Citation Nr: 21006669 Decision Date: 02/04/21 Archive Date: 02/04/21 DOCKET NO. 15-06 281A DATE: February 4, 2021 REMANDED Entitlement to service connection for allergic rhinitis/chronic sinusitis is remanded. Introduction The Veteran served honorably on active duty in the United States Army during the Peacetime and Gulf War Era, from August 1986 to April 1992. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2013 Rating Decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). When this matter came before the Board previously in December 2018, it was remanded for additional development, particularly, to afford the Veteran an adequate VA medical examination. The Board observes that the additional development has been completed, and the matter returns to the Board for further appellate review. The medical evidence of record documents diagnoses and treatment for both allergic rhinitis and chronic sinusitis. As such, the Board has recharacterized the issue as stated above. Finally, while further delay is regrettable, remand for additional development in substantial compliance with the Board’s prior remand directives is necessary before the matter can be decided. See Stegall v. West, 11 Vet. App. 268, 271 (1998). REASONS FOR REMAND Entitlement to service connection for allergic rhinitis/chronic sinusitis is remanded. The Board remanded this matter for additional development, particularly, a VA medical examination in December 2018. Thereafter, the Veteran underwent a VA examination in September 2019. The examiner opined that the Veteran’s claimed condition “was less likely than not … incurred in or caused by the claimed in-service injury, event, or illness.” By way of rationale, the VA examiner reported that “[s]easonal [a]llergic [r]hinitis” was diagnosed in 2008 and, “therefore, the rhinitis condition is less likely than not incurred in/due to service.” For the following reasons, the Board finds the VA examiner’s report is not in substantial compliance with the prior remand directives and is inadequate for purposes of determining service connection. See Stegall, 11 Vet. App. at 271; Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). First, although VA medical treatment records include diagnoses of, inter alia, both allergic rhinitis and chronic sinusitis, without explanation the VA examiner only diagnosed allergic rhinitis. Next, the VA examiner failed to adequately address “the Veteran’s assertions of an in-service development of sinus difficulties and of continuous symptoms since service,” as the prior Board remand directed. The examiner briefly noted nasal congestion and runny nose “whenever season changes” and an “allergy to cats and mold;” however, the examiner did not discuss such factors as the frequency, duration, and severity of the Veteran’s symptoms or condition(s) during military service and continuing thereafter. Further, the Board finds the VA examiner’s reliance upon a diagnosis date of “2008” is, without more, not an adequate basis to support the negative nexus opinion. Finally, the VA examiner did not address the Veteran’s March 2012 written statement referenced in the Board’s prior decision and indicating “[c]ontinuous sinus problems” and having to “breathe out of [his] mouth,” which he stated “developed during Germany.” Accordingly, the matter is REMANDED for the following action: 1. Schedule the Veteran for a VA medical examination with a physician, other than Dr. J.R.P., possessing the necessary expertise to fully assess and provide an opinion regarding the nature, severity, and likely etiology of the Veteran’s allergic rhinitis/chronic sinusitis condition(s). The examiner must obtain a full history from the Veteran. It should be noted the Veteran is competent to attest to factual matters of which he has first-hand knowledge, such as observable symptomology. All pertinent symptomology, including any continuity of symptomology since military service, must be reported in detail. Based upon a review of all pertinent documents in the Veteran’s claims file, including medical records, lay statements, and the examination results, the examiner must opine as to whether it is at least as likely as not (i.e., 50 percent probability or greater) that the Veteran’s allergic rhinitis/chronic sinusitis condition(s) manifested during active duty service; or, is due to, related to, or otherwise etiologically associated with an in-service injury, event, or disease. In offering the above opinion(s), the examiner must consider and discuss as necessary all pertinent lay and medical evidence of record including, but not limited to: (a.) the Veteran’s March 2012 written statement indicating “[c]ontinuous sinus problems … [that] developed during Germany;” and (b.) VA treatment records repeatedly noting diagnoses of both allergic rhinitis and chronic sinusitis. A complete and thorough rationale for any opinion(s) expressed must be provided. T. REYNOLDS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E. Worsham, Attorney Advisor 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.