Citation Nr: 21040977 Decision Date: 07/07/21 Archive Date: 07/07/21 DOCKET NO. 17-06 400 DATE: July 7, 2021 ORDER Entitlement to service connection for bilateral hearing loss is denied. Entitlement to service connection for a dental disability, claimed as receding gums, for purposes of disability compensation is denied. REMANDED ISSUE Entitlement to service connection for a dental disability, claimed as receding gums, for purposes of VA outpatient treatment is remanded. Entitlement to service connection for a cervical spine disability is remanded. Entitlement to service connection for infertility is remanded. Entitlement to an initial rating in excess of 30 percent for asthma, with bronchitis, is remanded. INTRODUCTION The Veteran served on active duty from October 1985 to August 1989. These matters come before the Board of Veterans' Appeals (Board) on appeal from rating decisions by a Department of Veterans Affairs (VA) Regional Office (RO). In January 2021, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A transcript of this hearing has been associated with the claims file. FINDINGS OF FACT 1. The preponderance of the evidence of record is against finding that the Veteran has had bilateral hearing loss at any time during or approximate to the pendency of the claim. 2. The preponderance of the evidence of record is against finding that the Veteran has had qualifying dental disability at any time during or approximate to the pendency of the claim. CONCLUSIONS OF LAW 1. The criteria for service connection for bilateral hearing loss are not met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.385. 2. The criteria for service connection for a dental disability, for disability compensation purposes, are not met. 38 U.S.C. §§ 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS Bilateral Hearing Loss The salient issue presented by the Veteran's claim is whether the evidence establishes a current diagnosis of bilateral hearing loss. See Degmetich v. Brown, 104 F.3d 1328, 1333 (1997) (holding that the existence of a current disability is the cornerstone of a claim for VA disability compensation). Impaired hearing will be considered a disability when the auditory threshold in any of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz is 40 decibels or greater; or when the auditory thresholds for at least three of the frequencies 500, 1000, 2000, 3000, or 4000 Hertz are 26 decibels or greater; or when speech recognition scores using the Maryland CNC Test are less than 94 percent. 38 C.F.R. § 3.385. In April 2016, the Veteran underwent a VA audiological examination. Testing demonstrated that none of her relevant puretone thresholds was 40 decibels or more. Indeed, none of the relevant puretone thresholds was 26 or above. On speech recognition testing using the Maryland CNC word list, the Veteran scored 98 percent, bilaterally. The Veteran submitted statements wherein she reported that her hearing acuity had worsened since the April 2016 examination. In July 2019, the Veteran underwent a VA audiological examination. Testing demonstrated that none of her relevant puretone thresholds was 40 decibels or more. Indeed, none of the relevant puretone thresholds was 26 or above. On speech recognition testing using the Maryland CNC word list, the Veteran scored 100 percent, bilaterally. During the January 2021 hearing, the Veteran testified as to in-service noise exposure and the onset and course of her bilateral hearing loss. The Veteran did not submit, and the evidence of record is otherwise negative for, evidence demonstrating that her right and/or left ear hearing loss satisfies the regulatory definition for a current disability. 38 C.F.R. § 3.385. Absent competent evidence reflecting the current presence of the claimed disability, a basis upon which to establish service connection for bilateral hearing loss has not been presented and the appeal must be denied. To the extent that the Veteran asserts she has bilateral hearing loss, the Board finds that such a determination is more suited to the realm of medical, rather than lay expertise. The Veteran's statements are competent as to experiencing decreased hearing acuity; however, the diagnosis of bilateral hearing loss that satisfies the applicable regulations is too complex for a layperson to proffer a competent opinion. The evidence of record does not demonstrate that the Veteran possesses the ability, knowledge, or experience to provide competent diagnostic opinions. Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). Consequently, the Veteran's lay assertions do not constitute competent evidence of a current bilateral hearing disability in this case. Lathan v. Brown, 7 Vet. App. 359, 365 (1995). Because bilateral hearing loss for VA purposes has not been shown, the preponderance of the evidence is against this service connection claim, the benefit-of-the-doubt rule does not apply, and the claim of entitlement to service connection for bilateral hearing loss must be denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). Dental Disability Under 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 osteomyelitis, and not to the loss of the aveolar process as a result of periodontal disease, as such loss is not considered disabling. Id. at Note. In February 2017, the Veteran claimed entitlement to service connection for "receding gums due to exposure" to perfluorinated compounds and chlorine. In March 2017, the Veteran underwent a VA dental examination . The examiner stated that no diagnosis is rendered regarding the claimed condition, but that the Veteran's condition is due to periodontal disease. The examiner noted that the Veteran's teeth 19 and 20 has been recently removed, but there was no history as to why. Dental x-ray was obtained, but there were no significant findings. The examiner also noted the absence of the following teeth: 1, 2, 15, 16, 17, 18, and 31. During the January 2021 Board hearing, the Veteran reiterated her assertions as to a current dental disability that was incurred in or due to her active duty, to include exposures to chemicals. The evidence of record does not show that the Veteran currently has a dental disability for which VA compensation is available. The Veteran has not submitted evidence of a current diagnosis of a dental disability, such as osteomyelitis or osteoradionecrosis of the maxilla or mandible; loss of the mandible, maxilla, ramus, or coronoid process; loss of the hard palate, not replaceable by prosthesis; nonunion of the mandible; or limited motion of the temporomandibular articulation, which was incurred in service. See 38 C.F.R. §§ 3.381, 4.150. Further, replaceable missing teeth are not considered disabling for VA compensation purposes. See 38 C.F.R. § 3.381(a); see also 38 C.F.R. § 4.150. Under these circumstances, service connection for a dental disability for VA compensation purposes is not warranted. 