Citation Nr: A21019644 Decision Date: 12/09/21 Archive Date: 12/09/21 DOCKET NO. 190130-2009 DATE: December 9, 2021 ORDER Entitlement to service connection for other specified trauma related disorder is granted. Entitlement to service connection for a dental disability for compensation purposes is denied. FINDINGS OF FACT 1. The Veteran's acquired psychiatric disability, diagnosed as other specified trauma related disorder, is related to his service in Iraq. 2. The preponderance of the evidence is against finding that the Veteran had dental trauma or disease during service resulting in bone loss of the maxilla or mandible. CONCLUSIONS OF LAW 1. The criteria for service connection for other specified trauma related disorder are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria for service connection for a dental disability for the purposes of compensation have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.381, 4.150, 17.161. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Marine Corps from September 2006 to August 2011, to include service in Iraq. In an October 2014 rating decision, the Agency of Original Jurisdiction (AOJ) denied service connection for other specified trauma related disorder (claimed as posttraumatic stress disorder (PTSD)), and for a dental condition (claimed as secondary to PTSD). The Veteran disagreed with the decision and after the issuance of a March 2018 Statement of the Case (SOC), in April 2018 the Veteran requested Higher Level Review of the October 2014 rating decision. In an October 2018 Higher Level Review decision, the AOJ again denied the claims. The Veteran timely appealed the August decision to the Board of Veterans' Appeals (Board) and chose the Hearing docket. A videoconference was held in December 2019 before a Veterans Law Judge. A transcript of that hearing is of record. Therefore, the Board may only consider the evidence of record at the time of the RAMP opt-in, as well as any evidence submitted by the Veteran or his at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). The Veteran initially claimed entitlement to service connection for PTSD, but the record suggests additional psychiatric diagnoses. Thus, the Board has characterized the claim to include any acquired psychiatric disorder, to include other specified trauma related disorder. See Clemons v. Shinseki, 23 Vet. App. 1 (2009). The Veteran's June 2014 claim of service connection for dental condition encompasses the issue of entitlement to service connection for a dental disability for treatment purposes. See Mays v. Brown, 5 Vet. App. 302 (1993). See also 38 C.F.R. § 3.381. Regarding dental claims, the AOJ adjudicates claims of service connection for compensation benefits and the VA Medical Center (VAMC) adjudicates the claim for outpatient treatment. As this matter stems from an adverse determination by the RO, the appeal is limited to the issue of service connection for dental disability for the purpose of compensation. The claim of service connection for dental disability for the purpose of obtaining VA outpatient dental treatment is referred to the appropriate VAMC for adjudication. Entitlement to service connection for other specified trauma related disorder The Veteran asserts that he has PTSD that is related to his fear of hostile military or terrorist activity as a result of his service in Iraq. Alternatively, he asserts his other specified trauma related disorder is also related to his fear of hostile military or terrorist activity as a result of his service in Iraq. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110, 1131; 38 C.F.R.§ 3.303(a). Service connection may be granted for any disease diagnosed after discharge 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 PTSD requires: (1) medical evidence diagnosing PTSD; (2) credible supporting evidence that the claimed in-service stressor actually occurred; and (3) medical evidence of a link between current symptomatology and the claimed in-service stressor. 38 C.F.R. § 3.304 (f). The sufficiency of a stressor is a medical determination and is presumed by a medical diagnosis of PTSD. Cohen v. Brown, 10 Vet. App. 128 (1997). The Board concludes that the Veteran has a current acquired psychiatric disability that is related to his active duty service. 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). In the June 2014 VA PTSD Disability Benefits Questionnaire (DBQ), the examiner clearly found that the Veteran did not meet the diagnostic criteria for PTSD under either the DSM-IV or DSM-5 criteria and provided a negative nexus opinion to service, based on not meeting the diagnostic criteria. The examiner did, however, find that the Veteran had partial symptoms of PTSD, specifically difficulty feeling close to others, being numb to feelings, sleep disruption, irritability, and hypervigilance. Other specified trauma related disorder was diagnosed. The examiner found that his other specified trauma related disorder was due to his fear of hostile military or terrorist activity. In his September 2015 VA Form 9 substantive appeal, the Veteran reported he did not have a specific incident that affected him during service. He reported that he heard bullets go by his head, driven next to IEDs, and worried that every time leaving the wire he would not know would happen. Similarly, in his April 2016 statement in support of claim for service connection for PTSD, he reported that while serving in Iraq his duties included vehicle and foot patrols for base security, and he