Citation Nr: 21072024 Decision Date: 12/02/21 Archive Date: 12/02/21 DOCKET NO. 15-11 757 DATE: December 2, 2021 ORDER Entitlement to service connection for osteoporosis disease is granted. FINDING OF FACT The Veteran's osteoarthritis disease is related to in-service exposure to ionizing radiation and/or receiving steroid injections. CONCLUSION OF LAW The criteria for service connection for osteoporosis disease are met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from December 1982 to September 1996. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a An August 2012 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). The Board remanded the issue for further development in May 2021. The matter has been returned to the Board for appellate review. The Veteran testified at a January 2021 hearing before the undersigned Veterans Law Judge. A copy of the transcript is associated with the evidence of record. The Board notes that the issue has been previously considered as service connection for osteoporosis, to include in the Board's prior remand. In the inexplicable supplemental statement of the case dated October 2021, the DROC-DC broke out the issue into three different issues, indicating the thoracic spine and bilateral feet. The Board reiterates that this is a complete grant of the benefits sought on appeal and the Veteran should be rated accordingly. Entitlement to service connection for osteoporosis disease is granted. The Veteran asserts he is entitled to service connection for osteoporosis, to include as due to exposure to ionizing radiation and/or receiving steroid injections. The Board concludes that the Veteran has current osteoporosis disease that is related to in-service injury or disease. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). After the Veteran injured his back in a work-related accident in 2011, he was diagnosed with osteoarthritis by magnetic resonance imaging (MRI) and a bone density scan. The Veteran's in-service exposure to ionizing radiation has been conceded. See July 2018 Radiation Exposure Compensation Act Memorandum. The Veteran's service treatment records document his having received four steroid shots, however, the Veteran testified that he received approximately 25 to 29 shots for his service-connected headaches. See January 2021 Hearing Testimony. The Board finds the Veteran credible, and it is plausible that the medical corpsman administering the shots did not always record such. The Veteran asserts that he began losing bone mass in his teeth beginning in at least 1995 (following treatment for a root canal and infection) and possibly as early as 1992 (when a tooth broke off) and that he asserts that these were signs and symptoms of osteoporosis. The Veteran's service treatment records document these events. The remaining question is whether the Veteran's current osteoporosis is related to his service. On this question there are probative opinions in favor of and against the claim, however there is only one competent opinion of record pertaining to the dental evidence of record. Pursuant to the May 2021 Board Remand, the Veteran had an Oral and Dental Conditions examination in September 2021. The examiner conducted an examination of the Veteran via video telehealth and reviewed the Veteran's records. The examiner opined that the claimed condition is at least as likely as not incurred in or caused by the claimed in-service injury, event or illness. As rationale, the examiner stated that steroids have major effects on the way the body uses calcium and Vitamin D to build bones and that steroids can lead to bone loss, osteoporosis and broken bones. The examiner also stated that radiation therapy, which is an integral part of cancer treatment, may have major side effects including aberrant bone remodeling and bone loss. (Continued on the next page) The AOJ asked the examiner to review the record and reconsider the opinion. See October 2021 Examination Request. In an October 2021 addendum opinion, the examiner once again opined that the Veteran's osteoporosis is at least as likely as not due to both steroid injections and ionizing radiation exposure. The Board affords these medical opinions high probative value, as the examiner had access to the claims folder and provided an opinion with through and detailed supporting rationale, then reviewed the evidence again, reconsidered the evidence, and provided the same opinion. See Prejean v. West, 13 Vet. App. 444, 448-9 (2000). Accordingly, service connection for osteoporosis is granted. Jennifer White Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Susan Leary 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.