Citation Nr: 21063305 Decision Date: 10/13/21 Archive Date: 10/13/21 DOCKET NO. 17-17 293A DATE: October 13, 2021 ORDER An effective date prior to March 24, 2014, for service connection for posttraumatic stress disorder (PTSD) is denied. A 100 percent rating for PTSD as of December 18, 2017, is granted. Th appeal for a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) as of December 18, 2017, is moot. Service connection for headaches is granted. Service connection for a fractured left middle finger is denied. Service connection for a traumatic brain injury (TBI) is denied. Service connection for fibromyalgia is denied. Service connection for an eye condition (claimed as floaters) is denied. Service connection for bilateral hearing loss is denied. Service connection for tinnitus is denied. Service connection for a gastrointestinal condition, including irritable bowel syndrome (IBS), is denied. Service connection for an esophageal condition, including as due to a gastrointestinal condition, is denied. Service connection for bruxism is denied. REMANDED Service connection for a respiratory condition is remanded. A TDIU prior to December 18, 2017, is remanded. FINDINGS OF FACT 1. Prior to the Veteran's March 24, 2014, claim, there was no pending formal claims, informal claims, or a written intent to file a claim for service connection for PTSD. 2. As of December 18, 2017, the Veteran's PTSD more closely approximated total occupational and social impairment. 3. As the Veteran has been granted a 100 percent schedular rating for PTSD as of December 18, 2017, the issue of TDIU as of that date is moot. 4. The Veteran's headaches are caused by his PTSD. 5. The preponderance of the evidence is against a finding that the Veteran has a fractured left middle finger, fibromyalgia, or a TBI. 6. The preponderance of the evidence is against a finding that the Veteran has an eye disability for which service connection can be granted. 7. The Veteran does not have hearing loss for VA purposes. 8. The preponderance of evidence is against finding that the Veteran's tinnitus, gastrointestinal condition, or esophagal condition is related to his active duty service, to include his service in Southwest Asia. 9. The Veteran's bruxism is a symptom or manifestation of a diagnosed disability and has not been alleged or found to have caused a separately diagnosed disability. CONCLUSIONS OF LAW 1. The criteria for an effective date prior to March 24, 2014, for the grant of service connection for PTSD are not met. 38 U.S.C. § 5110; 38 C.F.R. § 3.400. 2. As of December 18, 2017, the criteria for a 100 percent rating for PTSD are met. 38 U.S.C. § 7105; 38 C.F.R. § 3.400. 3. As of December 18, 2017, a TDIU is moot. 38 U.S.C. § 1155; 38 C.F.R. § 4.16. 4. The criteria for service connection for headaches are met. 38 U.S.C. §§ 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.310. 5. The criteria for service connection for fractured left middle finger, fibromyalgia, a TBI, an eye condition, bilateral hearing loss, tinnitus, a gastrointestinal condition, an esophagal condition, and bruxism are not met. 38 U.S.C. §§ 1131, 1137, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.309, 3.310, 3.385. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from October 1978 to October 1998. Effective Date of PTSD Generally, except as otherwise provided, the effective date of an award of compensation based on an original claim will be the day following separation from active service or the date of entitlement arose, if the claim is received within one year after separation from service; otherwise, the effective date will be the date of receipt of the claim, or the date entitlement arose, if the claim is received within one year after separation from service; otherwise, the effective date will be the date of receipt of the claim, or the date entitlement arose, whichever is later. 38 U.S.C. § 5110 (a); 38 C.F.R. § 3.400 (b)(2)(i). The Veteran has sought an earlier effective date for the grant of service connection for PTSD. VA received the Veteran's claim for PTSD on March 24, 2014. A December 2014 rating decision granted service connection for PTSD as of March 24, 2014. The Veteran has not identified any date prior to his March 14, 2014, claim for the grant of service connection. As the Veteran separated from service in 1998 and did not seek service connection for PTSD until over a year after his separation, pursuant to the governing regulations, the appropriate effective date for the grant of service connection is the date of the receipt of the claim or the date the entitlement arose, whichever is later. March 24, 2014 is the later of the possible dates for the grant of service connection for the Veteran's PTSD. After review of the file, the Board has not found or identified any earlier correspondence from the Veteran or other documentation which could be construed as a claim for PTSD. Again, neither the Veteran nor his representative have identified any date on which an effective date prior to March 24, 2014, would be appropriate for the grant of service connection for PTSD. As such, an effective date prior to March 24, 2014, for the grant of service connection for PTSD is not supported by the evidence of record. As the preponderance of the evidence is against the claim, the benefit-of-the-doubt rule is not for application, and the claim must be denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Higher Rating for PTSD Disability evaluations are determined by the application of a schedule of ratings which is based on average impairment of earning capacity. