Citation Nr: 21028916 Decision Date: 05/12/21 Archive Date: 05/12/21 DOCKET NO. 17-22 773 DATE: May 12, 2021 ORDER Entitlement to service connection for dental trauma is denied. REMANDED Entitlement to an increased rating in excess of 20 percent prior to February 4, 2020 and in excess of 40 percent thereafter for lumbar spine intervertebral disc syndrome with residuals of a low back injury (lumbar spine IVDS) is remanded. REFERRED Entitlement to service connection for a dental disability for treatment purposes only is referred to the Agency of Original Jurisdiction (AOJ) for appropriate action. Specifically, the AOJ should refer the claim for dental treatment to the appropriate VA Medical Center. FINDING OF FACT The Veteran's only current dental disability is replaceable missing teeth. CONCLUSION OF LAW The criteria for entitlement to service connection for dental trauma have not been met. 38 U.S.C. §§ 1110, 1712, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303, 3.310, 3.381, 4.150 (2020). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from February 1969 to September 1992. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2013 rating decision by the Department of Veterans Affairs (VA). This case was remanded in December 2019 for further development. In December 2019, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge; a transcript of that hearing is of record. Since the Board's remand, the issue of entitlement to service connection for a neck disability was granted. See November 2020 rating decision. Because that decision represents a full grant of the benefit sought, the issue is no longer on appeal. Additionally, the AOJ increased the Veteran's rating for his lumbar spine IVDS to 40 percent, effective February 4, 2020. Id. The issue has been recharacterized accordingly. Entitlement to service connection for dental trauma. 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. Treatable carious teeth, replaceable missing teeth, dental or alveolar abscesses, and periodontal disease are not compensable disabilities, but may 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. When there is an approximate balance of positive and negative evidence regarding the merits of an issue, the benefit of the doubt shall be given to the Veteran. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. If the preponderance of the evidence is against the claim, the claim is to be denied. Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990). The Veteran asserts that his dental trauma is due to an accident in service. However, he reported that his only current disability is replaceable missing teeth. See December 2019 Board hearing. There is no additional evidence to the contrary. Because he has not been diagnosed with a dental disability for which service connection may be granted, the claim of service connection for dental trauma for compensation purposes must be denied. REASONS FOR REMAND Entitlement to an increased rating in excess of 20 percent prior to February 4, 2020 and in excess of 40 percent thereafter for lumbar spine IVDS. The Board must evaluate objective neurologic abnormalities associated with the Veteran's lumbar spine IVDS. 38 C.F.R. § 4.71a, General Formula, Note (1). The AOJ granted service connection for right lower extremity radiculopathy, effective April 26, 2017, see November 2017 rating decision, urinary incontinence, effective December 11, 2019, see December 2019 rating decision, and erectile dysfunction, effective December 11, 2019. See id. None of these grants encompass the entire period of appeal currently before the Board. December 2011 and January 2012 private treatment records indicate a past history of lumbar radiculopathy and reflect that the Veteran had bilateral lower extremity numbness and weakness prior to the current period of appeal, but a July 2013 VA examiner opined that the Veteran did not have right lower extremity radiculopathy. Because the record is unclear, remand for a medical opinion is necessary to determine whether the Veteran had right lower extremity radiculopathy as a neurologic abnormality associated with his lumbar spine IVDS prior to April 26, 2017. December 2011 private treatment records also indicate a past history of urinary incontinence prior to the current period of appeal. A February 2020 VA lumbar spine examiner opined that the Veteran's urinary incontinence was a neurologic abnormality associated with his service-connected lumbar spine IVDS, but an August 2017 VA examiner opined that the Veteran did not have any neurologic abnormalities. Because it is unclear whether the Veteran had urinary incontinence as a neurologic abnormality associated with his lumbar spine IVDS prior to December 11, 2019, remand for a new opinion is necessary. A February 2020 VA lumbar spine examiner opined that the Veteran's erectile dysfunction was a neurologic abnormality associated with his lumbar spine IVDS, but the evidence is unclear when the Veteran first had erectile dysfunction. During a December 2019 VA male reproductive organ examination, the Veteran reported that his erectile dysfunction had its onset in 2004 and that the disability had progressed over the past 15 years. Thereafter, during a February 2020 VA male reproductive organ examination, the Veteran reported that the condition began two to three years ago. Because the record is unclear as to whether the Veteran has had erectile dysfunction as a neurologic abnormality associated with his lumbar spine IVDS prior to December 11, 2019, remand for a new opinion is necessary. The matter is REMANDED for the following action: 1. The AOJ should obtain copies of VA treatment records from January 2020 to the present. 2. After the development in the first instruction is completed, the AOJ should arrange for an examination or telehealth interview of the Veteran to assess the nature of his right lower extremity radiculopathy, urinary incontinence, and erectile dysfunction as possible neurologic abnormalities associated with his lumbar spine IVDS. The examiner must review the entire record (including this remand) in conjunction with the examination and note such review was conducted. The examiner is requested to respond to the following: (a.) Has the Veteran's right lower extremity radiculopathy been a neurologic abnormality associated with his service-connected lumbar spine IVDS since the beginning of the current appeal (July 2012)? If not, please indicate when the Veteran's right lower extremity radiculopathy first manifested as a neurologic abnormality associated with his service-connected lumbar spine IVDS. The examiner must discuss the December 2011 and January 2012 private treatment records indicating radiculopathy. (b.) Has the Veteran's urinary incontinence been a neurologic abnormality associated with his service-connected lumbar spine IVDS since the beginning of the current appeal (July 2012)? If not, please indicate when the Veteran's urinary incontinence first manifested as a neurologic abnormality associated with his service-connected lumbar spine IVDS. The examiner must discuss December 2011 private treatment records indicating urinary incontinence. (c.) Has the Veteran's erectile dysfunction been a neurologic abnormality associated with his service-connected lumbar spine IVDS since the beginning of the current appeal (July 2012)? If not, please indicate when the Veteran's erectile dysfunction first manifested as a neurologic abnormality associated with his service-connected lumbar spine IVDS. The examiner must discuss conflicting reports of onset in December 2019 and February 2020 VA examinations. 3. If upon completion of the above action the issue remains denied, the case should be returned to the Board after compliance with appellate procedures. E. I. VELEZ Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Sandler, 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.