Citation Nr: 20041377 Decision Date: 06/17/20 Archive Date: 06/17/20 DOCKET NO. 17-51 526 DATE: June 17, 2020 ORDER Entitlement to service connection for hypothyroidism is granted. REMANDED Entitlement to service connection for dry mouth and loss of sense of taste is remanded. Entitlement to service connection for residuals of a menstruation disorder, to include a hysterectomy, is remanded. FINDING OF FACT Resolving all reasonable doubt in favor of the Veteran, her hypothyroidism is related to service. CONCLUSION OF LAW The criteria for service connection for hypothyroidism have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from December 2002 to October 2008. In March 2020, the Veteran testified before the undersigned Veterans Law Judge. A transcript of the hearing is of record. Hypothyroidism The Veteran asserts that her hypothyroidism is related to service. In particular, she states that she contracted the Epstein Barr virus in service, which she argues caused her hypothyroidism. Establishing service connection generally requires (1) evidence of a current disability; (2) evidence of in-service incurrence or aggravation of a disease or injury; and (3) evidence of a nexus between the claimed in-service disease or injury and the present disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). The Veteran has a current diagnosis of Hashimoto’s thyroiditis, a type of hypothyroidism, and her service treatment records document that she tested positive for the Epstein Barr virus in October 2007. Additionally, service treatment records document an enlarged thyroid. In support of her claim, the Veteran has submitted an article linking the development of Hashimoto’s Thyroiditis Disease to the Epstein Barr virus. The Veteran has also submitted a June 2018 private opinion, wherein the clinician linked the Veteran’s Hashimoto’s thyroiditis to the Epstein Barr virus she contracted in service. He noted review of her medical history, including in service, and cited his personal experience and medical literature showing a correlation between the Epstein Barr virus and development of autoimmune thyroiditis as the reasoning for his conclusion. The Board finds the June 2018 private opinion highly probative, as it was based on a review of the Veteran’s medical history, and provided a rationale for the conclusion reached. There is no other medical opinion of record with which to contradict this opinion. Accordingly, resolving any reasonable doubt in favor of the Veteran, the Board finds that service connection for hypothyroidism is warranted. REASONS FOR REMAND Dry Mouth and Loss of Sense of Taste The Veteran seeks service connection for dry mouth and loss of sense of taste, which she claims is secondary to her service-connected allergic rhinitis, or medications taken for her service-connected disorders. During her hearing, the Veteran stated that her previous dentist diagnosed her with xerostomia and that he expressed that it could be a possibility that such was related to medications that she was taking. The Board finds that a VA examination and etiological opinion is required to adjudicate the claim. Additionally, the Veteran’s dental records should be obtained. Residuals of a Menstruation Disorder The Veteran seeks service connection for residuals of a menstruation disorder. In particular, she claims she developed a menstruation disorder in service, which progressed into intrauterine fibroid tumors, leading her to get a hysterectomy. During her hearing, the Veteran stated that, during service, after the birth of her son, she developed menorrhagia and that she was treated with oral contraceptives. Service treatment records document that she underwent a pelvic ultrasound for pain, and note dysmenorrhea, premenstrual syndrome and the use of contraceptives. The Board notes that the Veteran was afforded a VA examination in April 2015; however, it does not appear that an etiological opinion was provided. Based on the above, the Board finds that a new VA examination, along with an etiological opinion, is required to adjudicate the claim. The matters are REMANDED for the following action: 1. Obtain updated VA treatment records. 2. Take appropriate action to obtain authorization from the Veteran to request any relevant private treatment or dental records, to include treatment from a Dr. C. Make at least two (2) attempts to obtain records from any identified sources. If any such records are unavailable, inform the Veteran and afford her an opportunity to submit any copies in her possession. 3. Schedule the Veteran for an appropriate VA examination for her claimed dry mouth and loss of sense of taste. The claims file and a complete copy of this REMAND must be made available to and reviewed by the examiner. The VA examination report should indicate that this has been accomplished. For any disorder present, the examiner is to opine on the following: Whether is it at least as likely as not (50 percent or better probability) that the Veteran’s dry mouth and loss of sense of taste is caused OR aggravated by medications taken for her service-connected disorders? In rendering an opinion, the examiner should consider the Veteran’s lay statements of record. A complete rationale should be provided for all opinions provided. If any requested opinion cannot be provided without resorting to speculation, court cases require the examiner to explain why the opinion cannot be offered, and state whether the inability is due to the absence of any evidence or is due to the limits of scientific or medical knowledge. 4. Schedule the Veteran for an appropriate VA examination for her claimed residuals of a menstrual disorder. The claims file and a complete copy of this REMAND must be made available to and reviewed by the examiner. The VA examination report should indicate that this has been accomplished. For any residuals present, to include her hysterectomy, the examiner is to opine on the following: Whether is it at least as likely as not (50 percent or better probability) that the Veteran’s residuals of a menstruation disorder, to include a hysterectomy, are related to her active duty service? In rendering an opinion, the examiner should consider the Veteran’s lay statements of record, and comment on service treatment records showing a pelvic ultrasound for pain, as well as documentation of dysmenorrhea, premenstrual syndrome and the use of contraceptives. A complete rationale should be provided for all opinions provided. If any requested opinion cannot be provided without resorting to speculation, court cases require the examiner to explain why the opinion cannot be offered, and state whether the inability is due to the absence of any evidence or is due to the limits of scientific or medical knowledge. 5. Readjudicate the appeal. L. M. BARNARD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A.Z., 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.