Citation Nr: 21042591 Decision Date: 07/13/21 Archive Date: 07/13/21 DOCKET NO. 15-06 819A DATE: July 13, 2021 REMANDED Service connection for a sinus disability, to include sinusitis and/or allergic rhinitis is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from June 2009 to September 2009, and from July 2011 to March 2012. She also had service in the United States Army Reserve, including a period of active duty for training (ACDUTRA) from January 2006 to June 2006. The Veteran's DD 214 indicates service in Afghanistan during her last period of active duty. This matter is before the Board of Veterans' Appeals (the Board) on appeal from the September 2013 Department of Veterans Affairs (VA) Regional Office (RO) rating decision. The rating decision, inter alia, denied service connection for sinusitis. The Veteran's Notice of Disagreement (NOD) was received in August 2014. The Statement of the Case was issued in January 2015, and the Veteran's VA Form 9, substantive appeal to the Board was received in March 2015. The Board remanded the claim in October 2018 and March 2021. Entitlement to service connection for a sinus disability, to include sinusitis and/or allergic rhinitis is remanded. The Veteran contends that she developed a sinus disability during service due to poor air quality during her deployment. The Veteran's November 2005 enlistment report of medical history indicates that she reported "NO" when asked about previously having sinusitis, and that she merely reported having pollen allergies. The May 2021 VA examination report indicates that the Veteran was diagnosed with allergic rhinitis and acute sinusitis. Specifically, the VA examiner opined that the Veteran's allergic rhinitis clearly and unmistakably pre-existed service and was not permanently aggravated by service. With respect to acute sinusitis, the May 2021 VA examination report notes a 2014 diagnosis, but indicates that the Veteran received multiple treatments for acute sinusitis from 2006 to 2021. The Veteran's service treatment records (STRs) likewise confirm that the Veteran was treated for sinusitis in service. However, there is no indication whether the Veteran's sinusitis is a separate and distinct disability from allergic rhinitis, and whether sinusitis pre-existed service or had its onset in service. When medical evidence is inadequate, VA must supplement the record by seeking an advisory opinion or ordering another medical examination. Colvin v. Derwinski, 1 Vet. App. 171, 175 (1991); Hatlestad v. Derwinski, 3 Vet. App. 213, 216 (1992). Accordingly, a VA addendum opinion is required. Namely, the VA examiner is requested to review the Veteran's file, inkling his STRs, the December 2019 and May 2021 VA examination reports and indicate whether the Veteran's sinusitis is a separate and distinct disability. In the event the Veteran's sinusitis is a separate and distinct disability, whether sinusitis clearly and unmistakably pre-existed service, and if so, whether it increased in severity during service beyond natural progression. The matter is REMANDED for the following action. 1. Obtain an addendum VA medical opinion regarding the nature and etiology of the Veteran's sinusitis. The claims file and a copy of the remand must be made available to and be reviewed by the examiner. The examiner is requested to review the Veteran's STRs, the September 2019 and May 2021 VA examination reports, and opine as to the following: (a.) Whether the Veteran's sinusitis is a separate and distinct disability from her allergic rhinitis, and if so, (b.) Whether sinusitis clearly and unmistakably preexisted service, and if so, (c.) Whether the preexisting sinusitis increased in severity during service beyond its natural progression. (d.) In providing this opinion, the VA examiner is requested to address the November 2005 enlistment notation that the Veteran did not have sinusitis, as well as the May 2021 VA examination report indicating that the Veteran had multiple acute sinusitis treatments from 2006 to 2021. (e.) The VA examiner is requested to provide a full rationale for all conclusions reached. In remanding this matter, the Board makes no finding, implicit or otherwise, as to the credibility of the Appellant's assertions. Neither the Appellant's credibility nor any lack thereof should be presumed in this remand. Z. SAHRAIE Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Kuksova, Kseniya 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.