Citation Nr: 21023007 Decision Date: 04/19/21 Archive Date: 04/19/21 DOCKET NO. 16-52 612 DATE: April 19, 2021 REMANDED Entitlement to service connection for mercury poisoning from dental fillings (Amalgam), to include neurological disorders or residuals, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from March 1986 to March 1989. The Veteran filed a claim for residuals of mercury poisoning due to leaking dental fillings (amalgam). In May 2019, the Veteran submitted a private treatment letter stating that mercury fillings possibly cause neurological disorders or residuals. The evidence of record shows that the Veteran is asserting residuals from mercury in dental fillings, leaking or intact. When a claimant makes a claim, he is seeking service connection for symptoms regardless of how those symptoms are diagnosed or labeled. See Clemons v. Shinseki, 23 Vet. App. 1 (2009). Therefore, the Board will recharacterize the Veteran’s claim for residuals of mercury poisoning pursuant to Clemons, as one for entitlement to service connection for mercury poisoning from dental fillings (Amalgam), to include neurological disorders or residuals. In the October 2016 substantive appeal, the Veteran requested a Board hearing. In a November 2016 hearing request, the Veteran withdrew his request for a Board hearing. In November 2019, the Veteran again requested a Board hearing. In a January 2020 Board of Veterans’ Appeals (BVA) general letter, the Board informed the Veteran that he must submit a motion demonstrating good cause for the delayed request pursuant to 38 C.F.R. § 20.1305. In a January 2020 hearing request, the Veteran specifically requested a video conference hearing; however, he did not provide any explanation for the delayed request for a hearing. As good cause has not been shown pursuant to 38 C.F.R. § 20. 1305(b)(1), the request for a personal hearing before the Board is denied, and the Board will proceed with adjudication of the appeal. This issue was remanded by the Board in December 2018 and April 2019 decisions for further development. The issue has since returned to the Board for appellate review. Entitlement to service connection for mercury poisoning from dental fillings (Amalgam), to include neurological disorders or residuals, is remanded. Remand is necessary to obtain an addendum VA opinion, or a new VA examination if necessary. When VA undertakes to obtain an opinion, it must ensure that the opinion is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). A medical opinion is considered adequate “where it is based on consideration of the veteran’s prior medical history and examinations and also describes the disability, if any, in sufficient detail so that the Board’s evaluation of the claimed disability will be a fully informed one.” Stefl v. Nicholson, 21 Vet. App. 120, 123 (2007). Here, the August 2019 examiner opined that the Veteran’s alleged mercury poisoning from in-service dental fillings is less likely than not caused by service. The examiner reasoned that the Veteran’s amalgam fillings were placed while he was in service and on examination, there is no indication that the amalgam fillings were leaking, which could have caused mercury poisoning. Unfortunately, the examiner did not address the May 2019 private treatment opinion from Dr. R.P.M. stating that it is plausible that the Veteran’s current neurological disorder or undiagnosed form of neuropathy is related to the effects of having mercury dental fillings placed in 1988. The medical provider also stated that mercury fillings have been known to develop neurological disorders. Further, the examiner did not address the medical literature submitted by the Veteran in June 2016 and October 2016. Therefore, a remand is required to obtain an addendum VA opinion, or to provide an additional VA examination if found necessary, to address the above-identified evidence. The matters are REMANDED for the following action: Obtain an addendum opinion, and if necessary, an additional VA examination, from an appropriate clinician to determine the nature and etiology of the Veteran’s symptoms or resulting disorders from mercury dental fillings, to include neurological disorders. The examiner must opine whether it is at least as likely as not that any diagnosed neurological disorder is related to the Veteran’s service, to include mercury dental fillings. The examiner must specifically address the May 2019 private treatment opinion from Dr. R.P.M., the etiology of any neurological disorders, and the medical literature submitted in June 2016 and October 2016 in the medical opinion. Caroline B. Fleming Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Thompson, 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.