Citation Nr: 21072201 Decision Date: 12/02/21 Archive Date: 12/02/21 DOCKET NO. 19-25 960 DATE: December 2, 2021 REMANDED Entitlement to service connection for a dental disability for compensation purposes is remanded. Entitlement to service connection for a dental disability for treatment purposes is remanded. INTRODUCTION The Veteran served from March to October 1970. These matters come before the Board of Veterans' Appeals (Board) on appeal from an August 2018 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In January 2020, the Board denied the Veteran's claim of entitlement to service connection for dental disability for compensation purposes. The Veteran appealed this decision to the United States Court of Appeals for Veterans Claims (Court). In April 2021, the Court issued a Memorandum Decision that vacated the January 2021 Board decision and remanded the appeal for action consistent with the findings in the Memorandum Decision. In the January 2020 decision, the Board also referred a claim of entitlement to service connection for dental disability for treatment purposes to an RO, with instructions to refer the claim to a VA Medical Center for development and consideration. REASONS FOR REMAND As discussed in the Introduction, in the January 2020 decision, the Board referred the issue of entitlement to service connection for a dental disability for VA outpatient treatment purposes. Upon further reflection, the Board erred by referring, instead of remanding this claim. See Mays v. Brown, 5 Vet. App. 302 (1993). Especially considering the absence of any development since the January 2020 decision, the Board finds it necessary to re-take jurisdiction of this claim for remand purposes, and it is remanded herein for development and consideration in the first instance by the appropriate RO and/or VA Medical Center. With respect to the claim of entitlement to service connection for a dental disability for compensation purposes, in the Court's April 2021 memorandum decision, it determined that Board failed to adequately consider the Veteran's assertion of in-service dental trauma or injury. In his February 2018 claim, the Veteran asserted that his "dental condition" was "due to injury in active service," without further elaboration. After his claim was denied in the August 2018 rating decision, the Veteran submitted an April 2019 notice of disagreement wherein he made no reference to in-service dental trauma or injury. The Veteran asserted that it was "clear that [his] teeth were extracted when [he] was in boot training." (emphasis added). The Veteran also stated five or six teeth were "removed" while in service, again without referencing in-service dental trauma or injury. In his Informal Brief to the Court, the Veteran again stated that he had six teeth "removed" during service, but he did not discuss the reason these teeth were removed or whether he experienced in-service dental trauma or injury. The Veteran's service treatment records demonstrate that several teeth were extracted, but the reason therefor is not included. However, there are aspects of the service treatment records that merit further development. Specifically, according to an April 1970 dental health record, the Veteran underwent an "initial" dental examination (as indicated by an "X" in the corresponding box). With respect to the type of examination administered, the examiner marked the number "2," and next to the applicable dental classification, the examiner marked the number "3" (again, as indicated by "Xs" in the corresponding boxes). This report does not include explanations as to significance of either a type 2 examination or a dental classification of 3. Additionally, in the August 1970 dental report, and in an attached Dental Attendance Record, there are generic representations of a person's full set of teeth, both upper and lower. On these images are various markings, including "Xs" over some teeth, darkly-shaded areas between teeth, parallel lines bisecting teeth, and small circles each of which appear to be contained within a single tooth. The significance of these markings is not provided. Moreover, according to his October 1970 discharge examination, the Veteran's "mouth and throat" were deemed clinically normal, but that the Veteran had eight "missing" teeth and two "restorable" teeth (as depicted in Section 44 of the report). In the remarks and additional dental defects and disease box of Section 44, the examiner notes "T-III," "C-II," and "Qual." Again, the significance of these abbreviations is not provided. Based on the above, the Board finds that a remand of this aspect of his claim is warranted in order to obtain from the Veteran additional details regarding the alleged in-service dental trauma and/or injury resulting in the loss of one or more teeth. Further, an appropriate examiner should be asked to determine the significance of the unexplained information in the Veteran's service dental records discussed above. The matters are REMANDED for the following action: 1. Request that the Veteran provide a statement, which as much detail as possible, as to the nature and timing of the alleged in-service dental trauma and/or injury resulting in the loss of one or more teeth. 2. Obtain an opinion from a VA examiner regarding the Veteran's claimed dental disability. The Veteran's electronic claims file must be made available to the examiner and the examiner must specify in the report that it was contemporaneously reviewed. All pertinent symptomatology and findings must be reported. The examiner is requested to explain the significance of the following items in the April 1970 dental health record and/or dental attendance record: (a) A type 2 dental examination; (b) A dental classification of 3; (c) The markings on the generic representations of a full set of teeth, specifically "Xs" over some teeth, darkly-shaded areas between teeth, parallel lines bisecting teeth, and small circles each of which appear to be contained within a single tooth. The examiner is also requested to explain the significance of the following items in Section 44 of the October 1970 discharge examination: (a) T-III; (b) C-II; and (c) Qual. Finally, the examiner asked to ascertain, if possible, the reason the Veteran underwent multiple tooth extractions during his service. In so doing, the examiner must consider and discuss the Veteran's assertions as to experiencing in-service dental trauma and/or injury. The examiner must also consider and discuss the March 1970 enlistment report of medical history that demonstrates that the Veteran was not then experiencing and did not have a history of severe tooth or gum trouble. All rendered opinions must be accompanied by a thorough rationale. 3. Develop and adjudicate the claim of entitlement to service connection for a dental disability for treatment purposes. This is not in addition to or separate from the claim referred in January 2020, but this remand is intended to ensure that the RO/VA Medical Center actually addresses this claim. 4. Inform the Veteran that to vest jurisdiction over the claim of entitlement to service connection for dental disability for treatment purposes with the Board, he must perfect an appeal. STEVEN D. REISS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Sean G. Pflugner, 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.