Citation Nr: 21023057 Decision Date: 04/20/21 Archive Date: 04/20/21 DOCKET NO. 15-08 944A DATE: April 20, 2021 REMANDED Entitlement to service connection for jaw disability, including temporomandibular joint (TMJ) syndrome is remanded. REASONS FOR REMAND The Veteran served on active duty with the United States Army from June 1986 to June 1991 and additionally on active duty in the United States Army Reserves from August 2004 to January 2005 and September 2007 to May 2011. The Veteran was also a member of the Colorado Army National Guard with active duty from March 2002 to May 2002. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a November 2012 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). This matter was previously before the Board in November 2018 and December 2020, at which time the Board remanded the claims for further development. Unfortunately, there has not been substantial compliance with the Board’s previous remand directives as previously directed by the Board. Stegall, 11 Vet. App. at 271. 1. Entitlement to service connection for jaw disability, including temporomandibular joint (TMJ) syndrome is remanded. The Board previously remanded this matter for further clarification as to whether the Veteran warrants a diagnosis for a TMJ disorder during or at any point following service. The Veteran underwent a VA examination in January 2021. The Board concludes this examination is inadequate upon which to assess the merits of this appeal. In particular, while the VA examiner concluded the Veteran’s claimed condition is less likely than not incurred in or caused by claimed in-service injury, event, or illness, the VA examiner also concluded the Veteran’s disability clearly and unmistakable existed prior to service and was clearly and unmistakably not aggravated beyond its natural progression by an in-service injury, event, or illness. The VA examiner’s rationale for both conclusions is that a possible diagnosis of TMJ was established in October 2011 but per the examiner, this cannot be confirmed and since prior VA examinations concluded there was no diagnosis of TMJ. The VA examiner provided conflicting conclusions regarding whether the Veteran has a diagnosis of a TMJ disability and the examiner’s rationale is insufficient. Additionally, the VA examiner did not distinguish whether the Veteran previously had a TMJ disability that was distinct from her bruxism. As such, the January 2021 opinion is inadequate, and a remand is warranted for a new opinion to be obtained. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). The Board notes that the VA requested the Veteran complete and return a VA Form 21-4142 in December 2020. To date, a response has not been received. As the Board is remanding this matter for further development, the Board will again request the private dental records be requested as it pertains to whether the Veteran has had a diagnosis of TMJ. The matter is REMANDED for the following actions: 1. Make two separate requests to the Veteran to obtain any private records from the civilian dentist who diagnosed the Veteran with TMJ in 2001. 2. Obtain an addendum opinion clarifying whether the Veteran was previously diagnosed with a TMJ disorder distinct from her bruxism. If a separate diagnosis of TMJ exists, the examiner is asked to determine whether TMJ diagnosis is at least as likely as not caused or aggravated by service. The examiner is asked to provide a rationale and to explain the reasons behind any opinions expressed and conclusions reached. J. NICHOLS Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Mouzakis, 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.