Citation Nr: 21075251 Decision Date: 12/20/21 Archive Date: 12/20/21 DOCKET NO. 18-18 094 DATE: December 20, 2021 REMANDED Entitlement to service connection for a sinus condition is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1977 to May 1981. Entitlement to service connection for a sinus condition is remanded. The claim must be remanded again because the medical opinion obtained in July 2021 did not substantially comply with the June 2021 remand. Stegall v. West, 11 Vet. App. 268(1998). The Veteran's representative argued that the opinion is inadequate and questioned the qualifications of the opinion provider. See November 2021 Brief. The Board agrees that the opinion is inadequate and the opinion on remand should be provided by a different examiner. The July 2021 examiner did not discuss the Veteran's January 2020 sworn testimony that he self-treated his sinus condition with OTC medication instead of seeking medical treatment specifically requested in the June 2021 remand directives. The remainder of the opinion is inadequate because although the examiner opines that sinus or rhinitis conditions are not caused by dental extractions, not rationale is provided why this is so. Therefore, on remand a new medical opinion is warranted. Barr v. Nicholson, 21 Vet. App. 303 (2007). The matters are REMANDED for the following action: Forward the copies of all pertinent records to an appropriate VA examiner (using a different examiner than the July 2021 examiner) to obtain a medical opinion on the likely etiology of any diagnosed sinus condition. If the examiner determines that an opinion cannot be provided without an examination, one should be scheduled. The examiner is asked to answer the following questions: (a) Identify all sinus related diagnoses since July 2016. (b) Did a sinus condition clearly and unmistakably (i.e., it is undebatable) preexist the Veteran's service? (b) If the answer to (a) is yes, does the evidence clearly and unmistakably show (i.e., it is undebatable) that the sinus condition was not aggravated by service or that any increase in disability was due to the natural progression of the condition? Please identify such evidence with specificity. (c) If the answer to either (a) or (b) is no, is it at least as likely as not (50 percent probability) that any currently diagnosed sinus condition was incurred in or is otherwise related to service? (d) If the answer to (c) is no, is it at least as likely as not (probability of at least 50 percent) that any sinus condition diagnosed since 2016 (is proximately due to (caused by) the Veteran's dental procedure during service (i.e., wisdom teeth extraction)? The examiner is asked to review and discuss the Veteran's January 2020 sworn testimony that he self-treated his sinus condition with OTC medication instead of seeking medical treatment. A complete rationale must be provided for all opinions. If the examiner cannot provide an opinion without resort to speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge; the examiner's own expertise, or whether additional facts are required and note what, if any, additional evidence would permit such an opinion to be made. M.E. Larkin Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. G. Perkins, 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.