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Separate diagnostic codes identify the various disabilities. Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. Any reasonable doubt regarding the degree of disability is resolved in favor of the Veteran. 38 C.F.R. § 4.3. In this matter, the Veteran was granted service connection for PTSD as of his March 2014 claim. He was assigned a 70 percent rating prior to February 1, 2016, and a 50 percent rating thereafter. The Veteran seeks higher ratings for his PTSD. PTSD is rated under the General Rating Formula for Mental Disorders. 38 C.F.R. § 4.130, Diagnostic Code 9411. Pursuant to DC 9411, a 70 percent rating will be assigned for occupational and social impairment with deficiencies in most areas such as work, school, family relations, judgment, thinking, or mood due to symptoms such as suicidal ideation; obsessional rituals which interfere with routine activities; intermittently illogical, obscure, or irrelevant speech; near continuous panic or depression affecting the ability to function independently, appropriately and effectively; impaired impulse control (such as unprovoked irritability with periods of violence); spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a work-like setting); and an inability to establish and maintain effective relationships. A 100 percent rating will be assigned for total occupational and social impairment due to symptoms such as gross impairment in thought processes or communication, persistent delusions or hallucinations, grossly inappropriate behavior, a persistent danger of hurting himself or others, an intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene), disorientation to time or place, and memory loss for names of close relatives, own occupation, or own name. The use of the term 'such as' in 38 C.F.R. § 4.130 demonstrates that the symptoms after that phrase are not intended to constitute an exhaustive list, but rather are to serve as examples of the type and degree of the symptoms, or their effects, that would justify a particular rating. Mauerhan v. Principi, 16 Vet. App. 436 (2002). Accordingly, the evidence considered in determining the level of impairment under § 4.130 is not restricted to the symptoms provided in the Diagnostic Code. VA must consider all symptoms of a claimant's condition that affect the level of occupational and social impairment, including, if applicable, those identified in the American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders. In this matter, the Board does not find that prior to December 18, 2017, the Veteran's PTSD warrants higher rating than those assigned. Prior to February 1, 2016, the Veteran's PTSD was assigned a 70 percent rating. A December 2014 VA examination regarding the Veteran's PTSD found that the Veteran's PTSD caused occupational and social impairment with occasional decrease in work efficiency. His reported PTSD symptoms were depressed mood, anxiety, suspiciousness, near-continuous panic or depression, chronic sleep impairment, mild memory loss, disturbances of motivation and mood, difficulty in establishing and maintaining effective work and social relationships, difficulty in adapting to stressful circumstances, including work or a worklike setting, suicidal ideation, obsessional rituals, and neglect of personal appearance and hygiene. Based on this examination, the Veteran was assigned a 70 percent rating. The Board finds that this rating is appropriate. A 100 percent rating contemplates total impairment evidenced by delusions, hallucinations, grossly inappropriate behavior, danger or hurting himself or others, intermittent inability to perform activities of daily living (including maintenance of minimal personal hygiene), disorientation to time or place, and memory loss for names of close relatives, own occupation, or own name. None of these symptoms were identified by the Veteran or diagnosed during his PTSD examination. Additionally, VA medical records do not establish or indicate that the Veteran was endorsing or reporting any of the symptoms associated with a 100 percent rating. See December 2014, February 2015, and March 2015 VA medical records. Furthermore, the Veteran and his representative have not identified any medical records which support a 100 percent rating prior to February 1, 2016. As such a rating higher than 70 percent prior to February 1, 2016, is denied. The Board has considered the lay statements of evidence and has concluded that the medical evidence, prepared by skilled professionals, is more probative regarding the Veteran's degree of disability. As of February 1, 2016, the Veteran's PTSD was assigned a 50 percent rating due to symptoms of depressed mood, anxiety, suspiciousness, chronic sleep impairment, mild memory loss, and difficulty adapting to stressful circumstances. See March 2015 VA examination. A July 2016 VA examination found that the Veteran's PTSD caused symptoms of depressed mood, anxiety, suspiciousness, panic attacks more