Citation Nr: 20005925 Decision Date: 01/23/20 Archive Date: 01/23/20 DOCKET NO. 16-44 315 DATE: January 23, 2020 ORDER Entitlement to service connection for a dental condition is denied. REMANDED Entitlement to service connection for a psychiatric disorder is remanded. FINDING OF FACT The Veteran does not have a dental disorder for which compensation is payable. CONCLUSION OF LAW The criteria for entitlement to service connection for a dental condition have not been met. 38 U.S.C. §§ 1110, 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.381, 4.150, 17.161. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from February 1968 to February 1970. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from October an April 2015 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In October 2019 the Veteran testified before the undersigned Veterans Law Judge at a Travel Board hearing; a transcript of the hearing is of record. 1. Entitlement to service connection for a dental condition Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active service, even if the disability was initially diagnosed after service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. The dental conditions for which service-connected compensation benefits are available are set under 38 C.F.R. § 4.150, Diagnostic Codes 9900-9916. Disability compensation and VA outpatient dental treatment may be provided only for certain specified types of service-connected dental disorders. For other types of service-connected dental disorders, the claimant may receive treatment only and not compensation. 38 U.S.C. § 1712; 38 C.F.R. §§ 3.381, 4.150, 17.161. Dental disabilities that may be awarded compensable disability ratings are set forth under 38 C.F.R. § 4.150. These disabilities include chronic osteomyelitis or osteoradionecrosis of the maxilla or mandible, loss of the mandible, nonunion or malunion of the mandible, loss of the maxilla, nonunion or malunion of the maxilla, limited temporomandibular motion, loss of the ramus, loss of the condyloid or coronoid processes, loss of the hard palate, loss of teeth due to the loss of substance of the body of the maxilla or mandible and where the lost masticatory surface cannot be restored by suitable prosthesis, when the bone loss is a result of trauma or disease but not the result of periodontal disease. 38 C.F.R. § 4.150, DCs 9900-9916. The Board notes that the portion of VA’s Schedule for Rating Disabilities addressing dental and oral conditions was revised effective September 10, 2017. The Veteran has not been notified as to the changes in the regulations and the RO has not adjudicated his claims under the new regulations; however, as the new regulations involve benign or malignant neoplasms that are not applicable to the Veteran’s current claim and the other changes involved only clarification of the rating terms, the Board finds that there is no prejudice in adjudicating the Veteran’s dental claim. Under 38 C.F.R. § 3.381, treatable carious teeth, replaceable missing teeth, dental or alveolar abscesses, and periodontal disease are to be considered service-connected solely for the purpose of establishing eligibility for outpatient dental treatment as provided in 38 C.F.R. § 17.161. The matter of eligibility for VA dental treatment is not the subject of the Board’s review. Rather, the Board will address whether the Veteran is entitled to service connection for VA compensation purposes. The service treatment records do not note any injuries to the mouth or teeth. In October 1968 the Veteran underwent extraction of teeth numbers 2, 4, 5, 10, 14, and 18. The separation examination in October 1969 noted normal mouth and throat examination. The treatment records associated with the claims file do not demonstrate any dental disability. Considering the pertinent evidence in light of the above, the Board finds that the Veteran does not have a compensable dental disorder. As noted above, replaceable missing teeth and periodontal gum disease may be considered service-connected solely for the purpose of establishing eligibility for outpatient dental treatment. See 38 C.F.R. § 3.381. In this case, there is no competent medical or dental evidence of loss of teeth due to loss of substance of the body of the maxilla or mandible due to bone loss through trauma or any other condition on which service connection for compensation purposes could be allowed. The records do not indicate that during service the Veteran incurred an injury to the mandible or maxilla and the Veteran does not contend otherwise. There is evidence of removal of teeth in service; however, there is no evidence that the loss or removal of the teeth was the result of the loss of mandible or maxilla. Thus, none of the other DCs, 9900 through 9916, apply in this case. Again, DCs 9917 and 9918 are not applicable because they involve neoplasms, which are not present in this case. While service connection may be established for treatment purposes for replaceable missing teeth and periodontal disease, the regulations listed above clearly prohibit service connection for purposes of compensation where the disability involves replaceable missing teeth or periodontal disease. As neither condition is recognized by the applicable regulations as a disability for which VA compensation may be granted, the Veteran’s claim is not warranted. See 38 C.F.R. § 3.381 (periodontal disease is not a disability for compensation purposes). In addition, there was no evidence of any in-service dental trauma which resulted in residuals, additional loss of teeth, malunion or nonunion of the