Citation Nr: 21064781 Decision Date: 10/21/21 Archive Date: 10/21/21 DOCKET NO. 16-33 865 DATE: October 21, 2021 ORDER Entitlement to service connection for sinusitis is denied. FINDING OF FACT The weight of the evidence is against a finding that sinusitis originated in service or for years thereafter; and, the evidence otherwise fails to establish that the Veteran's sinusitis is etiologically related to service. CONCLUSION OF LAW The criteria for service connection for sinusitis have not been met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.201, 3.303(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Navy from September 1989 to September 1994. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 2015 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO) that denied service connection for sinusitis. The Veteran participated in a hearing before the undersigned Veterans Law Judge in May 2019. A transcript of this hearing has been associated with the record. This matter was most recently before the Board in June 2020, when, in pertinent part, it remanded the Veteran's claim for service connection in order to obtain a nexus medical opinion. A nexus medical opinion was obtained in November 2020. The Board finds that there has been substantial compliance with its June 2020 remand directives, and it will proceed to a decision. The Board additionally remanded the issue of service connection for teeth grinding. In August 2021, the Agency of Original Jurisdiction (AOJ) granted service connection for bruxism with temporomandibular disorder. The Board will not further consider this claim for service connection because the AOJ's August 2021 rating decision granted the Veteran's claim in full. See Grantham v. Brown, 114 F.3d 1156, 1158 (Fed. Cir. 1997). Entitlement to service connection for sinusitis Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military, naval, or air service. 38 U.S.C. § 11). Service connection may be granted for any disease initially diagnosed after service when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Service connection for a disability requires evidence of: (1) a current disability; (2) a disease or injury in service, and; (3) a relationship or nexus between the current disability and any injury or disease during service. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004). The Veteran contends that he has sinusitis as a direct result of his service. Service treatment records are silent for complaints, treatments, or diagnosis of sinusitis. The Veteran specifically denied having sinusitis in reports of medical history completed in July 1989, May 1992, June 1993, and August 1994. Although an in-service treatment record from June 1992 noted sinus fullness and pain, these symptoms were related to an allergy flare-up, not a sinus infection. Following the Veteran's separation from service, the Veteran filed his claim for service connection in March 2015. The Veteran complained of chronic sinus allergy symptoms that get worse when the weather changes. In March 2019, he reported symptoms including congested nose, red and puffy face, and pain on the side of his nostrils. In a June 2015 VA examination, the Veteran was diagnosed with allergic rhinitis, but not sinusitis. The Veteran underwent a VA examination in April 2020, at which time the Veteran was diagnosed with chronic sinusitis and allergic rhinitis. The April 2020 VA examiner did not provide a nexus medical opinion, so one was obtained in November 2020. The November 2020 VA examiner opined that it was less likely than not that the Veteran's chronic sinusitis was related to his active duty service. As rationale for this opinion, the examiner noted that the Veteran's June 1993 medical examination and August 1994 separation examination did not reveal a history of or physical exam findings for ongoing acute or chronic treatment of a sinusitis condition. The examiner further noted that the Veteran's June 2015 VA examination was negative for a sinusitis condition. He explained that medical record review did not reveal continuous ongoing medical treatment or aggravation of acute or chronic sinusitis condition from the time of separation from service to the present day. As a result, the examiner concluded that it was less likely than not that the Veteran's chronic sinusitis was related to his active duty service. The weight of the medical evidence, particularly the conclusion of the November 2020 examiner, is against a finding that the Veteran's sinusitis is related to his active duty service. The November 2020 examiner's opinion was offered following a full review of the medical evidence, including the April 2020 VA examination, and consideration of the Veteran's contentions. This opinion is consistent with the remainder of the evidence of record and clearly explains its conclusion. There are no competent medical opinions linking the Veteran's sinusitis to his service. To the extent that the Veteran believes that his sinusitis is related to his service, the Board notes that the Veteran is competent to provide testimony concerning factual matters of which he has first-hand knowledge and experiences through his senses. Barr v. Nicholson, 21 Vet. App. 303 (2007); Washington v. Nicholson, 19 Vet. App. 362 (2005). Further, under certain circumstances, lay statements may support a claim for service connection by supporting the occurrence of lay-observable events or the presence of disability, or symptoms of disability, susceptible of lay observation. Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). Lay persons are also competent to provide opinions on some medical issues, such as when the Veteran began experiencing readily-observable symptoms associated with sinusitis such as nasal congestion and facial pain. See Kahanav. Shinseki, 24 Vet. App. 428 (2011). However, the issue of causation of sinusitis is a medical determination outside the realm of common knowledge of a lay person. Jandreau v. Nicholson, 492 F. 3d 1372 (Fed. Cir. 2007). Thus, although the Board has carefully considered the lay contentions suggesting that the Veteran's sinusitis is related to his service, the Board ultimately affords the objective medical evidence of record, which weighs against finding such a connection, with greater probative weight than the lay opinions, because such evidence was provided by a medical professional and concerned the functioning of the Veteran's ear, nose, throat, sinuses, and respiratory system, something that is not readily perceivable by the use of a person's senses. The Board concludes that the weight of the evidence is against granting service connection for sinusitis, and the claim is denied. 38 U.S.C. § 5107(b) (2012); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). MICHAEL A. HERMAN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E. Fairlie, 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.