does not have any dental disability stemming from combat wounds or service trauma, and he was not a prisoner of war. Additionally, he is ineligible for treatment under Class IIR, as it is not shown that he filed any application for dental treatment prior to his current claim. The Veteran also is ineligible for treatment under Class III, as there is no evidence demonstrating (nor has he alleged) that his dental problems have had any direct and material negative effect on any of his service-connected disabilities. Similarly, treatment is not warranted under either Class IV or V, as at no time during the pendency of his appeal has he been receiving VA disability compensation benefits at the 100-percent level, nor has he participated in a rehabilitation program under 38 U.S.C. Chapter 31. As well, there is no evidence of record showing the Veteran's dental problems are complicating a medical condition being treated under 38 U.S.C. Chapter 17 (i.e., the chapter governing access to, and provision of, VA health care), nor has he made any such allegation. Consequently, he is ineligible for treatment under Class VI. Turning next to his periodontal disease, the Veteran's service dental records show that several teeth were extracted during service due to caries and periodontal disease. In August 2010, he submitted a supporting statement from his private dentist indicating that apparently the gingivitis that was treated while in the service progressed to periodontal disease. This dentist then goes on to note this resulted in tooth decay and tooth loss. The missing teeth have allowed the adjacent and opposing teeth to shift and drift, in turn resulting in his teeth not occluding (aligning) properly. Periodontal disease and gingivitis, however, are not recognized as disabilities for which VA compensation may be granted. 38 C.F.R. § 3.381. Indeed, to the contrary, they are expressly precluded - even for treatment, except under certain specifically defined circumstances, none of which are herein presented. This claim therefore also must be denied. Sabonis v. Brown, 6 Vet. App. 426 (1994). ORDER The claim for service connection for a respiratory disorder is denied. The claim for service connection for a dental disability also is denied. ____________________________________________ Keith W. Allen Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs