Citation Nr: 18136705 Decision Date: 09/19/18 Archive Date: 09/19/18 DOCKET NO. 17-39 254 DATE: September 19, 2018 ORDER Entitlement to an increased, compensable disability evaluation for bilateral hearing loss is dismissed. REMANDED Entitlement to service connection for a dental disorder, including teeth extraction, for compensation purposes, is remanded. FINDING OF FACT On March 8, 2018, prior to the promulgation of a decision in the appeal, the Board received notification from the appellant that a withdrawal of the appeal of the claim of entitlement to an increased disability evaluation for bilateral hearing loss was requested. CONCLUSION OF LAW The criteria for withdrawal of the appeal of the claim of entitlement to an increased disability evaluation for bilateral hearing loss by the appellant (or his authorized representative) have been met. 38 U.S.C. § 7105(b)(2), (d)(5); 38 C.F.R. § 20.204 (2018). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active duty service in the U.S. Army from January 1953 to January 1955. These matters come before the Board of Veterans’ Appeals (Board) on an appeal of an August 2015 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Oakland, California. Entitlement to an increased, compensable disability evaluation for bilateral hearing loss The Board may dismiss any appeal which fails to allege specific error of fact or law in the determination being appealed. 38 U.S.C. § 7105. An appeal may be withdrawn as to any or all issues involved in the appeal at any time before the Board promulgates a decision. 38 C.F.R. § 20.204 (2018). Withdrawal may be made by the appellant or by his or her authorized representative. 38 C.F.R. § 20.204. In the present case, the Veteran, through testimony provided at a hearing before the undersigned VLJ on March 8, 2018, has withdrawn the appeal of the claim of entitlement to an increased disability evaluation for bilateral hearing loss. Hence, there remain no allegations of errors of fact or law for appellate consideration. Accordingly, the Board does not have jurisdiction to review this claim and the claim of entitlement to an increased disability evaluation for bilateral hearing loss is dismissed. REASONS FOR REMAND Entitlement to service connection for a dental disorder, including teeth extraction is remanded. The Veteran asserted at his March 2018 Board hearing before the undersigned that he did not have any dental disorders or abnormalities at entrance into service, and that he had in-service dental trauma, which caused him to lose all but 15 teeth. According to the Veteran, he was knocked out during a conversation near a tank, and fell on a part of a tank; he testified that the fall knocked out or loosened all most of his teeth and busted his lip. The Veteran also testified that his remaining teeth were pulled in the years following service, and he now requires dentures. The Board acknowledges that Veteran’s complete service personnel and treatment records are unavailable, and when a veteran’s service treatment records are unavailable through no fault of his own, the VA’s duty to assist, duty to provide reasons and bases for its findings and conclusions, and duty to consider carefully the benefit-of-the-doubt rule, are heightened. Milostan v. Brown, 4 Vet. App. 250, 252 (1993) (citing Moore v. Derwinski, 1 Vet. App. 401, 406 (1991) and O'Hare v. Derwinski, 1 Vet. App. 365, 367 (1991)). Under current VA regulations, 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 purposes 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; Simington v. West, 11 Vet. App. 41, 44 (noting the distinction between replaceable missing teeth which can be service connected for treatment purposes only and teeth lost “as a result of 'loss of substance of body of maxilla and mandible' which can be assigned ratings anywhere from 0 to 100 % for compensation purposes”). Although the Veteran is currently using dentures, and reports that he sought dental treatment in the years since service, it remains unclear whether the Veteran is diagnosed with a dental condition for which disability compensation may be provided; specifically, loss of teeth due to bone loss of the body of the maxilla or the mandible due to trauma or disease such as osteomyelitis, but not periodontal disease. See 38 C.F.R. §§ 4.150, Diagnostic Code 9913; 17.161(a) (2018). Moreover, although the Veteran’s service treatment records clearly reflect dental work, a remand is required so that a VA dental examination can be conducted. VA adjudicators may consider only independent medical evidence to support their findings; they may not rely on their own unsubstantiated medical conclusions. If the medical evidence of record is insufficient, VA is always free to supplement the record by seeking an advisory opinion, or ordering a medical examination to support its ultimate conclusions. See Colvin v. Derwinski, 1 Vet. App. 171 (1991). Therefore, additional clinical assessment and medical opinion is necessary to adequately address the Veteran’s claim of entitlement to service connection. Accordingly, the Board finds that the Veteran should be afforded a VA examination in order to determine nature and etiology of the Veteran’s claimed dental disability. See McClendon v. Nicholson, 20 Vet. App. 79 (2006). The matter is REMANDED for the following action: 1. The RO should request that the Veteran provide sufficient information and authorization to enable it to obtain any additional evidence pertinent to the claim for service connection for loss of all teeth, including, but not limited to all available dental treatment records since January 1955. 2. After any additional records are associated with the claims file, the RO should schedule the Veteran for a VA dental examination. The VA examiner should identify the Veteran’s current dental disabilities and should specifically indicate whether the Veteran has loss of teeth due to bone loss of the body of the maxilla or the mandible due to trauma or disease such as osteomyelitis. The examiner should also render an opinion, based on the entire medical history, as to whether it is at least as likely as not (50 percent probability or more) that any of the Veteran’s currently diagnosed dental disability is a result of an incident in service, to include the Veteran’s claimed dental trauma during his service. A complete rationale, with specific reference to the relevant evidence of record, should accompany each opinion provided. (Continued on the next page)   3. After completing any additional notification or development deemed necessary, the Veteran’s claim should be readjudicated. If the claim remains denied, the Veteran should be furnished with a supplemental statement of the case and afforded a reasonable opportunity for response. GAYLE STROMMEN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Hallie E. Brokowsky, Counsel