Citation Nr: 18158473 Decision Date: 12/18/18 Archive Date: 12/17/18 DOCKET NO. 17-01 044 DATE: December 18, 2018 ORDER Service connection for a dental disorder for VA compensation is denied. REMANDED Service connection for a lumbar spine disorder (claimed as degenerative disc disease) is remanded. Service connection for a saliva gland disorder is remanded. FINDING OF FACT The Veteran does not have a current dental disability subject to VA compensation. CONCLUSION OF LAW The criteria for service connection for a dental disorder for VA compensation purposes have not been met. 38 U.S.C. §§ 1131, 5103, 5103A; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.381, 4.150. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran, who is the Appellant, served on active duty from December 1970 to December 1974. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an January 2013 rating decision from the Regional Office (RO), which denied service connection a saliva gland disorder, degenerative disc disease (lumbar spine disorder), a dental disorder, bilateral hearing loss and tinnitus. A November 2016 rating decision granted service connection for bilateral hearing loss and tinnitus, which is a full grant of the benefits sought on appeal, so is no longer before the Board. In April 2017, the Veteran testified at a Travel Board hearing from the RO in Indianapolis, Indiana, before the undersigned Veterans Law Judge. The hearing transcript has been associated with the record. Since issuance of November 2016 statement of the case, additional evidence has been received by the Board for which a waiver of initial RO consideration was provided in writing in the April 2017 Statement in Support of the Claim. 38 U.S.C. § 7105(e); 38 C.F.R. § 20.1304. The Board finds that the duties to notify and assist in this case have been fulfilled regarding the claim for service connection for a dental disorder. Neither the Veteran nor the evidence has raised any specific contentions regarding the duties to notify or assist. The Board need not address the duties to notify and assist regarding service connection for a saliva gland disorder and lumbar spine disorder, as these issues are being remanded for additional development. 1. Service Connection for a Dental Disorder The Veteran contends that service connection for a dental disorder is warranted as secondary to a saliva gland disorder. Specifically, the Veteran contends that he was exposed to radiation while assisting in the removal of the reactor shielding of a malfunctioning reactor during service on the USS Woodrow Wilson in 1972. The Veteran contends that he had recurrent problems with dental cavities and gum disease since the radiation exposure, which resulted tooth decay and eventual removal of all his teeth 1999. The Veteran contends a dentist told him that the pH balance in his mouth was very low due to past radiation exposure, which resulted tooth decay over the years due to increased acidity in the mouth. See April 2017 Board hearing transcript; August 2010 lay statement. Under the relevant laws and regulations, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Generally, service connection for a disability requires evidence of: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred in or aggravated by service. Compensation is only available for certain types of dental and oral conditions listed under 38 C.F.R. § 4.150, such as impairment of the mandible, loss of a portion of the ramus, and loss of a portion of the maxilla. Compensation is available for loss of teeth only if such is due to loss of substance of body of maxilla or mandible due to trauma or disease such as osteomyelitis, but not periodontal disease. Otherwise, a veteran may be entitled to service connection for dental conditions including treatable carious teeth, replaceable missing teeth, dental or alveolar abscesses, and periodontal disease, for the sole purpose of receiving VA outpatient dental services and treatment, if certain criteria are met. 38 U.S.C. § 1712; 38 C.F.R. §§ 3.381, 17.161. After reviewing all the evidence, both medical and lay, the Board finds that the weight of the evidence is against a finding that the Veteran has a dental disability subject to compensation. 38 C.F.R. § 17.161. The service treatment records show that the Veteran was exposed to a 00.078 dose of radiation during the period from May 13, 1972 to June 14, 1972. Although the Veteran contends that dental cavities and tooth decay are the result of a saliva gland disorder due to radiation exposure in 1972, the service treatment records show problems with dental caries and missing teeth prior to the 1972 radiation exposure. A January 1971 service examination report reflects notation of dental caries and that teeth five, 12, and 32 were missing, while teeth 20 and 28 were restorable. See January 1971 service treatment record. Additionally, the Veteran denied problems with severe tooth or gum trouble at service separation in 1974 after the 1972 radiation exposure. See August 1974, December 1974 service treatment records. The service treatment records do not reflect complaints or treatment for dental trauma during active service, and the Veteran has not asserted otherwise. The evidence of record, both medical and lay, is unremarkable for any compensable dental condition. 