38 U.S.C. § 5107; Gilbert, 1 Vet. App. at 53. REASONS FOR REMAND Dental Treatment A claim of entitlement to service connection for dental disability for compensation purposes is also accepted by VA as a claim of entitlement to service connection for dental disability for treatment purposes. 38 C.F.R. § 20.202; see Mays v. Brown, 5 Vet. App. 302 (1993). This aspect of the Veteran's claim has not been developed or adjudicated by the RO and, thus, it is remanded. Cervical Spine The Board finds that a remand is warranted in order to obtain an opinion with respect to whether the Veteran's cervical spine disability was incurred in or due to her active duty. McLendon v. Nicholson, 20 Vet. App. 79 (2006); see also 38 U.S.C. § 5103A(d)(2), 38 C.F.R. § 3.159(c)(4)(i). Infertility The Veteran has asserted that she was exposed to perfluorinated compounds, chlorine, and other chemicals during her active duty. She asserts that infertility, among other issues, are a consequent of this alleged exposure. The Veteran also submitted evidence related to the U.S. Department of Defenses use of such chemicals. She also submitted evidence suggesting an etiological connection between exposure and infertility issues. The Board finds that a remand is warranted for further development. Asthma As of January 2021, service connection is in effect for allergic rhinitis (at 30 percent) and "asthma with chronic bronchitis associated with allergic rhinitis" (also assigned a 30 percent rating). In January 2012, the Veteran underwent a VA examination to assess the severity of her allergic rhinitis, during which see reported difficulty breathing through her nose. It is unclear from the record what disability is contemplated under the rating for allergic rhinitis and separately under asthma with chronic bronchitis. Moreover, the Veteran reported that she experiences pneumonia, asserting that it due to either or both of these disabilities. For these reasons, the Board finds that a remand for a VA examination is warranted. The matters are REMANDED for the following action: 1. Develop the claim of entitlement to service connection for a dental disability for VA outpatient treatment purposes. 2. Request from the appropriate records repository or repositories evidence regarding the nature and extent of perfluorinated compound, chlorine, and related chemical use at the Veteran's duty stations throughout her active duty, with particular attention on the Veteran's military occupation specialty. 3. Provide the Veteran with a VA examination regarding her cervical spine. The Veteran's electronic claims file must be made available to the examiner, and the examiner must specify in the report that it was contemporaneously reviewed. All pertinent symptomatology and findings must be reported. Any indicated special diagnostic tests that are deemed necessary for an accurate assessment must be conducted. The examiner should then provide an opinion as to whether any of the Veteran's cervical spine disability was incurred in or due to her active duty. In so doing, the examiner must specifically consider and discuss the Veteran's assertions regarding in-service events. 4. Provide the Veteran with a VA examination regarding her infertility. The Veteran's electronic claims file must be made available to the examiner, and the examiner must specify in the report that it was contemporaneously reviewed. All pertinent symptomatology and findings must be reported. Any indicated special diagnostic tests that are deemed necessary for an accurate assessment must be conducted. The examiner should then provide an opinion as to whether the Veteran's infertility issues were incurred in or due to her active duty. In so doing, the examiner must specifically consider and discuss evidence of record regarding the Veteran's alleged in-service exposure to perfluorinated compounds, chlorine, etc., to include the Veteran's assertions. 5. Provide the Veteran with a VA examination regarding her asthma. The Veteran's electronic claims file must be made available to the examiner, and the examiner must specify in the report that it was contemporaneously reviewed. All pertinent symptomatology and findings must be reported. Any indicated special diagnostic tests that are deemed necessary for an accurate assessment must be conducted. The examiner is asked to assess the severity of the Veteran's asthma, to include, if possible, disability separately and distinctly associated with her asthma versus disability associated with her service-connected allergic rhinitis. 6. After completing the above actions, and any other development as may be indicated by any response received as a consequence of the actions taken in the paragraphs above, the claims must be re-adjudicated. If any benefit sought on appeal remains denied, a supplemental statement of the case must be provided to the Veteran and her representative. After they have had an adequate opportunity to respond, the appeal must be returned to the Board for appellate review. T. REYNOLDS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Sean G. Pflugner, 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.