Citation Nr: 21003421 Decision Date: 01/21/21 Archive Date: 01/21/21 DOCKET NO. 16-57 962 DATE: January 21, 2021 REMANDED Entitlement to service connection for nasal damage/nose bleeds is remanded. REASONS FOR REMAND The Veteran had active duty service with the United States Air Force from May 1991 to May 2014. For his meritorious service, the Veteran was awarded (among other decorations) the Meritorious Service Medal, the Air Medal, the Aerial Achievement Medal, and Campaign Medals from Afghanistan and Iraq. This matter comes before the Board of Veterans’ Appeals (Board) on appeal of a January 2015 rating decision. In June 2019, the Veteran testified at a Board hearing. A copy of the hearing transcript is associated with the claims file. In December 2019, the Board remanded the claim for further development. The Board had also remanded the issues of entitlement to service connection for bilateral hearing loss and for insomnia which have been granted in a November 2020 rating decision and are no longer on appeal. The Board notes that the claim for insomnia was recharacterized as a circadian rhythm sleep-wake disorder and was combined with the Veteran’s PTSD. 1. Entitlement to service connection for nasal damage/nose bleeds is remanded. The Veteran contends that he has chronic nose bleeds which began during his military service. A March 1997 Health History Questionnaire shows that the Veteran reported that he had a “bleeding nose.” The Veteran was afforded a VA examination in September 2020. The examiner diagnosed the Veteran with nasal damage/nose bleeds and mucocele cyst and noted that the Veteran reported current symptoms of nose bleeds and dry nasal passages. However, the examiner stated the Veteran’s reports of nasal damage/nose bleeds/ mucocele cyst during service were acute and that there was no evidence of chronicity of care. The Board finds the opinion to be confusing because the examiner provided a current diagnosis of nasal damage/nose bleeds/mucocele cyst but ultimately stated that the Veteran’s symptoms were subjective only and that a nexus could be provided. In light of the conflicting nature of the opinion, the Board finds that a remand is warranted for clarification. The matters are REMANDED for the following action: Forward the claims file to the September 2020 examiner (or an appropriate substitute) for an addendum opinion on the etiology of the Veteran’s claimed nasal damage/nose bleeds. If the examiner determines that the Veteran should be provided another examination, one should be scheduled. Clarify if the Veteran has a current disability manifested by current nasal damage/nose bleeds. If no such disability is identified, the examiner must indicate whether the Veteran’s reported nose bleeds and dry nasal passages causes any functional impairment. For any disability diagnosed or if it is determined that that current nose bleeds/dry nasal passages causes functional impairment, please opine as to the whether it is at least as likely as not (a 50 percent or greater probability) that such disability/functional impairment had its onset during active service or is otherwise a result of active service.. A complete rationale is required. Evan M. Deichert Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Henriquez, 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.