Citation Nr: 18141520 Decision Date: 10/10/18 Archive Date: 10/10/18 DOCKET NO. 16-12 632 DATE: October 10, 2018 REMANDED The issue of entitlement to service connection for a sinus condition, to include sinusitis and allergic rhinitis, is remanded. REASONS FOR REMAND The Veteran, who is the appellant in this case, served on active duty from October 1993 to May 2000. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a rating decision dated April 2015 of the Department of Veterans Affairs (VA) Regional Office (RO) in Muskogee, Oklahoma. As reflected herein, the Board has broadened the service connection claim to entitlement to service connection for a sinus condition, to include sinusitis and allergic rhinitis. In his March 2016 substantive appeal to the Board (VA Form 9), the Veteran requested a Board video-conference hearing. A hearing was scheduled to be held on October 1, 2018; however, the Veteran failed to report for the hearing without good cause. Accordingly, his hearing request is deemed withdrawn. See 38 C.F.R. § 20.702(d). The issue of entitlement to service connection for a sinus condition, to include sinusitis and allergic rhinitis, is remanded. A remand of the service connection claim is necessary to obtain a new VA examination and medical opinion, as specified below, to ensure that the Board’s evaluation of the Veteran’s claim is a fully informed one. When VA undertakes to provide a VA examination, it must ensure that the examination is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007) (holding that once VA undertakes the effort to provide an examination when developing a claim, even if not statutorily obligated to do so, VA must ensure that the examination provided is adequate). Furthermore, the Board may consider only independent medical evidence to support its findings, and may not substitute its own unsubstantiated medical conclusions. Colvin v. Derwinski, 1 Vet. App. 171, 175 (1991). The Board finds deficiencies with the April 2015 VA examination. The VA examiner diagnosed chronic sinusitis and polyp of left maxillary sinus. However, instead of providing the requested medical opinion as to whether the Veteran’s sinusitis is related to service, the examiner simply stated that there was “no objective evidence of sinusitis” during the examination. Furthermore, the examiner merely stated that the Veteran’s sinus symptoms onset in 1995, but failed to acknowledge and discuss multiple diagnoses of sinusitis noted in the Veteran’s service treatment records. See VA Sinusitis Disability Benefits Questionnaires dated April 6, 2015 and April 13, 2015. Accordingly, the Board finds that the April 2015 VA examinations was inadequate. Barr, supra. On remand, the Veteran is to be afforded a new VA examination. The etiology of any sinusitis diagnosed since the date of claim must be ascertained. The matter is REMANDED for the following action: 1. Ensure that all outstanding VA and/or private treatment records are associated with the claims file. 2. Then, schedule the Veteran for a VA examination, preferably by an examiner other than the one who conducted the April 2015 VA examination, to determine the nature and etiology of any currently diagnosed sinus disorders. Any and all studies, tests, and evaluations deemed necessary by the examiner should be performed. The examiner is requested to review all pertinent records associated with the claims file, including this Remand, and the Veteran’s service treatment records, post-service medical records, and lay assertions. The examiner should respond to the following: (a) Elicit from the Veteran the history of his sinusitis and other sinus disorder symptoms since service. The examiner should note that the Veteran is competent to report symptoms of sinus disorders. (b) Identify all sinus disorders currently shown since December 28, 2014 (the date of the Veteran’s claim), to include chronic sinusitis and allergic rhinitis. (c) For each sinus disorder, provide an opinion as to whether it is at least as likely as not (50 percent probability or greater) that the disorder is etiologically related to the Veteran’s active service. The examiner should consider the Veteran’s lay assertions regarding the identified sinus disorders and account for them in the opinion(s). The examiner should provide a complete rationale for the opinion(s), whether favorable or unfavorable, and cite to specific evidence of the record, as necessary. 3. Thereafter, readjudicate the claim on appeal. S. B. MAYS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Farrell, Bradley