Citation Nr: 21021045 Decision Date: 04/09/21 Archive Date: 04/09/21 DOCKET NO. 17-46 661 DATE: April 9, 2021 REMANDED Entitlement to service connection for loss of sense of taste, to include as secondary to the service-connected postoperative submucous resection and rhinoplasty for deviated septum, is remanded. Entitlement to service connection for sleep apnea, to include as secondary to the service-connected postoperative submucous resection and rhinoplasty for deviated septum, is remanded. Entitlement to service connection for an acquired psychiatric disorder is remanded. Entitlement to a rating in excess of 10 percent for postoperative submucous resection and rhinoplasty for deviated septum is remanded. REASONS FOR REMAND The Veteran had active service from June 1953 to June 1957. He testified before the undersigned Veterans Law Judge during a June 2018 hearing. This matter is on appeal from a January 2017 rating decision. The case was remanded by the Board of Veterans’ Appeals (Board) in July 2018, and then denied in a March 2020 decision. The Veteran appealed the Board’s decision to the United States Court of Appeals for Veterans Claims (Court). In an Order dated in November 2020, the Court granted a Joint Motion for Remand (JMR) by the Veteran and VA General Counsel, which was incorporated by reference, to vacate the Board’s decision and remand the case for readjudication in accordance with the JMR. 1. Entitlement to service connection for loss of sense of taste The Board cannot make a fully-informed decision on the issue of service connection for loss of sense of taste. No VA examiner has opined whether the Veteran has a disorder manifested by loss of sense of taste; and, if so, whether it is related to service or to a servcie-connected disability. In this regard, an August 2019 examiner provided an opinion regarding the Veteran's loss of sense of smell, but did not specifically address his loss of taste as noted in the November 2020 JMR. A remand is necessary for a new VA examination. 2. Entitlement to service connection for sleep apnea The Board cannot make a fully-informed decision on the issue of service connection for sleep apnea. No VA examiner has provided an adequate opinion. In this regard, an August 2019 examiner opined that it is not caused or aggravated by the service-connected postoperative submucous resection and rhinoplasty for deviated septum. However, the opinion did not address medical records showing that the Veteran's two surgeries were unsuccessful or that his sleep apnea symptoms reportedly started after his second surgery. A remand is necessary for a new VA opinion. 3. Entitlement to service connection for an acquired psychiatric disorder. The Board cannot make a fully-informed decision on the issue of service connection for an acquired psychiatric disorder. While the Veteran was provided a VA posttraumatic stress disorder (PTSD) VA examination in August 2019, he was not provided an examination for other psychiatric disorders. A remand is necessary for a new examination. 4. Entitlement to a rating in excess of 10 percent for postoperative submucous resection and rhinoplasty for deviated septum. The Veteran was last provided a VA examination in August 2019. This examination considered his chronic sinusitis and his deviated septum. As noted in the JMR, the Veteran also has a diagnosis of rhinitis, described as one condition with his deviated septum. See August 2019 VA treatment record. A remand is necessary for a new VA examination that considers symptoms associated with rhinitis. The matters are REMANDED for the following action: 1. In accordance with the provisions of 38 C.F.R. § 3.159(c)(1), make efforts to obtain all records identified by the Veteran, including any outstanding VA treatment records. 2. Schedule the Veteran for a VA examination by an appropriate clinician to determine the etiology of his claimed loss of sense of taste. The most up-to-date Disability Benefits Questionnaire (DBQ) should be utilized. The Board requests flexibility and understanding in affording the Veteran an opportunity to report for an examination in view of the COVID-19 epidemic. For any loss of sense of taste diagnosed, the examiner is requested to review the claims file and opine whether it is at least as likely as not (a 50 percent or greater probability) that any diagnosis is related to the service or is caused or aggravated by the service-connected postoperative submucous resection and rhinoplasty for deviated septum. (If loss of sense of taste is found to have been aggravated by the service-connected postoperative submucous resection and rhinoplasty for deviated septum, the examiner should quantify the approximate degree of aggravation.) A complete rationale should be given for all opinions and conclusions expressed. 3. Obtain an addendum medical opinion from the August 2019 VA sleep apnea examiner (or, if unavailable, from a medical professional with appropriate expertise) to determine the etiology of the diagnosed sleep apnea. The examiner is requested to review the claims file and opine whether it is at least as likely as not (a 50 percent or greater probability) that sleep apnea is caused or aggravated by the service-connected postoperative submucous resection and rhinoplasty for deviated septum. (If sleep apnea is found to have been aggravated by the deviated septum disorder, the examiner should quantify the approximate degree of aggravation.) The examiner should consider the evidence suggesting that the two surgeries were unsuccessful. This evidence includes 2019 VA treatment record showing that his prior surgeries did not improve his nasal airway; June 2018 hearing testimony of the two surgeries being “messed up;” and the September 1958 VA examination showing that the Veteran reported he still could not breathe through his nose after two operations. The examiner should also consider the Veteran's assertions that his sleep apnea symptoms started after the second surgery. A complete rationale should be given for all opinions and conclusions expressed. 4. Schedule the Veteran for a VA examination by an appropriate clinician to determine the etiology of any diagnosed acquired psychiatric disorder. The most up-to-date DBQ for mental disorders other than PTSD should be utilized. The Board requests flexibility and understanding in affording the Veteran an opportunity to report for an examination in view of the COVID-19 epidemic. For any acquired psychiatric disorder diagnosed, the examiner is requested to review the claims file and opine whether it is at least as likely as not (a 50 percent or greater probability) that any diagnoses are related to the Veteran’s military service. A complete rationale should be given for all opinions and conclusions expressed. If no psychiatric disorder is diagnosed, the examiner should address the August 2018 VA treatment record showing a diagnosis of major depressive disorder during this appeal. 5. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected postoperative submucous resection and rhinoplasty for deviated septum. The most up-to-date DBQ should be utilized. The Board requests flexibility and understanding in affording the Veteran an opportunity to report for an examination in view of the COVID-19 epidemic. The examiner should provide a full description of the disability and report all signs and symptoms, including those pertaining to rhinitis, necessary for evaluating the Veteran’s disability under the rating criteria. A. C. MACKENZIE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board L. Barstow, 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.