than once a week, chronic sleep impairment, mild memory loss, difficulty in establishing/maintaining effective work and social relationships, and difficulty adapting to stressful circumstances. The veteran did not endorse symptoms more closely associated with a 70 percent rating, including spatial disorientation, neglect of personal hygiene, an inability to establish and maintain effective relationships, obsessional rituals, suicidal ideation, intermittently illogical, obscure, or irrelevant speech, or near continuous panic or depression affecting the ability to function independently, appropriately, and effectively. Though the Veteran did report previous thoughts of self-harm, he associated those thoughts to trouble with a neighbor and not his PTSD. The Veteran's March 2015 VA medical records did not indicate that the overall picture of the Veteran's PTSD was more captured by a 70 percent or higher rating as he did not endorse symptoms of suicidal ideation, spatial disorientation, neglect of personal hygiene, an inability to establish and maintain effective relationships, obsessional rituals, suicidal ideation, intermittently illogical, obscure, or irrelevant speech, or near continuous panic or depression affecting the ability to function independently, appropriately and effectively. He also did not endorse any symptoms associated with a 100 percent rating. As such, the Board finds that the evidence of record does not support a rating higher than 50 percent as of February 1, 2016. The Board has again considered the lay statements of evidence and has concluded that the medical evidence, prepared by skilled professionals, is more probative regarding the Veteran's degree of disability. However, in December 2017, the Veteran submitted a private PTSD evaluation which reported that his PTSD caused total social and occupational impairment. See October 2017 private psychological examination and report. The private examiner reported the Veteran endorsed symptoms of social and relationship problems, isolation, anxiousness, irritation around people, avoidance, hypervigilance, daily panic attacks, chronic sleep impairment unprovoked irritability with verbal aggression, suicidal ideation, persistent delusional thoughts, neglect of personal hygiene, low appetite, and intermittent inability to perform activities of daily living. There are no medical records or other evidence of record which contradicts the private report submitted by the Veteran. Additionally, the Veteran's wife submitted a statement regarding the impact that the Veteran's PTSD symptoms caused. See December 2017 lay statement. Based on this evidence, the Board finds that the Veteran's PTSD warrants a 100 percent rating as of VA's December 18, 2017, receipt of the aforementioned evidence. In sum, a rating higher than 70 percent prior to February 1, 2016, and higher than 50 percent prior to December 18, 2017, for PTSD is denied. As the preponderance of the evidence is against these claims, the benefit-of-the-doubt rule is not for application, and the claim must be denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). A 100 percent rating for PTSD as of December 18, 2017, is granted. TDIU as of December 18, 2017 TDIU may be assigned where the schedular rating is less than total, when it is found that the disabled person is unable to secure or follow a substantially gainful occupation because of a single service-connected disability ratable at 60 percent or more, or because of two or more disabilities, provided at least one disability is ratable at 40 percent or more, and there is sufficient additional service-connected disability to bring the combined rating to 70 percent or more. 38 C.F.R. §§ 3.340, 3.341, 4.16(a). A 100 percent rating under the Schedule for Rating Disabilities means that a Veteran is totally disabled. Holland v. Brown, 6 Vet. App. 443, 446 (1994). If VA has found a veteran to be totally disabled as a result of a particular service-connected disability or combination of disabilities pursuant to the rating schedule, there is no need, and no authority, to otherwise rate that veteran totally disabled on any other basis. Herlehy v. Principi, 15 Vet. App. 33, 35 (2001). Thus, the Veteran's claim for a TDIU as of December 18, 2017, is moot as he has been awarded a 100 percent schedular rating as of that date. A TDIU prior to December 18, 2017, has been remanded and is addressed in this Decision, below. Service Connection Service connection requires competent evidence showing: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004); see also Caluza v. Brown, 7 Vet. App. 498 (1995). The determination as to whether these requirements are met is based on an analysis of all the evidence of record and the evaluation of its credibility and probative value. Baldwin v. West, 13 Vet. App. 1 (1999); 38 C.F.R. § 3.303(a). Service connection may also be granted for a disability that is proximately due to, or aggravated by, service-connected disease or injury. 38 C.F.R. § 3.310. Under certain circumstances, service connection may be granted on a presumptive basis for a Persian Gulf veteran who exhibits objective indications of a qualifying chronic disability. A qualifying chronic disability for VA purposes is a disability resulting from any combination of the following: (1) an undiagnosed illness; or (2) a diagnosed, medically unexplained chronic multi-symptom illness. 