Citation Nr: 18123726 Decision Date: 08/02/18 Archive Date: 08/02/18 DOCKET NO. 15-32 326 DATE: August 2, 2018 REMANDED Entitlement to service connection for a lumbar disability, to include lumbar strain, is remanded. Entitlement to service connection for a sinus condition, to include a sinus condition, is remanded. Entitlement to service connection for allergic rhinitis, also claimed as allergies, is remanded. REASONS FOR REMAND The Veteran served in the Army National Guard with periods of active duty from June 2004 to October 2003, May 2006 to December 2006, and March 2010 to April 2011. This matter comes before the Board of Veterans’ Appeals (Board) from a May 2013 rating decision from the Department of Veterans Affairs (VA) Regional office (RO) in Jackson, Mississippi. 1. Entitlement to Service Connection for a Lumbar Disability. A remand is necessary to obtain a new examination for the Veteran’s lumbar spine disability. The Veteran was afforded an examination in September 2012, which found the Veteran had no current back disability. However, medical evidence since then has indicate the Veteran has an active back disability, with treatment reports noting lumbar strain as an active problem. As the Veteran has a present lumbar disability and the Veteran’s active service records indicate she reported lumbar pain in service, a new examination is needed to determine if the Veteran’s current lumbar disability is etiologically related to in-service reports of lumbar strain. 2. Entitlement to Service Connection for a Sinus Condition. A remand is necessary to obtain an examination for the Veteran’s sinus disability. The Veteran’s treatment records indicate a current diagnosis for chronic frontal sinusitis. The Veteran reported headaches in service, to which she attributed to sinus problems. An examination has not been provided to determine if there is a nexus between these occurrences. Therefore, an examination is needed to determine if the current sinus condition is etiologically related to in-service reports of headaches. Additionally, the Board notes that the Veteran’s sinus problems may be related to environmental hazards experienced during service in Southwest Asia. While the Veteran was provided a Gulf War examination, the sinus condition had not been diagnosed at that time, thus an opinion was not rendered as to the specific issue of whether the Veteran’s sinus condition is related to exposure to environmental hazards, to include as part of a medically unexplained chronic multi-symptom illness. Moreover, the opinions in the examination were flawed as they state the wrong standard for service connection, in that it does not afford the Veteran the benefit of the doubt if evidence is in equipoise. The Gulf War examination opinions state “not likely (50% probability or less)”; thus, not affording the Veteran’ the benefit of the doubt where the evidence is approximately even. Therefore, upon remand a new Gulf War examination is also warranted. 3. Entitlement to Service Connection for Allergies. Similar to the claim for a sinus condition, the claim for allergies must also be remanded for an examination. The Veteran’s records indicate she has current diagnosis of allergic rhinitis. She associates this with her headaches documented in service. Further, they may be related to exposure to environmental hazards while serving in Southwest Asia. Therefore, this matter should be remanded to obtain a new examination to determine if the Veteran’s allergic rhinitis is etiologically related to her in-service headaches or exposure to environmental hazards. The matters are REMANDED for the following action: 1. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any lumbar spine disability that is demonstrated in treatment records since approximately May 2011. The examiner must opine whether it is at least as likely as not related to an in-service injury, event, or disease, including lumbar pain reported during active service. 2. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any sinus condition. The examiner must opine whether it is at least as likely as not related to an in-service injury, event, or disease, including headaches reported during active service or exposure to environment hazards in Southwest Asia. 3. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any allergy condition, to include allergic rhinitis. The examiner must opine whether it is at least as likely as not related to an in-service injury, event, or disease, including headaches reported during active service or exposure to environment hazards in Southwest Asia. 4. Schedule the Veteran for a Gulf War examination to address the nature and etiology of her symptoms of back pain, sinusitis, and allergic rhinitis. The examiner must opine whether they, in combination of any other related symptoms are at least as likely as not related to a medically unexplained chronic multi-symptom illness. K. J. ALIBRANDO Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S. Reed, Associate Counsel