Citation Nr: 22009167 Decision Date: 02/16/22 Archive Date: 02/16/22 DOCKET NO. 15-02 290 DATE: February 16, 2022 REMANDED Service connection for a sinus or throat disability. REASONS FOR REMAND The Veteran served on active duty from August 1977 to January 1978 with subsequent service in the Reserves. The case is on appeal from an August 2014 rating decision. In a January 2021 decision, the Board denied service connection for back, neck, foot or ankle, chest knot, and sinus or throat disabilities. The Veteran appealed the decision to the United States Court of Appeal for Veterans Claims (Court) and, in September 2021, the parties to this appeal entered into a Joint Motion for Partial Remand (Joint Motion). In the Joint Motion, the parties agreed that the portion of the Board's decision denying service connection for a sinus or throat disability should be vacated and that the denial of service connection for back, neck, foot or ankle, and chest knot disabilities should be left undisturbed. The Court granted the parties' Joint Motion in an Order issued later in September 2021. The Board notes that the Veteran subsequently appealed a higher rating for posttraumatic stress disorder (PTSD) to the Board. This issue will be the subject of a future Board decision, when in order. Service connection for a sinus or throat disability. The Veteran asserts that he has a current sinusitis disability, including problems breathing and coughing, that began or occurred during service. He describes sinus problems related to sleeping in cold and hot barracks generally. The Veteran also reports that, during basic training between September 1977 and November 1977, he was sent to a nuclear biological chemical chamber. He reported that he was required to take a gas mask off during exposure to poison gas resulting in a burning sensation in his skin, difficulty breathing, and a nosebleed. The Veteran further reports that he began experiencing problems with sinusitis and his throat while flying from Fort Bragg to Fort Jackson on August 25, 1979. He stated that he went to the dispensary at Fort Bragg, but was told nothing could be done because he was leaving active duty for training (ACDUTRA) the next week. He also stated that a few years later he had his tonsils removed at a private hospital and that he still has sinusitis and throat trouble with problems breathing and coughing. In an August 1977 report of medical history, the Veteran denied ear, nose, or throat (ENT) trouble, sinusitis, chronic or frequent colds, hay fever, and chronic cough. During an August 1977 entrance examination, his head, neck, nose, sinuses, mouth, and throat were marked normal. However, during a January 1978 examination for release from ACDUTRA, the Veteran reported ENT trouble and sinusitis, but again denied the other relevant conditions. The examiner noted for ENT trouble and sinusitis that the Veteran surgery at 4 to 5 years of age with no residuals. No recent symptoms or symptoms during training were mentioned, and he was again found normal for his head, neck, nose, sinuses, mouth, and throat. In August 1979, the Veteran was treated at Fort Bragg for strep throat diagnosed on August 25, 1979, which was found to be progressing well with all signs diminished. He was advised to continue medications, drink fluids, and return to the clinic as needed. This record is consistent with the report by the Veteran and his brother that he was treated for a throat condition in August 1979. The Veteran's service personnel records (SPRs) include the Veteran's request for correction of his points for inactive duty training for multiple dates for one to three points per month, including for August 25, 1979. During an April 1982 retention examination, the Veteran reported ENT trouble and sinusitis, and the examiner noted occasional tonsillitis with swelling. He was found clinically normal for relevant areas. A February 22, 1983, private operative report reflects a tonsillectomy for recurrent tonsillitis. The Veteran reported that over the prior years he experienced "extremely frequent episodes of tonsillitis with flareups almost on a bimonthly basis." During an August 1989 retention examination, the Veteran expressly denied ENT trouble, chronic or frequent colds, sinusitis, and chronic cough. He again reported treatment for sinusitis prior to service, stating that he was hospitalized for a sinus infection at age 7, but he did not mention recent symptoms or symptoms related to service. The Veteran's post-service VA treatment records reflect that a June 2019 CT scan of the cervical spine was found to show a small mucous retention cyst in the right maxillary sinus and asymmetry involving the left tonsillar region and oropharynx and hypopharynx. A July 2019 record noted that the Veteran had pharyngeal asymmetry, and he reported having a difficult tonsillectomy in 1983. Pursuant to a June 2018 Board decision, the Veteran was afforded a VA examination in September 2019. The examiner reported diagnoses of chronic sinusitis, allergic rhinitis, right maxillary sinus cyst, and deviated uvula. The examiner found that the Veteran had sinusitis prior to service that was not aggravated by service. The examiner also found that the other diagnosed conditions were not incurred in or caused by service. The RO obtained an addendum opinion for this claim in May 2020. The examiner found that the Veteran's sinusitis and deviated uvula clearly and unmistakably pre-existed service and were not aggravated by service. However, the examiner explained that the Veteran underwent a tonsillectomy prior to service when the medical evidence shows that this did not occur until February 1982. The Board finds that a remand is required to obtain another examination and opinion in regard to this claim. The claim is REMANDED for the following action: Schedule the Veteran for a VA examination or examinations to determine the nature and etiology of all diagnosed sinus and throat disorders. The entire claims file should be reviewed by the examiner. Thereafter, the examiner(s) is to provide opinions as to the following: Identify all diagnosed sinus or throat disorders present since June 2013. For each diagnosed disorder, state whether it is undebatable from a medical standpoint that such disorder preexisted the Veteran's entrance into service in August 1977. (a.) For each diagnosed disability that preexisted entrance into service in August 1977, state whether it is undebatable from a medical standpoint that each condition was not aggravated during service beyond its natural progression during active duty service from August 1977 to January 1978 service, to include from sleeping in cold and hot barracks and being exposed to gas without a gas masks. (b.) For each diagnosed disability that preexisted entrance into service in August 1977, state whether it is it at least as likely as not that the condition was aggravated during or as a result of a period of ACDUTRA service, to include sleeping in cold and hot barracks or sinus and throat problems experienced on August 24, 1979 while flying from Fort Bragg to Fort Jackson. Aggravation means an increase in severity beyond the natural progress of the disease. (Continued on the next page) (c.) For each non-preexisting disability, state whether it is at least as likely as not that the condition had its onset during active service or ACDUTRA or is otherwise related to an event, disease, or injury during such service, to include sleeping in cold and hot barracks, being exposed to gas without a gas masks, or sinus and throat problems experienced on August 24, 1979 while flying from Fort Bragg to Fort Jackson. A rationale should be provided for opinions expressed. RYAN T. KESSEL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Jimerfield 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.