38 C.F.R. § 3.317. Medically unexplained chronic multi-symptom illnesses are defined by a cluster of signs or symptoms, such as: chronic fatigue syndrome, fibromyalgia, or functional gastrointestinal disorders. 38 C.F.R. § 3.317. Headaches The Veteran sought service connection for headaches in March 2014. In December 2017, the Veteran submitted a private medical examination which noted the Veteran's treatment for headaches while in-service and his current diagnosis of a tension headache disorder. The examiner also found that the Veteran's headaches were precipitated and aggravated by his service connected PTSD. The Veteran's wife also submitted a statement which reported the impact her husband's PTSD has upon his headaches. See December 2017 lay statement. There is no evidence of record which contradicts the December 2017 private examiner's report, specifically linking the Veteran's headaches to his PTSD. As such and resolving all reasonable doubt in favor of the Veteran, service connection for headaches is granted. Fractured Left Middle Finger Fibromyalgia TBI 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 the Veteran does not have a current diagnosis of fractured left middle finger, fibromyalgia, or a TBI and has not had one at any time during the pendency of the claims or recent to the filing of the claims. Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). The Veteran's service treatment records (STRs) that that he did not have treatment or diagnosis of a fractured left middle finger, fibromyalgia, or a TBI. While the Veteran did suffer a burn on his left middle finger in 1991 and a mild concussion after a motor vehicle accident in 1985, he was not diagnosed with a fractured finger or a TBI. Furthermore, VA examinations and the Veteran's own private examination specifically found he did not have a TBI or have been diagnosed with a TBI. See December 2014, February 2016, July 2016, and October 2017 examination reports. Additionally, multiple VA examinations regarding fibromyalgia found that the Veteran did not have fibromyalgia. See January 2014, November 2014, and April 2015 VA examinations. Thus, there is no evidence of record which showed that the Veteran has a diagnosed disorder or disability of fractured left middle finger, fibromyalgia, or a TBI. Indeed, neither the Veteran nor his representative have identified any record which diagnoses the claimed conditions or contradicts the medical evidence which found that the Veteran had no diagnosis of a TBI or fibromyalgia. The Board recognizes that pain alone can constitute a disability for VA purposes when such pain amounts to functional impairment of earning capacity, however, the evidence of record does not show that any of the claimed conditions is a disability which has been found to cause functional impairment of earning capacity. Saunders v. Wilkie, 886 F.3d 1356, 1368 (Fed. Cir. 2018). While the April 2015 VA examination reported that the Veteran indicated he had functional limitations, the examination noted that the limitations listed were related to the Veteran's diagnosed disabilities, including his service connected PTSD and other non-service connected conditions. Thus, there is no evidence which indicated that any of the Veteran's reported pain symptoms which he related to fibromyalgia caused independent functional limitations. The Board acknowledges the Veteran's statements regarding his symptoms and that the Veteran has complaints of joint/body pain, specifically including December 2013 lay statements. However, the Veteran is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education. Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377, n.4 (Fed. Cir. 2007). The Board gives more probative weight to the competent medical evidence which includes medical records and VA examination reports which show no diagnosis of a fractured left middle finger, fibromyalgia, or a TBI. Therefore, the preponderance of the evidence is against the granting of service connection for a fractured left middle finger, fibromyalgia, or a TBI. As the preponderance of the evidence is against the claims, the benefit-of-the-doubt rule is not for application, and the claims must be denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Eye Condition The Veteran sought service connection for an eye condition claimed as a "floater." See March 2014 statement in support of claim. However, a review of the record does not indicate that the Veteran has a diagnosed eye disability which is appropriate for service connection. Medical records of evidence, including the Veteran's STRs, private medical treatment, and VA medical records do not show complaint of or treatment for a floater or any other service connectable eye condition. An October 2015 VA medical record showed the Veteran had been diagnosed with myopia, astigmatism, and presbyopia. No other records indicate that the Veteran has any other diagnosed eye condition. See April 2015 SSA report and July 2015, and May 2016 VA record. The Veteran specifically denied eye conditions in a February 2015 VA medical record, including floaters. While the Veteran has impaired vision, this condition is not a service connectable