maxilla, or loss of body of the maxilla or mandible. See generally, VAOPGCPREC 5-97; 38 C.F.R. § 4.150, DCs 9913-9916. Consequently, there is no basis for entitlement to service connection for the Veteran’s claimed dental condition for compensation purposes. In reaching the conclusions above the Board has considered the applicability of the benefit of the doubt doctrine. However, as the preponderance of the evidence is against the Veteran’s claim, that doctrine is not applicable. See 38 U.S.C. § 5107 (b) (2012); see generally Ortiz v. Principi, 274 F.3d 1361 (Fed Cir. 2001). REASONS FOR REMAND 1. Entitlement to service connection for a psychiatric disorder is remanded. The Veteran seeks service connection for a psychiatric disorder, to include PTSD. See Clemons v. Shinseki, 23 Vet. App. 1 (2009). The Veteran relates his condition(s) to his experience in service, to include a fatal motor vehicle accident in Germany in January 1970, and to an incident in 1969 when he was stabbed in the hand by a fellow soldier. The RO conducted appropriate stressor development in this case and determined that there is insufficient information to confirm these incidents occurred as the Veteran reports. In the absence of credible, official evidence to corroborate the events as they are purported to have occurred, the Board does not find- either implicitly or explicitly- that the events transpired exactly as described by the Veteran. The Board notes, however, that the service treatment records do document that the Veteran received sutures for a right thumb laceration in August 1969, and that he was a driver involved in a vehicle accident in January 1970. The contemporaneous treatment records make no mention of a stabbing that caused injury to his hand, or that the vehicle accident caused a fatality. The records further reflect that he denied depression or excessive worry, nightmares, nervous trouble or trouble sleeping on his Report of Medical History that was completed at separation. The clinical psychiatric examination was also reportedly normal. The Veteran has asserted that he continues to relive the accident and he testified that he began experiencing mental health symptoms shortly after service due in part to the pain he continued to feel in his hand and guilt from the vehicle accident. A VA treatment record dated in March 2015 shows that the Veteran has a current diagnosis of unspecified depressive disorder. He has not been afforded an examination to determine if he has a current psychiatric disorder related to him sustaining a cut to his hand and/or being involved in a motor vehicle accident in service. One should be provided. The matters are REMANDED for the following action: 1. Notify the Veteran that he may submit any further clarifying medical or lay evidence including, but not limited to, official records in his possession, contemporaneous letters that he received or sent, photographs, statements from service colleagues (“buddy statements”), or any other contemporaneous evidence referable to the claimed in-service incidents. Advise him that, if possible, he should provide names of other individuals who were also present and witnessed or knew of his claimed stressor incidents, or who can confirm his proximity to them. 2. Schedule the Veteran for a psychiatric examination to determine the nature and etiology of any acquired psychiatric disorder. The claims file, and complete copy of the Remand, must be made available to the VA examiner for review. The examiner is advised that the Veteran asserts that he continues to ‘relive’ the accident and he testified that he began experiencing mental health symptoms shortly after service due in part to the pain he continued to feel in his hand and guilt from his involvement in the vehicle accident discussed above. The examiner is advised that there is no official corroboration that the Veteran was involved in a fatal vehicle accident or that he was stabbed by another soldier in the hand. In the absence of credible, official corroboration of the events as they are purported to have occurred, the Board does not find- either implicitly or explicitly- that the events transpired exactly as described by the Veteran. The Board notes, however, that the service treatment records document that the Veteran received sutures for a right thumb laceration in August 1969, and that he was a driver involved in a vehicle accident in January 1970. These contemporaneous treatment records make no mention of a stabbing that caused injury to his hand, or that the vehicle accident caused a fatality. a) The examiner is asked to identify all current psychiatric disorders. For any psychiatric disorder that is noted in the treatment records, but not found on current examination, the examiner should attempt to reconcile these findings. b) The examiner must opine whether the Veteran has a current diagnosis of PTSD. If the examiner determines that PTSD is present, then he or she must specify the stressor supporting that diagnosis. c) With respect to any additional psychiatric disorder present during the period of this claim, state whether it is at least as likely as not that such disorder originated during service or is otherwise etiologically related to service. Complete rationales are to be provided for each of the requested opinions noted above. If the examiner feels that any requested opinion cannot be rendered without resorting to speculation, then such examiner must explain why this is so. D. JOHNSON Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. G. Mazzucchelli, Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.