Citation Nr: 21015987 Decision Date: 03/18/21 Archive Date: 03/18/21 DOCKET NO. 19-08 717A DATE: March 18, 2021 REMANDED Entitlement to service connection for vertigo, to include as secondary to service-connected disabilities, is remanded. Entitlement to service connection for a jaw disorder, to include as secondary to service-connected disabilities, is remanded. REASONS FOR REMAND The Veteran had active service in the United States Army from March 1951 to March 1953. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a February 2018 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge (VLJ) at a Board videoconference hearing in October 2019; a transcript is of record. These matters were subsequently remanded by the Board for additional development in December 2019. 1. Entitlement to service connection for vertigo, to include as secondary to service-connected disabilities, is remanded. The Veteran asserts service connection for vertigo, to include as secondary to his service-connected disabilities. The Veteran underwent an examination in January 2020. The examiner reported that the Veteran did not have a current diagnosis for his vertigo. She further stated that the treatment records were silent for any specific vertigo or similar disorder. However, the examiner did not discuss the December 2017 examination which documented vertigo and the Veteran’s assertions that he has had vertigo for years and the symptoms were worsening. See 2/7/2018, C&P Examination – Vertigo. As such, the Board finds that an addendum opinion/examination is warranted to discuss the documented vertigo from 2017. 2. Entitlement to service connection for a jaw disorder, to include as secondary to service-connected disabilities, is remanded. The Veteran asserts service connection for a jaw disorder, to include as secondary to his service-connected disabilities. His medical records indicate that he has a current diagnosis of osteoarthrosis of his temporal mandibular joint. See 2/21/2018, CAPRI – TMJ, at p. 1. As such, the first element of service connection is met. An October 2020 examiner provided a negative nexus for the Veteran’s jaw disorder. The examiner stated that the Veteran’s service-connected disabilities would not cause or permanently aggravate degenerative joint disease of the temporomandibular joint. However, in this regard, the examiner did not address the Veteran’s contentions that his service-connected disabilities cause him to grind his teeth which he asserts has caused his TMJ degenerative joint disease. See 10/4/2019, Hearing Transcript. These matters are REMANDED for the following actions: 1. Obtain any outstanding VA treatment records. All requests and responses for the records must be documented. If any identified records cannot be obtained, notify the Veteran of the missing records, the efforts taken, and any further efforts that will be made by VA to obtain such evidence, and allow him an opportunity to provide the missing records. 2. After associating any treatment records with the claims file, obtain an addendum opinion or schedule the Veteran for an appropriate examination if necessary, to determine the etiology of the Veteran’s vertigo. The claims file is to be made available to the examiner and reviewed in conjunction with the examination. Then, identify any vertigo or related disorders during the period on appeal (November 2017 onward). If the examiner disagrees with any prior diagnosis (e.g., December 2017 examination reporting vertigo) he/she MUST clearly explain why. See 2/7/2018, C&P Examination – Vertigo. Then, address: (a.) It is at least as likely as not (50 percent or greater probability) that his disability was caused by a disease or injury in service. (b.) If no, is it at least as likely as not (50 percent or greater probability) that any disability was either 1) proximately due to OR 2) aggravated by any service-connected disability? 3. After associating any treatment records with the claims file, then obtain an addendum opinion or schedule the Veteran for an appropriate examination if necessary, to determine the etiology of the Veteran’s jaw disorder (osteoarthritis). The claims file is to be made available to the examiner and reviewed in conjunction with the examination. Then, address whether: (a.) It is at least as likely as not (50 percent or greater probability) that his jaw disorder was caused by a disease or injury in service. (b.) If no, is it at least as likely as not (50 percent or greater probability) that any disability was either 1) proximately due to OR 2) aggravated by any service-connected disability? **Please review and address the Veteran’s contentions that his service-connected disabilities cause him to grind his teeth which he asserts has caused his jaw disorder.** See 10/4/2019, Hearing Transcript. The term “aggravated” refers to a worsening of the underlying condition beyond the natural progression of the disease, as opposed to temporary or intermittent flare-ups or symptoms that resolve with return to the baseline level of disability. If aggravation is found, please state, to the extent possible, the baseline level of disability prior to aggravation. Inform each examiner that a comprehensive rationale for all opinions must be provided. All pertinent evidence, including both lay and medical, should be considered. (Continued on the next page)   If an opinion cannot be provided without resorting to speculation, the examiner must explain why this is so and state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), the record (additional facts are required), or the examiner (does not have the knowledge or training). Paul Sorisio Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board G. Morales, Associate 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.