disability. See 38 C.F.R. §§ 3.303 (c), 4.9. VA regulations specifically prohibit service connection for refractory errors of the eyes unless such defect was subjected to a superimposed disease or injury creating additional disability. See VAOPGCPREC 82-90, 55 Fed. Reg. 45711 (1990). Here, no such superimposed disability has been claimed or is found in the evidence of record. Additionally, neither the Veteran nor his representative have provided any evidence or information regarding any disability of the Veteran's eye. As such, the Board finds that the evidence of record establishes that the Veteran does not have an eye condition for which service connection can be granted. As the preponderance of the evidence is against the claim, the benefit-of-the-doubt rule is not for application, and the claim must be denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Bilateral Hearing Loss Tinnitus For the purposes of applying the laws administered by VA, impaired hearing will be considered to be a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, 4000 Hertz is 40 decibels or greater; or when the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, 4000 Hertz are 26 decibels or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385. The Veteran underwent a VA examination regarding his claim for hearing loss in November 2014. The findings indicated that the Veteran's hearing did not meet the criteria for hearing loss for VA purposes. There is no evidence in the file which contradicts these findings, and the Veteran has not introduced any evidence which supports that he has hearing loss for VA purposes. As such, there is no basis upon which to grant service connection for hearing loss and the claim must be denied. Similarly, in the November 2014 VA examination, the examiner found that the Veteran's reported tinnitus was not related to his active duty service. Despite the Veteran indicating that his tinnitus began in service, there are no records which indicate the Veteran had any hearing shift or any report of tinnitus while in-service. The Veteran and his representative have not identified any evidence which indicated that the Veteran's tinnitus was related to his active duty service or contradicts the findings of the November 2014 examiner. As such, the Board finds that the preponderance of the evidence is against the claim. The Veteran, while credible in his relation of his perceived hearing loss and reports of tinnitus, has not been shown to possess the requisite training or credentials needed to render a competent opinion as to medical diagnosis or causation. King v. Shinseki, 700 F.3d 1339, 1345 (Fed. Cir. 2012). The Board has concluded that the medical evidence, prepared by skilled professionals, is more probative regarding the etiology of Veteran the Veteran's tinnitus. As the preponderance of the evidence is against the claim, the benefit-of-the-doubt rule is not for application, and the claims must be denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Gastrointestinal Condition Esophageal Condition The Veteran sought service connection for a gastrointestinal condition/IBS and an esophageal condition as due to his stomach condition. There is no evidence of record which supports finding that the Veteran's conditions are related to his active duty service, to include his service in Southwest Asia. The medical records of evidence do not show that the Veteran has been diagnosed or treated for IBS. He has reported a history of diarrhea and has a diagnosis of diverticulitis. See November 2014 and April 2014 VA record. He does report a history of gastroesophageal reflux disease (GERD) dating back to 1989. See SSA April 2015 medical report. The Veteran's STRs show one episode of reported diarrhea with cramping in February 1991. There are no records which indicate or show that the Veteran was diagnosed with IBS, GERD, or any other stomach or esophageal condition during his service. A February 2012 private medical record showed the Veteran complained of abdominal cramping which he stated had been an intermittent pattern for the past 3 weeks. He reported the pain was crampy and the Veteran reported the pain "comes and goes only when he drinks." He denied diarrhea, nausea, or vomiting. The Veteran did not relate his pain to his active duty service or indicate that he had a history of abdominal pain or symptoms. The Veteran was not diagnosed with IBS or GERD or any stomach or esophageal condition. See February 2012 private record. VA examinations show the Veteran has a diagnosis of GERD. See November 2014 VA examination. But, examinations do not indicate that the Veteran has a diagnosis of IBS. See November 2014 examination. VA medical records show that the Veteran has treated for diarrhea alternating with constipation, but also denied diarrhea. See February 2015, June 2015, December 2015 VA medical records. Overall, while the Veteran has reported both diarrhea and GERD, and has a diagnosis of diverticulitis, there is no evidence of record linking those conditions to his active duty service. VA examinations did not find that the Veteran's conditions were linked to his service, including his service in Southwest Asia. See January 2014 and November 2014 VA examinations. The Veteran has not identified or introduced any evidence