BVA9508013 DOCKET NO. 93-08 585 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Medical Center in Bay Pines, Florida THE ISSUE Entitlement to Class III VA outpatient dental treatment. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL The veteran ATTORNEY FOR THE BOARD Keith W. Allen, Associate Counsel INTRODUCTION The veteran served on active duty from October 1939 until his retirement in November 1963. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a May 1992 decision by the Department of Veterans Affairs (VA) Medical Center (VAMC) in Bay Pines, Florida, which denied the veteran's claim for Class III VA outpatient dental treatment. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends he is entitled to Class III VA outpatient dental treatment because a dental condition is aggravating his service-connected duodenal ulcer. He points out that he received VA outpatient dental treatment for a number of years in the past, prior to being denied this benefit. DECISION OF THE BOARD The Board, in accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991), has reviewed and considered all of the evidence and material of record in the veteran's claims file and medical administration records folder. Based on its review of the relevant evidence in this matter, and for the following reasons and bases, it is the decision of the Board that the preponderance of the evidence is against the claim for Class III VA outpatient dental treatment. FINDING OF FACT It has been medically determined that the veteran's service- connected duodenal ulcer is not being aggravated by a dental disorder. CONCLUSION OF LAW The criteria for Class III VA outpatient dental treatment have not been met. 38 U.S.C.A. § 1712 (West 1991); 38 C.F.R. § 17.123 (1994). REASONS AND BASES FOR FINDING AND CONCLUSION I. Factual Background The veteran is service connected for several disabilities which are not relevant to the subject matter of this appeal. He is also service connected for a duodenal ulcer that is rated as 10 percent disabling. In April 1992, the veteran twice filed applications (VA Forms 10- 10) for VA outpatient dental treatment. On both occasions, a VA physician reviewed the veteran's case and indicated that he did not qualify for adjunct dental care (i.e., Class III eligibility for those having a dental condition aggravating a service- connected disability). At a January 1993 VAMC hearing, the veteran's representative pointed out that the veteran received VA outpatient dental treatment for a number of years in the past, on a Class III basis, prior to it being denied in 1992. The veteran said he was treated in a VA outpatient dental clinic in 1985 for an abscess and that he was prescribed medication and later had root canal therapy. He said that he had VA dental checkups at 6-month intervals because of gingivitis and pyorrhea, and that he was last seen in February 1992. He claimed that his service- connected duodenal ulcer was active, that he was taking medication for this disorder, and that it was probably being aggravated by a dental condition, described as a dull aching pain in his jaw. II. Legal Analysis The veteran's claim is well-grounded within the meaning of 38 U.S.C.A. § 5107(a). That is, he has presented a claim which is not inherently implausible. All relevant facts have been properly developed and, therefore, the VA's duty to assist him in developing evidence pertinent to his claim has been satisfied. Id. The veteran seeks VA outpatient dental treatment based upon his assertion that a dental condition is aggravating his service- connected duodenal ulcer. The type of outpatient dental treatment referred to by him is known as Class III VA outpatient dental treatment. It also is commonly referred to as VA "adjunct" dental treatment and is governed by the criteria listed in 38 U.S.C.A. § 1712(b)(1)(D); 38 C.F.R. § 17.123(g). Under this legal authority, a veteran may be furnished outpatient dental services for only those dental conditions professionally determined to be aggravating a service-connected disability and which, in sound medical judgment, have a direct and material detrimental effect upon the associated service-connected disability. Id. It is acknowledged that the veteran received Class III VA outpatient dental treatment for a number of years until 1992. However, it should be noted that Class III status is not a permanent benefit, but is subject to periodic review which considers the veteran's current dental and medical circumstances, as well as the prevailing medical opinion of the day. After having reviewed the veteran's case, a VA physician twice determined in 1992 that a dental disorder was not aggravating the veteran's service-connected duodenal ulcer (i.e., that he did not have a dental condition which was considered to be adjunct to his service-connected duodenal ulcer). The determination of the VA physician is not controverted by any other medical evidence on file, and although the veteran asserts in his hearing testimony and written statements that an aggravating relationship exists between his dental problems and his service-connected duodenal ulcer, he, as a layman, does not have the competence to give a medical opinion. See Espiritu v. Derwinski, 2 Vet.App. 492 (1992). Based on the adverse medical determination that is on file, the veteran does not meet the criteria for entitlement to Class III VA outpatient dental treatment. For the foregoing reasons, the Board finds that the preponderance of the evidence is against the claim. Hence, the benefit-of-the doubt rule does not apply, and the requested benefit must be denied. 38 U.S.C.A. § 5107(b) (West 1991); Gilbert v. Derwinski, 1Vet.App. 49 (1990). ORDER Entitlement to Class III VA outpatient dental treatment is denied. L. W. TOBIN Member, Board of Veterans' Appeals The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___ (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West 1991), a decision of the Board of Veterans' Appeals granting less than the complete benefit, or benefits, sought on appeal is appealable to the United States Court of Veterans Appeals within 120 days from the date of mailing of notice of the decision, provided that a Notice of Disagreement concerning an issue which was before the Board was filed with the agency of original jurisdiction on or after November 18, 1988. Veterans' Judicial Review Act, Pub. L. No. 100-687, § 402 (1988). The date which appears on the face of this decision constitutes the date of mailing and the copy of this decision which you have received is your notice of the action taken on your appeal by the Board of Veterans' Appeals.