Citation Nr: 18140596 Decision Date: 10/03/18 Archive Date: 10/03/18 DOCKET NO. 15-15 062 DATE: October 3, 2018 ORDER Entitlement to service connection for a dental disability, claimed as a top front teeth disability, for compensation purposes is denied. REMANDED Entitlement to service connection for internal derangement and meniscectomy with degenerative joint disease of the right knee is remanded. Entitlement to service connection for degenerative joint disease of the left knee is remanded. FINDING OF FACT The claimed disability, a top front teeth disability, is not a disability for which service connection for compensation purposes may be granted. CONCLUSION OF LAW The claim for service connection for a dental disability, for compensation purposes, is without legal merit. 38 U.S.C. §§ 1110, 1712; 38 C.F.R. §§ 3.303, 3.381, 4.150. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Army from June 1967 to June 1969, to include service in the Republic of Vietnam (Vietnam), for which he was awarded the Bronze Star Medal for meritorious achievement. These matters come before the Board of Veterans’ Appeals (Board) on appeal from a January 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Denver, Colorado. As a preliminary matter, the Board notes that a claim for service connection for a dental disability is also considered a claim for VA outpatient dental treatment. Mays v. Brown, 5 Vet. App. 302, 305-06 (1993). A review of the records reveals, however, that the RO has only adjudicated the issue of entitlement to service connection for a dental disability for VA compensation purposes. In the April 2015 statement of the case, the RO indicated that it referred the Veteran’s claim to the dental clinic at the Grand Junction VA Medical Center. Further, the Veteran was notified that he could also apply directly to the dental clinic at the Grand Junction VA Medical Center to receive a determination on his claim for dental treatment. To date, it does not appear that an appeal had been generated regarding the request for dental treatment. Thus, the Board only has jurisdiction of the service connection claim for a dental disability. The Veteran claims that he is entitled to service connection for a dental disability, as he had dental work completed in service. The Board finds that the claim fails as a matter of law. As discussed in more detail below, the Veteran does not have a dental disability that, under law, is eligible for service connection disability compensation. 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). However, under current legal authority, compensation is only available for certain types of dental and oral conditions, such as impairment of the mandible, loss of a portion of the ramus, and loss of a portion of the maxilla. 38 C.F.R. § 4.150 (setting forth the schedule of ratings for dental and oral conditions). Compensation is available for loss of teeth only if such loss is due to in-service trauma or disease such as osteomyelitis, and not due to the loss of the alveolar process as a result of periodontal disease. 38 C.F.R. § 4.150, Diagnostic Code 9913, Note. Treatable carious teeth, replaceable missing teeth, dental or alveolar abscesses, and periodontal disease are not compensable disabilities, but may be service connected solely for establishing eligibility for outpatient dental treatment. 38 U.S.C. § 1712; 38 C.F.R. §§ 3.381, 4.150. Considering the pertinent evidence in light of the governing legal authority, the Board finds that service connection for teeth requiring fillings (treatable carious teeth), and replaceable missing teeth is not warranted. The Veteran’s dental records reflect that while on active service, he received somewhat regular dental treatment, which included treatment for cavities with fillings, and tooth extractions. However, there is no evidence of record, nor does the Veteran allege, that the Veteran has a dental disorder for which compensation may be payable. The Veteran should understand that this decision does not adjudicate the issue of entitlement to service connection for a dental disability for treatment purposes only, or the factual issues relating to such a claim. A claim of entitlement to service connection for a dental disability for treatment purposes only is a separate and distinct claim from a claim of entitlement to service connection for a dental disability for compensation purposes. As discussed above, the RO indicated that it forwarded the Veteran’s claim for treatment purposes to the appropriate VA Medical Center. In conclusion, as the Veteran seeks service connection for treatable carious teeth and extractions, and such disabilities can only be considered service-connected for the purpose of establishing eligibility for outpatient dental treatment and not for compensation purposes, the claim for entitlement to service connection for a dental disability, for compensation purposes, must be denied. See Sabonis v. Brown, 6 Vet. App. 426, 430 (1994) (where the law and not the evidence is dispositive, the claim must be terminated or denied as without legal merit). REASONS FOR REMAND The Veteran further claims that he is entitled to service connection for his bilateral knee disabilities, as he claims that he injured his knees while repelling with his gear while in Vietnam. The Board notes that the Veteran was provided a VA examination in December 2013 and was provided a diagnosis of internal derangement and meniscectomy of the right knee, and degenerative joint disease of both the right and left knee. The Veteran reported that he first experienced bilateral knee pain while repelling in Vietnam. After separation from service, he went back to college and wrestled, but indicated that he experienced bilateral knee pain. In 2012, he was walking and his right knee collapsed. He was diagnosed with a torn medial meniscus, which was repaired, in June 2013. Since then, he experienced aches in both of his knees and no longer jogs due to the pain. The VA examiner noted an indication of a right knee injury with occasional pain and locking in January 1966, prior to service. The entrance examination was negative. However, the accompanying report of medical history notes knee problems and injury. No in-service injury was noted. The VA examiner opined that the claimed right knee disability, which clearly and unmistakably existed prior to service, was not aggravated beyond its natural progression by an in-service event, injury, or illness. The examiner reasoned that the Veteran clearly had a pre-existing right knee meniscal condition with a history of injury, occasional pain, and locking. Further, there was no evidence of any in-service injury that might have aggravated the right knee. Regarding direct service connection, the VA examiner opined that the claimed bilateral knee disability was less likely than not (less than a 50 percent probability) incurred in or caused by the claimed, in-service injury, event, or illness. The examiner reasoned that there was no evidence of an in-service knee injury of either leg. Also of record is a May 2012 statement by the Veteran where he indicated that the first time he hurt his knees was repelling with full gear while in Vietnam; and that the pain shot through his knees. He did not go to sick call because his division was being moved the next day. He indicated that his knees were sore for the next couple of weeks. Finally, the Board notes that upon reviewing the Veteran’s VA outpatient treatment records, there is an indication on May 3, 2012, that the Veteran had a right knee injury from wrestling in high school. The Board notes that once VA undertakes the effort to provide an examination, or obtain an opinion, it must provide an adequate one. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). The Board finds the December 2013 VA examination to be inadequate, as the examiner did not take the Veteran’s lay statements concerning his in-service injury into consideration. As the Veteran was serving in combat in Vietnam, his statements should be accepted as sufficient evidence of an in-service incurrence. See 38 U.S.C. § 1154(b). Accordingly, the Board finds that an addendum opinion is necessary taking the Veteran’s lay statements concerning his injuries into consideration. Thus, these matters are REMANDED for the following action: 1. Obtain and associate with the claims file any outstanding VA treatment records related to the Veteran’s claims on appeal. 2. Forward the Veteran’s electronic claims file to an appropriate examiner for supplemental opinions as to the nature and etiology of the Veteran’s right and left knee disabilities. It is left to the examiner’s discretion whether to reexamine the Veteran. Following the review of the claims file, the examiner should identify any currently diagnosed right and left knee disabilities, and provide opinions on the following: a) Regarding the Veteran’s right knee, whether the Veteran had a right knee disability that clearly and unmistakably existed prior to service, and was not aggravated beyond its natural progression by the repelling injury the Veteran reports happened in Vietnam. b) Regarding the Veteran’s left knee disability, whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran’s current left knee disability was caused by the repelling injury he reports happened in Vietnam. For purposes of this opinion, the examiner is asked to presume that the repelling injury occurred as described by the Veteran. (Continued on the next page)   A complete rationale for all opinions should be provided. H.M. WALKER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Angeline DeChiara, Associate Counsel