Citation Nr: 25007167 Decision Date: 05/27/25 Archive Date: 05/27/25 DOCKET NO. 19-30 000 DATE: May 27, 2025 ORDER Entitlement to service connection for a sinus disorder is denied. FINDING OF FACT The persuasive evidence indicates the Veteran's current allergic rhinitis is unrelated to any aspect of active-duty service. CONCLUSION OF LAW The criteria for entitlement to service connection for a sinus disorder have not been met. ?38?U.S.C. §§?1101, 1112, 1113, 1131, 1137;?38?C.F.R. §§?3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from February 1969 to November 1970, to include service in the Republic of Vietnam. The Board denied these claims in September 2022. The Veteran appealed that decision to the Court of Appeals for Veterans' Claims, which issued a Memorandum Decision vacating that portion of the Board decision denying the claim returning the matter to the Board for adjudication, which in turn remanded the matter in August 2024 and again in March 2025. In the Board's March 2025 directive, the Board remanded the case for a VA examination to explore the presence and etiology of the Veteran's sinus disorder. The Board further instructed the examiner to opine whether the Veteran's sinus condition was due to the Veteran's toxic exposure in service. The VA examination was completed in April 2025 in which the examiner provided the requested opinions. As such, the Board finds there has been substantial compliance with the previous directives. Stegall v. West, 11 Vet.App. 268 (1998); D'Aires v. Peake, 22 Vet. App. 97 (2008). 1. Entitlement to service connection for a sinus disorder Service connection may be granted for a disability resulting from disease or injury incurred coincident with or aggravated by service.?38?U.S.C. §§?1110, 1131;?38?C.F.R. §?3.303?(a). To establish a right to compensation for a present disability, a Veteran must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship (nexus) between the present disability and the disease or injury incurred or aggravated during service. Holton v. Shinseki,?557 F.3d 1362, 1366?(Fed. Cir. 2009) (quoting Shedden v. Principi,?381 F. 3d 1163, 1167?(Fed. Cir. 2004)). The absence of any one element will result in denial of service connection. Coburn v. Nicholson,?19?Vet. App.?247, 431?(2006). Service connection may be granted for any disease initially diagnosed after discharge when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service.?38?C.F.R. §?3.303?(d). In addition, for veterans who have served 90 days or more of active service during a war period or after December 31, 1946, certain chronic disabilities, including other organic diseases of the nervous system, are presumed to have been incurred in service if they manifested to a compensable degree within one year of separation from service.?38?U.S.C. §§?1101, 1112, 1113, 1131, 1137;?38?C.F.R. §§?3.307, 3.309. For the showing of chronic disease in service, there is required a combination of manifestations sufficient to identify the disease entity and sufficient observation to establish chronicity at the time. If chronicity in service is not established, a showing of continuity of symptoms after discharge is required to support the claim.?38?C.F.R. §§?3.303?(b), 3.309; Walker v. Shinseki,?708 F.3d 1331?(Fed. Cir. 2013). The Veteran has a current diagnosis of allergic rhinitis, confirmed on VA examination. The examiner with whom he met in April 2025 did not furnish any other diagnosis, and noted diagnostic imaging taken the same month reflecting "unremarkable sinuses." The Veteran has a history of sinus surgeries, the examiner confirming that the normal diagnostic imaging indicated that those surgeries were successful in addressing sinus symptoms without sequelae during the current appeal period. As for the Veteran's current symptoms, the examiner explained that because of the gulf of time between separation and initial complaint, the absence of any diagnosis of a sinus condition or notation of sinus issues around the time of separation, or for many years thereafter, and the absence of any evidence of a plausible service-related causative mechanism for a current disability shown in the record, the Veteran's current allergic rhinitis, (which the Board notes is the only currently diagnosed sinus-related condition,) bears no etiological relationship to service. The examiner further opined that the Veteran's rhinitis was less likely than not due to the synergistic effects of the Veteran's toxic exposure, to include herbicides. The examiner stated that a sinus condition, which was first reported 13 years following service, was less likely due to any TERA exposure in service. The examiner's assessment is uncontroverted by objective or competent opinion evidence in this case, and the Board observes that post-service treatment records do not suggest any service-related etiology for a sinus disorder. The Board acknowledges that the Veteran's service records have been lost, and as such VA has a heightened duty to assist the Veteran in substantiating his claim. VA has met this duty in this case by ensuring a thorough and responsive VA expert medical opinion regarding etiology, and affording due consideration to the Veteran's lay statements with respect to in-service onset of his claimed sinus condition. In this case, even assuming that service records were to reflect in-service sinus-related symptoms, several facts militate against determining that a nexus exists between those symptoms and any current disability. First, there is no evidence of any sinus-related issues in the record until over a decade following separation. Second, the evidence indicates the Veteran's sinus surgery was completed successfully without apparent sequelae, as evidenced by recent diagnostic imaging, summarized above. Third, no treating or examining provider has opined that the Veteran's current diagnosis of allergic rhinitis bears any plausible etiological relationship to active-duty service, and the record does not suggest any such relationship. Accordingly, although the Board has resolved all reasonable doubt and ambiguity in favor of the claim, the persuasive evidence in this case is against the claim, and on that basis the appeal must be denied. Paul R. Casey Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Z. Sahraie, 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.