Citation Nr: 21061666 Decision Date: 10/04/21 Archive Date: 10/04/21 DOCKET NO. 17-32 267 DATE: October 4, 2021 ORDER Entitlement to service connection for residuals of Bell's Palsy is denied. FINDING OF FACT The preponderance of the evidence of record is against finding that the Veteran has had Bell's palsy, residual facial spasm, or nerve damage at any time during or approximate to the pendency of the claim. CONCLUSION OF LAW The criteria for service connection for Bell's Palsy are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from April 1990 to May 2000, and from December 2000 to November 2010. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a February 2011 rating decision issued by the Department of Veterans Affairs (VA) Agency of Original Jurisdiction (AOJ). This case was previously before the Board in April 2019. At that time the Board remanded the claim to the AOJ to obtain additional information. As an initial matter, in May and June 2018, the Veteran was invited to participate in the Rapid Appeals Modernization Program (RAMP) by completing the RAMP opt-in form within 60 days of the letter. The Veteran filed a completed RAMP opt-in form selecting Higher-Level Review on February 15, 2019, which is over 60 days from the initial May and June 2018 RAMP invitation letters. The Board proceeded to adjudicate the claim under the legacy claim process and remanded the above claim in April 2019 under the legacy system. Duty to Assist VA must notify the claimant of any information, including any medical or lay evidence, not previously provided to VA, that is necessary to substantiate the claim. See 38 U.S.C. § 5103 (2012); 38 C.F.R. § 3.159 (2017); see also Scott v. McDonald, 789 F.3d 1375 (Fed. Cir. 2015). VA has satisfied its duties to inform and assist the Veteran in this case. See 38 U.S.C. §§ 5103, 5103A; 38 C.F.R. § 21.1032(a). The duty to notify was satisfied by VA Veterans Claims Assistance Act correspondence dated October 2010 and November 2012. See also June 2017 Statement of the Case and April 2021 Supplemental Statement of the Case (SSOC). The RO's efforts have substantially complied with the instructions contained in the April 2019 Board remand. See Stegall v. West, 11 Vet. App. 268 (1998). The record was available to the November 2010 and April 2021 examiners, examinations were performed, and were sufficient to adequately address all potential rating criteria. Further development and further assistance by VA is not warranted. VA's duty to assist functions to assist a claimant in obtaining evidence necessary to substantiate a claim, but VA is not required to provide assistance to a claimant when there is no reasonable possibility that assistance would aid in substantiating the claim. See 38 U.S.C. § 5103A (2012). As for VA's duty to assist the Veteran, medical examinations and medical opinions have been obtained, sufficient to apply the applicable rating criteria and to make a decision on the claim. See 38 U.S.C. § 7104(d)(1); 38 C.F.R. §§ 3.385, 4.87. The Board finds that VA has done everything reasonably possible under 38 C.F.R. § 21.1032(a) to assist the Veteran. A remand or further development of this claim would serve no useful purpose. Accordingly, the Board finds that no prejudice to the Veteran will result from the adjudication of his claim in this Board decision. The Veteran has not identified any available, outstanding records that are relevant to the claim decided herein, nor is there an indication that any outstanding evidence, relevant to the claim, needs to be obtained. All pertinent due process requirements have been met. See 38 C.F.R. § 3.103 (2017). 1. Entitlement to service connection for residuals of Bell's Palsy The Veteran asserts that he has residuals of an in-service occurrence of Bell's Palsy, to include headaches and facial numbness. See November 2012 DRO Hearing Transcript. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. After review of the record, the Board concludes that, while the Veteran is shown to have an episode of acute Bell's Palsy in service, the preponderance of the evidence weighs against finding that the Veteran has a current chronic disability that began during service or is otherwise related to an in-service injury, event, or disease. The Veteran's service treatment records (STRs) show that he experienced an episode of Bell's Palsy. See September 2009 STR. The Veteran had been followed by neurology in service for several years for headaches, cervical spine and bilateral upper and lower extremities. A March 2010 STR noted previous abnormal neurology evaluations and an inconclusive muscle biopsy. The doctor noted the diagnosis that had resolved spontaneously and the Veteran was not treated or evaluated further for this condition, it was also noted that the Veteran's facial strength and sensation were intact. On examination in November 2010, the examiner found that the Bell's Palsy observed during service had resolved without residuals. The April 2019 Board found the opinion of the November 2010 examiner was inadequate as it did not consider the Veteran's claims of residuals, to include headaches and facial numbness. On remand, the Veteran was afforded an examination in April 2021. At that time the diagnosis was "bell's palsy, resolved, no residuals problem associated with the diagnosis: bell's palsy". The examiner noted that the Veteran developed "Bell's palsy which lasted only 1-2 hours on the left side of face." The examiner noted normal muscle strength testing and sensation testing. The examiner found that the condition was less likely than not due to service as the diagnosis had resolved with no objective residual. The examiner noted that the Veteran reported symptoms of a left side facial droop and numbness, that it was a onetime occurrence that resolved within 12 hours and without recurrence. The VA examiners' medical opinions are supported by the Veteran's current treatment records, which do not show that he has been diagnosed or treated for residuals of Bell's Palsy. While the Veteran is competent to report having experienced symptoms since service, he is not competent to provide a diagnosis in this case or determine that these symptoms were manifestations of Bell's Palsy since service. The issue is medically complex, as it requires knowledge of the interaction between multiple organ systems in the body. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007). Further, taken together, the two VA opinions of record establish that the Veteran does not have Bell's Palsy or residuals therefor that is at least as likely as not related to an in-service injury, event, or disease, including an acute episode of Bell's Palsy during service. Both VA examiners opined that the Veteran's Bell's Palsy in service was acute in nature and were not at least as likely as not related to any current disability. The examiners' combined opinion is probative, because they are based on an accurate medical history and provide explanations that contain clear conclusions and supporting data. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). For these reasons, the Board finds that a preponderance of the evidence is against the Veteran's claim for service connection for residuals of Bell's Palsy, and the claim must be denied. Because the preponderance of the evidence is against the claim, the benefit of the doubt doctrine is not for application. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102. MARJORIE A. AUER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Kelsey Love, Associate 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.