38 C.F.R. § 17.161. That is, there is no diagnosis of record, nor has the Veteran submitted evidence of a diagnosis of loss of whole or part of the mandible, nonunion or malunion of the mandible, loss of whole or part of the ramus, loss of whole or part of the maxilla, nonunion or malunion of the maxilla, loss of the condyloid or coronoid process, or loss of any part of the hard palate, for which service-connected compensation could be granted. See 38 C.F.R. § 4.150, Diagnostic Codes 9900-9916. Post-service records only show that the Veteran continues to have missing teeth and poor dentation. See August 2015 VA treatment record. In addition, although the Veteran asserts that he had dental cavities, tooth decay and eventual loss of teeth due to radiation exposure and a resulting saliva gland disorder, there is no evidence of record that any claimed teeth and gum disability are due to the loss of substance of body of maxilla or mandible during service through trauma or disease such as osteomyelitis. 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. See 38 C.F.R. § 3.381(a). The existence of a current disability is the cornerstone of a claim for VA disability compensation. 38 U.S.C. § 1110. Evidence must show that the veteran currently has a compensable dental or oral disability for which benefits are being claimed. Because the evidence does not establish that the Veteran has a current compensable dental condition during the pendency of the appeal, the Board finds that the Veteran is not entitled to service connection for a compensable dental disorder under 38 C.F.R. § 4.150. To the extent the Veteran seeks service connection solely for outpatient dental treatment, such issue is referred to the RO for appropriate action. REASONS FOR REMAND 1. Service Connection for a Lumbar Spine Disorder is remanded. 2. Service Connection for a Saliva Gland Disorder is remanded. The Veteran generally contends that service connection is warranted for a saliva gland disorder and lumbar spine disorder (claimed as degenerative disc disease) due to approximately one hour of radiation exposure while serving on USS Woodrow Wilson in 1972. The Veteran contends that he has had problems with dry mouth since active service and must always carry a drink with him to keep his mouth moist. Additionally, the Veteran contends that he was advised he had degenerative disc disease in the lumbar spine during an employment examination at age 40. The Veteran contends that he has no family history of arthritis and believes his back problems may be a result of the radiation exposure during service. See April 2017 Board hearing transcript, August 2010 lay statement. The service treatment and personnel records reflect that the Veteran assisted in the removal and replacement of reactor shielding in June 1972. Additionally, a report of Occupational Exposure to Ionizing Radiation reflects that for the period from May 13, 1972 to June 2, 1972 the Veteran was exposed to a 00.078 dose of radiation, which is the total dose of radiation the Veteran was exposed to throughout active service. See June 1972 service personnel and treatment records. Post-service treatment records reflect a current diagnosis of xerostomia and advanced degenerative changes at L4 through S1 in the lumbar spine. See August 2015, January 2017 VA treatment records. As such, a remand is necessary to provide a VA examination and medical nexus opinion regarding the etiology of the currant saliva gland disorder and lumbar spine disorder. Service connection for a saliva gland disorder and lumbar spine disorder are REMANDED for the following action: 1. Schedule the requisite VA low back and saliva gland (mouth/throat) examinations to address the relationship, if any, between any current lumbar spine disability and saliva gland disability and active service. The relevant documents in the record should be reviewed by the examiner and a detailed history of relevant symptoms should be obtained from the Veteran. All indicated studies should be performed. A rationale for all opinions and a discussion of the facts and medical principles involved should be provided. The examiner should provide the following opinions: a) Is it at least as likely as not (50 percent or higher degree of probability) that a current lumbar spine disability had its onset during, or was otherwise causally or etiologically related to active service, to include radiation exposure while serving on the USS Woodrow Wilson in 1972. (Continued on the next page)   b) Is it at least as likely as not (50 percent or higher degree of probability) that a current saliva gland disability had its onset during, or was otherwise causally or etiologically related to active service, to include radiation exposure while serving on the USS Woodrow Wilson in 1972. J. PARKER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S. Moore, Associate Counsel