Citation Nr: 21024246 Decision Date: 04/22/21 Archive Date: 04/22/21 DOCKET NO. 13-29 259 DATE: April 22, 2021 ORDER Entitlement to service connection for a dental implant mechanical failure (claimed as dental condition) is denied. REMANDED Entitlement to service connection for a right ankle disability is remanded. FINDING OF FACT The Veteran does not have a dental disability for which compensation benefits are payable. CONCLUSION OF LAW The criteria for entitlement to service connection for a dental implant mechanical failure for compensation purposes have not been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.303, 3.381, 4.150. REFERRED The issue of entitlement to service connection for a dental disability for treatment purposes only has been raised by the record, but this issue does not appear to have been adjudicated. Therefore, the Board does not have jurisdiction over it, and it is referred to the RO for appropriate action. Specifically, the RO should refer the claim for dental treatment to the appropriate VA Medical Center. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from May 1992 to May 1996. The Board denied claims for a bilateral ankle disability and low back disability in January 2018. The Veteran appealed to the United States Court of Appeals for Veterans Claims (“Court” or “CAVC”). In August 2018, the parties filed a Joint Motion for Partial Remand (“JMPR”) and the Court vacated/remanded the portion of the Board’s January 2018 decision. In January 2019, VA received an election from the Veteran to opt-in to VA’s Rapid Appeals Modernization Program (RAMP). However, he has been advised that only certain appeals are eligible to participate in RAMP, and this appeal (on remand from CAVC) is not eligible. To the extent he has other claims/appeals pending at the Regional Office (RO) level, his election to participate in RAMP will apply. In March 2019, the Board remanded claims for service connection for the back and bilateral ankles. While pending return to the Board, the RO granted service connection for the back and left ankle disabilities in a June 2020 rating decision. This represents a full grant of the benefits sought, and these issues are no longer in appellate status. See Grantham v. Brown, 114 F. 3d 1156, 1158 (Fed. Cir. 1997). Thereafter, in February 2021, the undersigned held a hearing addressing the issues of entitlement to service connection for a dental condition and the right ankle disability. 1. Entitlement to service connection for a dental condition. The Veteran contends he should be compensated for a dental implant which has suffered a mechanical failure since its original in-service implantation. Under current VA regulations, compensation is only available for certain types of dental and oral conditions, such as impairment of the mandible, loss of a portion of the ramus, and loss of a portion of the maxilla. See 38 C.F.R. § 4.150. Compensation is available for loss of teeth if such is due to loss of substance of body of maxilla or mandible, only if such bone loss is due to trauma or a disease such as osteomyelitis, and not to the loss of the alveolar process as a result of periodontal disease, as such loss is not considered disabling. Id. at Note. Treatable carious teeth, replaceable missing teeth, dental or alveolar abscesses, and periodontal disease are not compensable disabilities and will be considered service connected solely for the purpose of establishing eligibility for outpatient dental treatment. 38 U.S.C. § 1712; 38 C.F.R. §§ 3.381, 4.150. The evidence shows that the Veteran’s in-service dental implant and its post-service mechanical failure were not due to in-service trauma or other diseases. May and June 2017 VA examination opinions clarified that the Veteran’s dental implant mechanical failure was the only current dental disability. To that end, the examination report was negative for any conditions of the mandible, maxilla, or teeth due to anatomical loss or bony injury of the mandible or maxilla. The examiner also specified that the Veteran’s need for an implant in-service was because of “long term missing” teeth. Service treatment records, per the examiner, did not support that the Veteran’s tooth loss was due to any trauma, osteomyelitis, or osteoradionecrosis experienced in service. Correspondingly, review of service treatment records reveals they are silent for trauma to the teeth, mouth, or head. The Veteran has also not identified any trauma or other disease that could qualify for service-connected compensation. He even denied suffering from trauma during his Board hearing.   Thus, given the above, the current disability of a dental implant mechanical failure, absent any evidence of trauma or other disease, is not compensable. See 38 C.F.R. §§ 3.381 (b), 4.150. The law is against service-connected compensation for the Veteran’s dental condition. See 38 C.F.R. §§ 3.303, 3.381. Therefore, the benefit of the doubt doctrine is inapplicable, and the claim must be denied. See 38 C.F.R. § 3.102. REASONS FOR REMAND 2. Entitlement to service connection for a right ankle disability. The Veteran was afforded a VA examination in October 2019 to determine the nature and etiology of his right ankle condition. During his personal hearing, he asserted that this VA examination opinion was inadequate. He stated that the examiner did not address the lay contentions of record of on-going symptomatology in and since service. He also asserts that VA failed to adequately develop his claim that his right ankle disability is secondarily related to his newly service-connected left ankle disability. The Board agrees. Review of the record confirms that the examination opinion as to right ankle etiology was predicated solely on the lack of in-service documented injury. A remand is appropriate to obtain an addendum opinion considering the significance of the lay assertions of record. A remand is also appropriate to obtain a secondary service opinion. The matter is REMANDED for the following action: 1. Schedule the Veteran for a new VA examination to address the nature and etiology of his right ankle disorder. Following examination, review of the records, and consideration of the lay evidence, the examiner should address the following:   (*) Identify/diagnose any disability of the right ankle that presently exist or that has existed during the appeal period. Such should include discussion as to whether the Veteran has or has had functional impairment of the right ankle. (*) For each identified disability or disorder of the ankles, state whether it is at least as likely as not (50 percent probability or greater) that the disorder: (*) had its onset during active service, or (*) is etiologically related to his active service, or (*) was proximately due to his service-connected disability(ies), to include left ankle disability, or (*) underwent any incremental increase in disability, regardless of its permanence, due to a service-connected disability, to include left ankle disability. The term “incremental increase in disability” means additional impairment of earning capacity. Objective measurement, or numerical quantification, is not required to ascertain an increase in disability. Moreover, any “incremental increase in disability” need not be permanent (*) Any obtained opinion must address the lay contentions of record, to include those made on Board hearing. A complete rationale for any opinion expressed must be provided. An examiner’s report that he or she cannot provide an opinion without resort to speculation is inadequate unless the examiner provides a rationale for that statement. MICHAEL A. HERMAN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. L. Burroughs, 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.