Citation Nr: 21063777 Decision Date: 10/15/21 Archive Date: 10/15/21 DOCKET NO. 15-11 394 DATE: October 15, 2021 ORDER Service connection for temporomandibular joint (TMJ) dysfunction is granted. FINDING OF FACT The Veteran's TMJ dysfunction is related to an in-service head and face injury. CONCLUSION OF LAW The criteria for have been met for service connection for temporomandibular joint dysfunction. 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 September 1987 to September 1991. This case comes before the Board of Veterans' Appeals (Board) on appeal from an October 2017 rating decision of the Department of Veteran Affairs (VA) Regional Office (RO). In October 2021, the Veteran presented testimony at a virtual Board hearing before the undersigned Veterans Law Judge (VLJ). The transcript from the hearing has not yet been associated with the claims file, as this appeal is being adjudicated under the One Touch program. The hearing transcript will still be processed and associated with the claims file in the ordinary course of business. This issue was previously before the Board in January 2019, August 2020, and February 2021, when it was remanded for further development. The development was completed, and the case has since been returned to the Board for appellate review. Duties to Notify and Assist As provided for by the Veterans Claims Assistance Act of 2000 (VCAA), the VA has a duty to notify and assist claimants in substantiating a claim for VA benefits. 38 U.S.C. §§ 5103, 5103A, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.326(a). Considering the Board's favorable decision, however, any deficiencies in VA's duties to notify and assist the Veteran with his claim decided herein are moot. Service connection- TMJ Legal Criteria Service connection may be granted for disability caused by disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. To establish service connection for a claimed disability, there must be evidence of (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship ("nexus") between the claimed in-service disease or injury and the current disability. Hickson v. West, 12 Vet. App. 247 (1999). Factual Background The Veteran filed a July 2017 claim for TMJ. The Veteran stated he was attacked by a fellow service member in November 1987. The Veteran explained he was hit in the head with a rifle and kicked in the jaw. The Veteran stated he could not open his jaw for a week. Analysis First, the Board finds there is a current disability. The Veteran has met the present disability element by submitting diagnoses of TMJ dysfunction from private clinicians dated June 2017, September 2017, and August 2018. Second, the Board finds there was an in-service injury. The November 1987 service treatment records (STRs) documented an assault. The November 1987 STR noted the Veteran was hit several times to the face and head. During the October 2021 Board hearing, the Veteran gave competent and credible testimony that he did not receive a jaw x-ray initially during service because his jaw was too swollen. The Veteran explained that while his jaw was not fractured, he continued to have locking and other symptoms since the injury in service. (Continued on the next page) Lastly, the Veteran's TMJ dysfunction is related to the in-service injury. The Veteran submitted a June 2017, September 2017, and two August 2018 private opinions. Each private clinician stated it was more likely than not the Veteran's TMJ dysfunction was related to his injuries during service. The September 2017 private provider explained an initial facial injury can cause misalignment of the of the jaw joint which is a precursor to TMJ disease. The Board affords significant probative weight to the private opinions of record. Wensch v. Principi, 15 Vet. App. 362, 367 (2001) (the Board may favor the opinion of one competent medical authority over another if it explains why it is doing so). There are several VA opinions of record. However, the November 2020 and April 2021 opinions were provided by a physician's assistant and a medical doctor, whereas the June 2017 and September 2017 private opinions were provided by the Veteran's dentist. The Veteran's dentist specializes and in jaw disorders and regularly treats the Veteran. The November 2020 and April 2021 VA examiners did not see the Veteran at all. Similarly, the July 2017 and September 2017 VA examiners only examined the Veteran one time. Both examiners noted they were dentists but did not discuss the private provider's findings. By contrast, the Veteran's private providers have treated the Veteran for several years. Accordingly, the Board finds the Veteran's current TMJ dysfunction is related to his in-service injury and service connection is granted. David Gratz Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Bruton, Cherrelle 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.