Citation Nr: 21076910 Decision Date: 12/28/21 Archive Date: 12/28/21 DOCKET NO. 18-49 975A DATE: December 28, 2021 ORDER Entitlement to service connection for 12 fractured teeth and loss of 2 teeth as residuals of in-service jaw fracture is granted. FINDING OF FACT The Veteran is shown to have residuals of his jaw fracture in 1982, to include 12 fractured teeth and loss of 2 teeth; the evidence is at least in relative equipoise as to whether such injuries are caused by his in-service fall and jaw fracture. CONCLUSION OF LAW The criteria for service connection for 12 fractured teeth and loss of 2 teeth as residuals of in-service jaw fracture, have been met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from June 1982 to October 1982 and from June 1983 to August 1983. The Board must discuss all theories of entitlement raised by the Veteran or by the evidence of record. Robinson v. Mansfield, 21 Vet. App. 545 (2008). Accordingly, the Board has recharacterized the claim as indicated above to afford the Veteran the broadest possible scope of review. See Clemons v. Shinseki, 23 Vet. App. 1, 5-6 (2009). Furthermore, the Board notes that the RO originally adjudicated the Veteran's claim as a claim for a dental condition, however the Board notes that after a thorough review of the Veteran's statements and allegations, he has claimed his current disability as a residual of his in-service traumatic jaw injury. In August 2021, the Veteran testified at a Board videoconference hearing before the undersigned Veterans Law Judge. A hearing transcript has been associated with the record. Entitlement to service connection for 12 fractured teeth and loss of 2 teeth as residuals of in-service jaw fracture is granted. The Veteran alleges that he has fractured and missing teeth as a result of an injury he sustained in service. Specifically, he contends that he during service he fell and fractured his jaw, and that his current fractured and missing teeth are residuals of such in-service trauma. Service connection may be granted for disabilities due to disease or injury incurred in or aggravated by active military service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. Service connection may also be granted for any disease initially diagnosed after discharge when the evidence establishes that disability was incurred in service. 38 C.F.R. § 3.303 (d). Service connection may be established by showing continuity of symptomatology after discharge. 38 C.F.R. § 3.303 (b). To substantiate a claim of service connection, there must be evidence of: (1) a current disability (for which service connection is sought); (2) incurrence or aggravation of a disease or injury in service; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). The determination as to whether these requirements are met is based on an analysis of all evidence of record and an evaluation of its credibility and probative value. Baldwin v. West, 13 Vet. App. 1 (1999); 38 C.F.R. § 3.303 (a). When there is an approximate balance of positive and negative evidence regarding the merits of an issue, the benefit of the doubt shall be given to the claimant. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102. If the preponderance of the evidence is against the claim, the claim is to be denied. Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990). The Veteran's service treatment records reflect that on August 24, 1982 the Veteran fell while rehearsing for graduation at Fort Dix. He sustained a fractured jaw as well as fractured and missing teeth. Such injuries were noted to be consistent with a fall after losing consciousness. Post-service treatment records reflect extensive dental treatment to include restorative treatment to include root canals, bonding, bridges, and crowns. In March 2018 the Veteran underwent a VA Dental and Oral Conditions examination with an accompanying disability benefits questionnaire. The examiner noted that the Veteran had loss of teeth, temporomandibular disorder as well as anatomical loss or injury of the mouth to include lips or tongue. Specifically, the examiner noted that the Veteran suffered anatomical loss or bony injury to the mandible, anatomical loss or bony injury leading to loss of teeth, and anatomical loss or injury to the mouth, lips, tongue, or disfiguring scars. The examiner further noted that when the Veteran fell in service, he fractured the body of his mandible and lost a tooth and that he was advised that another of his teeth was nonrestorable. Such tooth was restored but later lost. The examiner opined that the Veteran had a diagnosis of 12 fractured teeth status post fall injury and loss of 2 teeth also status post fall injury and that such were at least as likely as not incurred in or caused by the Veteran's injury in service. In August 2021 the Veteran testified at a Board hearing. He reported that his fractured and missing teeth continued to cause him problems noting that they are painful and have continued to degrade. He stated that during service he fainted and fell on his jaw. He testified that when he woke up his jaw was fractured in 3 places and that his teeth felt like "broken glass." He stated that the immediate result of his fall and jaw fracture were broken teeth and one lost tooth. However, he noted that the residuals of his trauma continued to progress resulting in an additional lost tooth and lots of required treatment. Here, the evidence is not in dispute as to whether the Veteran carries diagnoses of fractured and lost teeth, as they are well-documented. Moreover, service connection for residuals of in-service jaw fracture, to which the Veteran relates his fractured and missing teeth, have already been conceded and granted by the RO in the July 2018 rating decision. Furthermore, as previously noted, while the RO originally treated the Veteran's claim as a straight dental condition, the Board notes that the Veteran is pro-se and therefore a more detailed and nuanced reading of his claim is warranted. In addition, in the light most favorable to the Veteran, the Board has interpreted his claim as another residual of his jaw fracture. Consequently, the only remaining question to be resolved is whether the Veteran's fractured and missing teeth are medically related to his fractured jaw. Whether such a relationship exists is a medical question beyond the scope of lay observation. Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). The only relevant medical opinion in the record is that of the March 2018 VA examiner. The examiner found that the Veteran's fractured and missing teeth were incurred during or caused by the Veteran's in-service injury, specifically his fractured jaw. It is clear that the March 2018 examiner is familiar with the Veteran's medical history and current condition, particularly given the meticulous review of the record. Therefore, his opinion is highly probative evidence in this matter. In addition, absent any other evidence to the contrary or suggesting an alternative etiology for the Veteran's fractured and missing teeth, the opinion is also persuasive. Therefore, service connection for 12 fractured teeth and loss of 2 teeth as residuals of in-service jaw fracture is warranted. In summary, the Board finds the evidence is at least in relative equipoise as to whether the Veteran's 12 fractured teeth and 2 missing teeth are related to the Veteran's in-service trauma and are residuals of the Veteran's jaw fracture. Accordingly, resolving all remaining reasonable doubt in the Veteran's favor, service connection for 12 fractured teeth and loss of 2 teeth as residuals of in- service jaw fracture is warranted, and the appeal in this matter must be granted. L. M. BARNARD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Unger, 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.