Citation Nr: 21062188 Decision Date: 10/06/21 Archive Date: 10/06/21 DOCKET NO. 16-35 103 DATE: October 6, 2021 REMANDED Entitlement to a compensable rating for Bell's palsy, prior to November 30, 2020, is remanded. Entitlement to a rating in excess of 10 percent for Bell's palsy, from November 30, 2020, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from July 1956 to October 1958. 1. Entitlement to a compensable rating for Bell's palsy, prior to November 30, 2020 2. Entitlement to a rating in excess of 10 percent for Bell's palsy, from November 30, 2020 By way of procedural history, the Board previously remanded the Veteran's claim for increased rating for her Bell's palsy, in a May 2021 decision, which also remanded the Veteran's claim for service connection for headaches, respiratory condition, and trigeminal neuralgia. During the development of the claims, after the last remand, the Veteran was afforded a VA examination to assess the nature and etiology of her claimed headaches and trigeminal neuralgia in a July 2021. In that examination report, the VA examiner concluded that both the Veteran's headaches and trigeminal neuralgia are related or secondary, to the Veteran's already service-connected Bell's palsy. As such, separate disability ratings for both headaches and trigeminal neuralgia were assigned. The Board, however, finds that the July 2021 VA examiner's analysis to be incomplete with specific regards to apportioning all symptomologies and manifestations to each specific and distinct service-connected disability. To this end, the Board notes that while the VA examiner comprehensively connected the etiology of these conditions to the Veteran's Bell's palsy, the examiner failed to adequately distinguish what symptomatology is caused by what condition, and/or if such distinctions can be made between these service-connected conditions. In this regard, without such finding, the Board is unable to properly assess the Veteran's claim for an increased rating for Bell's palsy without violating the VA's prohibition on pyramiding. 38 C.F.R. § 4.14. As such, remand is required for both current and retrospective opinions regarding allocating and/or differentiating, if possible, the symptomologies of all three service-connected conditions, to explicitly include Bell's palsy. The matters are REMANDED for the following action: Arrange for a review of the claims file by a VA examiner with an appropriate specialty for Bell's palsy, and/or cranial nerve diseases. The complete electronic claims file must be made available to the examiner in conjunction with the examination. The examiner should detail all findings. If the examiner first concludes that an in-person examination of the Veteran is necessary, arrange for that examination. The examiner is requested to render an opinion or opinions addressing the array of cranial nerve symptoms and/or manifestations identified during the course of the ENTIRE claims period that are/were caused by the Veteran's either the Bell's palsy and distinguishing those symptoms from those associated with her newly service-connected headaches or trigeminal neuralgia. This analysis must include retrospective findings for such disease back to 2010. If the examiner cannot allocate or separate such symptoms between the Veteran's Bell's palsy and trigeminal neuralgia, the examiner must explicitly note such conclusion and provide rationale as to why. DELYVONNE M. WHITEHEAD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Ziheng Zhu, 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.