Citation Nr: 21009872 Decision Date: 02/23/21 Archive Date: 02/23/21 DOCKET NO. 13-19 068 DATE: February 23, 2021 REMANDED Issue of entitlement to service connection for an allergy disability, to include allergic rhinitis, is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1991 to August 1994. This appeal to the Board of Veterans’ Appeals (Board) arose from an August 2010 rating decision issued by the Department of Veterans Affairs (VA). See February 2011 Notice of Disagreement (NOD); April 2013 Statement of the Case (SOC); June 2013 Substantive Appeal (VA Form 9). In September 2017, the Board granted Veteran’s request to reopen the prior finally disallowed claim of entitlement to service connection for an allergy disability and remanded the underly claim of entitlement to service connection for further development. September 2017 Board decision. In August 2018, the Board denied the claim. August 2018 Board decision. The Veteran appealed the August 2018 Board decision to the Court of Appeals for Veterans Claims (CAVC) and the claim was remanded for an adequate medical opinion and further reasons and bases. February 2020 CAVC decision. In October 2020, the Board remanded the claim for further development pursuant to the February 2020 CAVC decision. October 2020 Board decision. The Agency of Original Jurisdiction (AOJ) developed the evidence and continued the denial of the Veteran’s claim. December 2020 Supplemental Statement of the Case (SSOC). The case is now back before the Board. Issue of entitlement to service connection for an allergy disability, to include allergic rhinitis, is remanded. Unfortunately, the Board cannot make a fully informed decision on the issue of entitlement to service connection for an allergy disability because further development through a VA examiner is needed. The October 2020 Board decision remanded the issue and directed that an opinion from a VA examiner be obtained for the Veteran’s allergy disability, to include his allergic rhinitis. A November 2020 VA examination medical opinion was obtained on remand, but the examiner noted that she was not asked to complete an “ENT DBQ Allergic Rhinitis/Sinusitis, etc. examination” and was not able to review all of the Veteran’s service treatment records for an ENT allergy condition. The Board finds that a remand is needed for further consideration of whether the Veteran has a current disability of allergic rhinitis that was incurred in or otherwise related to service. In addition, the Board finds that further clarification is needed about the Veteran’s asserted allergies to medications. The November 2020 VA examiner opined that the Veteran’s service treatment records show no allergy disability during service. November 2020 VA examination medical opinion. However, a review of the service treatment records show that the Veteran was prescribed Benadryl during service for “itching.” See e.g. June 1993 Service treatment record. The service treatment records also show that the Veteran denied having known allergies earlier in his period of service, but he later reported having allergies to Percocet, Darvocet, acetaminophen, and that he was taking Benadryl for “hives - itching from medication.” See May 1991 Report of Medical History; March 1994 Service treatment record. The August 2016 VA examination for hematologic and lymphatic conditions also noted that the service treatment records showed reports of allergy to medications. The Board finds that clarification is needed about whether the Veteran’s allergies to medications were incurred in or otherwise due to service. The matters are REMANDED for the following action: 1. Obtain an opinion to determine the nature and cause of any allergy disability, to include allergic rhinitis. If the examiner deems it necessary, the Veteran should be scheduled for an examination. The examiner must review the claims file. The examiner is asked to provide a response to the following: (a) Is the Veteran’s current allergic rhinitis at least as likely as not (a 50 percent or greater probability) related to service? The Board notes that the examiner should consider if the evidence supports that this allergic rhinitis was incurred in or otherwise related to service in general, as well as specifically due to the 1992 motorcycle accident, the residuals of his in-service injuries, and treatment through blood transfusions and use of medications for his injuries. The examiner should consider and discuss the Veteran’s lay testimony and assertions regarding any pertinent complaints and symptoms. A detailed explanation (rationale) is requested, including citing to supporting clinical data (and/or medical literature), as appropriate (b) Is the Veteran’s reported history of allergies to Percocet, Darvocet, acetaminophen, Naprosyn, and Latex at least as likely as not (a 50 percent or greater probability) related to service? The Board notes that the VA examiner should consider if the evidence supports that his allergy to medications was incurred in or otherwise related to service in general, as well as specifically due to his 1992 motorcycle accident, the residuals of his in-service injuries, and treatment through blood transfusions and use of medications for his injuries. The VA examiner should consider and discuss the June 1993 and March 1994 service treatment records noting that the Veteran was taking Benadryl for “itching.” The examiner should also consider and discuss the March 1994 service treatment record that shows the Veteran reported having allergies to Percocet, Darvocet, and acetaminophen while having reported no known allergies earlier during the period of service. The examiner should opine on whether this supports that Veteran’s allergy was incurred in or otherwise related to service. The examiner should also consider the “BMC Medicine” research article submitted by the Veteran about transfusion and infection, and whether it is probative here. (b) If the Veteran’s allergy disability, including allergic rhinitis, is deemed to be unrelated to service, the examiner should, if possible, identify the cause considered more likely and explained why that is so.   2. Readjudicate the appeal. R. FEINBERG Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Lin 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.