needed to be constantly on guard and vigilant. He reported that while he served in Walid, Iraq, there was a high-ranking enemy sniper in the area and that his base had been previously attacked. At the December 2019 videoconference hearing, the Veteran testified that his duties as a military police officer included base security with foot patrols, patrols around their area, and gunner patrols using a Humvee. He also testified that they performed a customs-like role on the Syria and Iraq border. He testified that they had reports of snipers in the area, and IEDs. He described that other Marine units had engaged in combat. The Veteran's representative noted that the Veteran's redeployment to come home was on April 20th and on April 22nd two Marines died at a guard gate to the base. The Veteran also testified that during his second deployment he primarily performed convoy security and was in fear of IEDs and ambushes. Upon review of the record, the Board finds the evidence is in equipoise as to whether the Veteran's current other specified trauma related disorder is related to his active duty service in Iraq. The June 2014 VA examiner specifically found that his other specified trauma related disorder was due to his fear of hostile military or terrorist activity and the Veteran testified that he had fears of terrorist activity while performing his duties as a military police officer. The Board finds that the Veteran is competent to report his experiences in service. Outside of the context of a PTSD claim, VA regulations do not specifically require the reported events to be corroborated. The Veteran's personnel records reflect he was deployed to Iraq as a military police officer. Additionally, the Board finds that the Veteran's reports of fears of enemy attacks during service are credible because they are consistent across all lay statements and medical records, and they are reasonably consistent with the conditions of his service. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for other specified trauma related disorder is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. Entitlement to service connection for a dental disability for compensation purposes The Veteran seeks service connection for a dental disability. He asserts that his dental disability is secondary to his acquired psychiatric disorder. Dental disorders are treated differently than other medical disorders in the VA benefits system. See 38 C.F.R. § 3.381. Compensation is only available for certain types of dental and oral conditions listed under 38 C.F.R. § 4.150, such as impairment of the mandible, loss of a portion of the ramus, and loss of a portion of the maxilla. Compensation is available for loss of teeth only if such loss is due to the loss of substance of the body of maxilla or mandible due to trauma or disease such as osteomyelitis, but not loss of the alveolar process as a result of periodontal disease. See 38 C.F.R. § 4.150; Simington v. West, 11 Vet. App. 41 (1998). Otherwise, a veteran may be entitled to service connection for dental conditions including treatable carious teeth, replaceable missing teeth, dental or alveolar abscesses, and periodontal disease, for the sole purpose of receiving VA outpatient dental services and treatment, if certain criteria are met. 38 U.S.C. § 1712; 38 C.F.R. §§ 3.381, 17.161. Absent a demonstration of dental trauma, service connection may be considered solely for the purpose of determining entitlement to dental examinations or outpatient dental treatment. See Woodson v. Brown, 8 Vet. App. 352 (1995). Dental treatment of teeth, even extractions, during service is not tantamount to dental "trauma." VAOPGCPREC 05-97 (January 22, 1997). The Veteran's service treatment records reflect he had dental treatment during service; however, there is no assertion that the Veteran experienced dental trauma or disease during service. In a July 2018 letter, private dentist, Dr. C.J.B. reported that he had treated the Veteran since February 1993 and that the Veteran had a very strong bite which required him to wear a night guard/deprogrammer to protect his teeth while grinding through the night. He reported that the Veteran's teeth continue to break down from grinding, clenching and GERD, and since August 2016 he has had broken teeth (#3, #4, #4, and #15). He opined that the Veteran's dental health had been affected by his service and the stress he carries after that experience. At the December 2019 videoconference hearing, the Veteran asserted that his TMJ was secondary to his psychiatric condition. Considering the pertinent evidence in light of the governing legal authority, the Board finds that the preponderance of the evidence is against the claim. As noted above, dental conditions including treatable carious teeth, replaceable missing teeth, dental or alveolar abscesses, and periodontal disease be considered service-connected solely for the purpose of establishing eligibility for outpatient dental treatment. 38 C.F.R. § 3.381. As noted elsewhere in this decision, this matter has been referred. There is no evidence, or assertion, that the claimed inservice dental trauma caused a loss of substance of the body of either the maxilla or the mandible. The criteria for service connection for a dental condition for compensation purposes have not been met. Accordingly, compensation is not warranted, and the appeal is denied. J. Kirby Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Eric Struening 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.