which contradicts the VA examinations of record. As such, there is no evidence upon which service connection could be granted, as there is no evidence linking the Veteran's claimed gastrointestinal condition or his GERD to his active duty service. Furthermore, as his gastrointestinal condition has not been liked to his service and is not service connected, service connection for GERD on a secondary basis as due to gastrointestinal conditions is not applicable. Though the Veteran has credible reports of his gastrointestinal condition and GERD symptoms and the Board has considered the lay statements of evidence, specifically including the December 2013 statements, he has not been shown to possess the requisite training or credentials needed to render a competent opinion as to medical diagnosis or causation. King v. Shinseki, 700 F.3d 1339, 1345 (Fed.Cir.2012). The Board has concluded that the medical evidence, prepared by skilled professionals, is more probative regarding the etiology of the Veteran's claimed conditions. As the preponderance of the evidence is against the claims, the benefit-of-the-doubt rule is not for application, and the claims must be denied. See 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Bruxism Bruxism is defined as "involuntary, nonfunctional, rhythmic or spasmodic gnashing, grinding, and clenching of teeth (not including chewing movements of the mandible), usually during sleep, sometimes leading to occlusal trauma. Causes may be related to repressed aggression, emotional tension, anger, fear, and frustration." See Dorland's Illustrated Medical Dictionary 260 (32nd ed. 2012). Bruxism is not itself a disability. Bruxism is a symptom or manifestation of a diagnosed disability. Indeed, a December 2014 VA medical record showed the Veteran's bruxism was found to be a symptom of his service connected PTSD. Bruxism, as a symptom of a disability, must result in a separate disability, as defined under 38 C.F.R. § 4.150. The Veteran has not identified any disability caused by his bruxism or indicated that his bruxism has caused a disability. Further, the medical evidence of record does not indicate that any separate disability has been caused by the Veteran's bruxism. There is no dispute as to any pertinent fact. The dispute is a legal one. The Board finds that, as a matter of law, there is no entitlement to service connection for bruxism. There are no compensable disabilities alleged to have been caused by bruxism shown or alleged here. Therefore, as a matter of law service connection is not warranted. See Sabonis v. Brown, 6 Vet. App. 426, 430 (1994) (where the law is dispositive, the claim must be denied due to a lack of legal merit). REASONS FOR REMAND Respiratory Condition The Veteran sought service connection for a respiratory condition, including as due to his service in Southwest Asia. The Veteran's STRs show he was diagnosed multiple times with upper respiratory infection during service. While VA examinations regarding Gulf War Illness were performed, an examination which addresses the etiology of the Veteran's diagnosed respiratory conditions and the possible direct link to his service has not been performed. Remand is necessary to obtain such an examination. TDIU prior to December 18, 2017 With respect to the Veteran's claim of entitlement to a TDIU prior to the grant of 100 percent rating for his PTSD as of December 18, 2017, the claim is inextricably intertwined with the above grant of service connection for headaches contained in the Decision herein and the above remand of the claim for service connection for a respiratory condition as the issue of TDIU prior to December 18, 2017, may be affected by the assignment of the disability rating and effective date for the grant of service connection. The appropriate remedy where a pending claim is inextricably intertwined with a claim currently on appeal is to remand the claim on appeal pending the adjudication of the inextricably intertwined claim. Harris v. Derwinski, 1 Vet. App. 180, 183 (1991). The matters are REMANDED for the following action: 1. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of his diagnosed respiratory condition. The claims file should be made available to the examiner for review. The examiner must opine whether it is at least as likely as not (50 percent or greater probability) that any diagnosed respiratory condition was incurred in, or due to, the Veteran's service. The examiner is specifically asked to note the Veteran's STRs which document in-service diagnoses of upper respiratory infection. The Veteran's lay statements regarding onset and continuity of symptomology should be recorded and considered. A rationale for all opinions must be provided. 2. Thereafter, after the above directives have been completed and appropriate action has been taken on the remanded claims, after a disability rating and effective date for the grant of service connection for headaches contained in this Decision has been assigned, and completing any other development necessary, readjudicate the claim of entitlement to a TDIU prior to December 18, 2017, considering all pertinent evidence and legal authority. JOHN Z. JONES Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Parrish, 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.