Citation Nr: 18151270 Decision Date: 11/19/18 Archive Date: 11/16/18 DOCKET NO. 09-28 139 DATE: November 19, 2018 REMANDED Entitlement to an initial compensable disability rating prior to November 21, 2013, and in excess of 10 percent thereafter, for service-connected allergic rhinitis and chronic rhinosinusitis is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1986 to December 1994. In a June 2017 decision, the Board, in pertinent part, denied entitlement to a compensable rating for residuals of a fractured nose and remanded the claim for an increased rating for sinusitis for evidentiary development, to include a new VA examination. Subsequent to the Board’s decision, the RO issued a rating decision in August 2017 which recharacterized the disability on appeal as “allergic rhinitis and chronic rhinosinusitis” from “sinusitis” and granted an increased 10 percent rating, effective November 21, 2013. In December 2017, the Board remanded this matter clarify the Veteran’s sinus-related diagnoses and all symptomatology resulting from his service-connected disability. However, for the reasons that follow, another remand is needed before the Board can adjudicate this claim. Entitlement to an initial compensable disability rating prior to November 21, 2013, and in excess of 10 percent thereafter, for service-connected allergic rhinitis and chronic rhinosinusitis is remanded. A remand is needed to afford the Veteran a new VA examination to fully assess the severity of his service-connected disability. Following the prior Board remand, the Veteran was afforded a VA examination in December 2017 which noted that he experienced a partial loss of his senses of smell and taste. However, the examiner did not clearly state whether these functional impairments were due to his service-connected disability. In a June 2018 addendum, the examiner stated the Veteran experienced some degree of airway resistance, but otherwise did not provide any clear medical findings regarding the severity of the Veteran’s disability. In an October 2018 VA addendum, an examiner suggested that a new examination was needed to clarify the Veteran’s sinus-related diagnoses and address the severity of his service-connected disability. Finally, there was no retrospective opinion provided addressing the Board’s December 2017 question asking whether the Veteran’s reports of chronic congestion and diminished sense of smell prior to November 21, 2013, were consistent with obstruction of nasal passages on both sides or complete obstruction on one side. As such, a remand is needed to cure these deficiencies. See Stegall v. West, 11 Vet. App. 268 (1998). Since this claim is being remanded, the file also should be updated to include all outstanding VA treatment records. See 38 C.F.R. § 3.159 (c)(2); see also Bell v. Derwinski, 2 Vet. App. 611 (1992). The matter is REMANDED for the following action: 1. Obtain and associate with the Veteran’s claims file copies of all outstanding VA treatment records dated from December 2017 to the present. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected allergic rhinitis and chronic rhinosinusitis. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran’s disability under the rating criteria. The examiner must attempt to elicit information regarding the severity, frequency, and duration of any flare-ups, and the degree of functional loss during flare-ups. To the extent possible, the examiner should identify any symptoms and functional impairments due to allergic rhinitis and chronic rhinosinusitis alone and discuss the effect of the Veteran’s disability on any occupational functioning and activities of daily living. If it is not possible to provide an opinion regarding flare-ups, symptoms, or functional impairment without speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner does not have the knowledge or training. The VA examiner is also asked to provide a retrospective medical opinion as to whether the Veteran’s reports of chronic congestion and diminished sense of smell prior to November 21, 2013, were consistent with obstruction of nasal passages on both sides or complete obstruction on one side. Any opinion expressed by the VA examiner should be accompanied by a complete rationale. M. E. Larkin Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Jack S. Komperda, Counsel