Citation Nr: 21022516 Decision Date: 04/16/21 Archive Date: 04/16/21 DOCKET NO. 17-61 143 DATE: April 16, 2021 REMANDED Entitlement to service connection for a respiratory disorder is remanded. Entitlement to service connection for a facial nerve disorder is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Marine Corps from September 1967 to November 1970. In September 2019, the Board, in pertinent part, denied service connection for a respiratory disorder and remanded service connection for a facial nerve disorder. The Veteran appealed that decision as it pertained to the respiratory disorder to the United States Court of Appeals for Veterans Claims (Court). In August 2020, the Court granted a Joint Motion for Partial Remand (JMPR) filed by representatives for both the Veteran and the VA Secretary, vacating the Board’s decision as to the denial of service connection for a respiratory disorder and remanding the claim to the Board for further proceedings consistent with the JMPR. In particular, the Court noted that the Board, in finding that the Veteran did not have a current respiratory disorder, relied on an October 2015 VA medical opinion, which found “no evidence of lung scarring or any other respiratory condition,” but did not address an April 2016 VA radiology report reflecting findings “suggestive of old granulomatous disease.” Accordingly, the Board finds that a VA examination is warranted to determine whether the Veteran has a current respiratory disorder. Regarding the Veteran’s facial nerve disorder, the Board notes that a VA examination and opinion was obtained in September 2020. However, the Board finds that an addendum opinion is needed. In this regard, the examiner did not provide a rationale for her finding as to why the Veteran’s facial pain disorder was not caused by an in-service motor vehicle accident, as he contends, other than that it did not have its onset until many years after service. Additionally, the record indicates that the Veteran’s facial nerve pain may be secondary to his service-connected peripheral neuropathy or migraines. In this regard, the Veteran has described to his physician experiencing facial pain at the same time with shooting pain in his limbs. See, e.g., January 2018 private treatment note. Private treatment notes also include descriptions of the Veteran having a burning sensation down his left cheek and seems to indicate that the Veteran experiences numbness of the cheek as a symptom of his migraines. See October 1990 private treatment note. Accordingly, further opinion is required. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination by an appropriately qualified clinician to determine the nature and etiology of any respiratory disorder. The examiner should respond to the following: (a.) Does the Veteran have a diagnosis for any respiratory disorder? If so, please identify each diagnosis. If no diagnosis is made, the examiner should comment on an April 2016 VA radiology report reflecting findings “suggestive of old granulomatous disease.” (b.) For each diagnosis, provide an opinion regarding whether the Veteran’s respiratory disorder is at least as likely as not related to his active duty service, to include in-service treatment for bronchopneumonia. The examiner should ensure that any diagnostic testing conducted, including pulmonary function testing, is reliable and adequate for purposes of identifying the Veteran’s respiratory diagnosis. If the needed opinion cannot be provided without resort to speculation, court cases require the examiner explain why the opinion cannot be offered, and state whether the inability is due to the absence of any evidence or to the limits of scientific or medical knowledge. 2. Forward the claims file to an appropriate medical professional to obtain an addendum opinion regarding the Veteran’s facial nerve pain. The claims file must be reviewed, and such review should be noted in the opinion. An additional VA examination may be provided if deemed appropriate. Specifically, the examiner should opine on the following: (a.) Is it at least as likely as not that the Veteran’s facial nerve pain disorder is related to service, to include an in-service motor vehicle accident? If not, (b.) Is it at least as likely as not that the Veteran’s facial nerve pain is caused or aggravated by his service-connected peripheral neuropathy or migraines? A complete rationale should be given for any opinion rendered. A medical opinion based solely on the absence of documentation of symptoms in the record is inadequate. If the needed opinion cannot be provided without resort to speculation, court cases require the examiner explain why the opinion cannot be offered, and state whether the inability is due to the absence of any evidence or to the limits of scientific or medical knowledge. 3. Readjudicate the appeal. L. M. BARNARD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A.Z., 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.