Citation Nr: 21012085 Decision Date: 03/03/21 Archive Date: 03/03/21 DOCKET NO. 19-08 786 DATE: March 3, 2021 REMANDED Entitlement to service connection for a tooth split due to dental trauma is remanded. REASONS FOR REMAND The Veteran had active duty for training (ACDUTRA) with the Army National Guard from January 1965 to July 1965. This matter is on appeal to the Board of Veterans’ Appeals (the Board) from a September 2018 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In January 2021, the Veteran testified in a hearing before the undersigned Veterans Law Judge. A transcript of the hearing is in the evidence of record. The Board finds additional development is necessary prior to final adjudication of the service connection claim for the dental disorder on appeal. The Veteran’s service treatment records showed normal clinical findings in his October 1964 enlistment examination. His teeth were found acceptable. During his June 1965 examination releasing him to the reserves he denied severe tooth or gum trouble. The clinical examination was normal. In the Veteran’s November 2018 notice of disagreement (NOD), he reported while cutting down trees a branch hit the left front tooth causing the it to split. He was sent home to see his dentist, received a temporary cap for the tooth, and returned to training the next day. The Veteran reported that doctor was now deceased, and records were not kept after 20 years. However, he had been receiving treatment from Dr. D.G. In August 2012 and July 2014, Dr. D.G. performed crown repairs related to the tooth he injured in service. He contends the need for multiple crown repairs by Dr. D.G. were due to his dental trauma in service. During the January 2021 hearing, he testified to chronic tooth problems since the injury in service. He reported at the time of his injury no dentist was on post, therefore, arrangements were made for him to see his personal dentist. He reiterated that no records were available from this medical provider, but he has been treated by another dentist for the last 20 years. His dentist of the last 20 years has performed multiple crown replacements. The Veteran testified that he does not currently have enough tooth left to place another crown and would need a tooth implant. The only treatment records from Dr. D.G. (DDS) in the claims file are from 2018. In April 2018, decay was present at teeth number eight and 10. The decay was completely evacuated and an A3E/C4D Filtek Supreme was placed. It is not clear from this document the history or extent of the Veteran’s treatment. The initial VA Form 21-4142 provided by the Veteran only identified treatment with Dentistry at the Center in 2018. However, based on the Veteran’s testimony he has been receiving treatment for his dental trauma from this provider for the last 20 years. Therefore, on remand the RO should attempt to obtain and associate these records with the claims file. The Veteran should be provided the opportunity to complete a VA Form 21-4142 to authorize the release of information from the private medical provider(s) he identifies. The Board notes that VA is obligated to provide an examination when the record contains competent evidence that the claimant has a current disability or signs and symptoms of a current disability, the record indicates that the disability or signs and symptoms of disability may be associated with active service; and the record does not contain sufficient information to make a decision on the claim. 38 U.S.C. § 5103A(d). The threshold for finding a link between current disability and disease or injury in service is low. McLendon v. Nicholson, 20 Vet. App. 79 (2006). VA compensation is only available for certain types of dental and oral conditions listed under 38 C.F.R. § 4.150. The types of dental conditions covered are loss of teeth due to bone loss of the body of the maxilla or the mandible due to trauma or disease such as osteomyelitis, but not periodontal disease. See 38 C.F.R. §§ 4.150, Diagnostic Code (DC) 9913. Based on the current record, it remains unclear whether the Veteran is diagnosed with a dental condition for which disability compensation may be provided. After the above development, the Board finds he should be scheduled for a VA examination and opinion to determine whether the Veteran has a current dental disorder for compensation purposes that is related to service. The matters are REMANDED for the following action: 1. Provide the Veteran a VA Form 21-4142. Request that he identify all relevant non-VA health care providers including the name and address who have treated him. If the Veteran identifies a private provider, make two requests for the authorized records, unless it is clear after the first request that a second request would be futile. Obtain and associate all other outstanding VA and non-VA treatment records with the claims file. 2. Once the above development has been completed, schedule the Veteran for a VA examination of his tooth split. The claims file should be forwarded to an appropriately qualified clinician. The complete record, to include a copy of this remand and the claims folder, must be made available to and reviewed by the examiner in conjunction with the examination. The examination report must include a notation that this record review took place. (a.) The reviewing clinician is asked to opine on the following: The examiner should identify all current dental disorders. In this regard, the examiner is requested to indicate whether there is osteomyelitis or osteoradionecrosis of the maxilla or mandible; loss (or a portion thereof), nonunion, or malunion of the mandible; limited motion of temporomandibular articulation, loss of the ramus; loss of the condyloid process; loss of the coronoid process; loss (or a portion thereof) of the hard palate; loss (or a portion thereof), nonunion, or malunion of the maxilla; and/or loss of teeth due to loss of substance of the body of maxilla or mandible without loss of continuity. With regard to loss of teeth, the examiner should specifically state whether such loss is due to loss of substance of the body of the maxilla or mandible during service due to in-service trauma or disease such as osteomyelitis, and not to the loss of the alveolar process as a result of periodontal disease. (b.) If it is at least as likely as not that his tooth split had its onset in service or was otherwise etiologically related to any event or circumstance of his service. 3. After completion of the above and any additional development deemed necessary, the issue on appeal should be reviewed with consideration of all applicable laws and regulations. If any benefit sought remains denied, the Veteran and his representative should be furnished with a supplemental statement of the case and afforded the opportunity to respond. Thereafter, the case should be returned to the Board for further consideration. MICHAEL LANE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K.L. Byers 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.