Citation Nr: 22012010 Decision Date: 03/02/22 Archive Date: 03/02/22 DOCKET NO. 16-28 107 DATE: March 2, 2022 REMANDED Entitlement to service connection for dental trauma/gum disease is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1973 to January 1977 and from October 1983 to September 1994. The Department of Veterans Affairs (VA) is grateful for his service. The Veteran testified before the undersigned Veterans Law Judge of the Board of Veterans Appeals (Board) at a hearing in October 2019. A transcript of the hearing is of record. In August 2021, the Board remanded the appealed claim for additional development, and it now returns to the Board for further review. Entitlement to service connection for dental trauma/gum disease is remanded. The Board remanded the claim for service connection for dental trauma/gum disease for an examination to address the nature and etiology of that condition, to include any oral condition characterized by mandibular bone loss and effects of such loss. A VA contract examination in November 2021 adequately addressed these issues as related directly to service. However, the Board's remand also required the examiner to address questions of causation or aggravation of claimed dental trauma/gum disease by claimed sinusitis, including based on the Veteran's assertions of a link to sinusitis at the October 2019 hearing. Subsequent to the August 2021 remand, the RO granted service connection for sinusitis. Thus, the questions of causation or aggravation of dental trauma/ gum disease by sinusitis have become more relevant. Unfortunately, the November 2021 examiner failed to address questions of causation or aggravation by sinusitis. Accordingly, remand is regrettably again required, to address medically these unaddressed questions. Substantial compliance with the terms of the Board's remand is required pursuant to Stegall v. West, 11 Vet. App. 268 (1998). D'Aries v. Peake, 22 Vet. App. 97 (2008). The matter is REMANDED for the following actions: 1. Undertake appropriate development to obtain any outstanding records pertaining to the appealed claim. This should include any additional VA treatment records as well as pertinent private records. 2. Thereafter, obtain an addendum to the November 2021 VA examination, either by that examiner or another qualified examiner, to address questions of causation or aggravation of dental trauma/gum disease by service-connected sinusitis. The examiner should be advised that this does not require chronic sinusitis or sinusitis present at the time of examination. Rather, the relevant questions are whether the Veteran's service-connected sinusitis at any time caused or aggravated claimed dental trauma/gum. The claims file must be reviewed for the addendum, and any necessary tests or studies should be performed, with pertinent results stated in the examination report. The examiner must also document and consider the Veteran's own statements regarding his disability, including his October 2017 testimony, since a layperson is competent to address symptoms as experienced and his recollections of past history and treatment. If the examiner has reason based on other evidence of record or medical knowledge to question the Veteran's self-reported history, the examiner should so state and provide a complete explanation why this is so. The examiner should opine whether it is at least as likely as not (50 percent or greater probability) that the Veteran has had any dental trauma or gum disease or mandibular disease present during the claim period which was (a) caused or (b) aggravated (worsened) by sinusitis. Aggravation, or worsening, need not be of a permanent nature. Separate opinions are required to address causation and aggravation. A complete rationale must be provided for all opinions rendered. 3. Thereafter, readjudicate the appealed claim. L. CHU Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Schechter 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.