93 Decision Citation: BVA 93-03110 Y93 BOARD OF VETERANS' APPEALS WASHINGTON, D.C. 20420 DOCKET NO. 92-16 289 ) DATE ) ) ) THE ISSUE Entitlement to service connection for a lung disorder. REPRESENTATION Appellant represented by: Missouri Veterans Commission WITNESS AT HEARING ON APPEAL The veteran ATTORNEY FOR THE BOARD Jill L. Rygwalski, Associate Counsel INTRODUCTION This matter came to the Board of Veterans' Appeals (Board) on appeal from a rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in St. Louis, Missouri. The veteran served on active duty during the Korean conflict and had peacetime service thereafter. A rating decision dated in July 1991 denied the veteran's claim for service connection for a lung disorder. The veteran filed a notice of disagreement in October 1991. A statement of the case was issued in December 1991. The veteran filed his substantive appeal in December 1991. At the veteran's request, a hearing was held at the RO in January 1992 and the hearing officer issued his decision later that month. A supplemental statement of the case was issued in January 1992. The case was received and docketed at the Board in September 1992. The veteran has been represented in his appeal by the Missouri Veterans Commission. That organization submitted written argument on behalf of the veteran in August 1992. REMAND We note that the veteran contends that during service he worked as a fireman and that as a result of inhaling smoke and noxious fumes he developed a lung disorder. He asserts that although he was provided a protective mask, it did not provide adequate protection when it was used, and he often worked without using the mask. The veteran asserts that throughout service he experienced shortness of breath, wheezing, and occasional chest pain. We note that the service medical records indicate that in August 1954 the veteran complained of a head and chest cold of four days' duration. In addition, in November 1954, the veteran complained of a cough, a headache and a cold of three days' duration. At that time, it was noted that the veteran's lungs were clear. In addition, in March 1957, the veteran complained of pain in the right anterior chest. It was noted that a chest X-ray was negative. The report of the veteran's separation physical examination, performed in February 1958, noted that the veteran had had pain and pressure retrosternally for five years and that all X-ray studies had been negative. The veteran's VA Form DD-214 confirms that the veteran's specialty during service was a fire fighter. After separation from service, there is no clinical evidence of record of treatment for a lung disorder until the 1980's. At that time, private treatment records indicate that the veteran received treatment for asthma and chronic obstructive pulmonary disease. In addition, a statement by Stephen J. Kracht, D.O., dated in June 1991, indicates that when he saw the veteran in June 1991, the veteran complained of difficulty breathing, particularly at night. The veteran reported that he had had difficulty breathing for the past several years and that his symptoms had grown progressively worse. At that time, the veteran reported that he had been exposed to fumes and smoke during service when he was a fire fighter. It was Dr. Kracht's opinion that the veteran had chronic obstructive pulmonary disease as a result of exposure to smoke and fumes during service. We note that the veteran, in his substantive appeal, indicated that he had received treatment at the VA Medical Center in Kansas City, Missouri, since 1957. When the veteran testified at the hearing on appeal, he stated that he had received treatment at the VA Medical Center in Kansas City, Missouri, for a lung disorder since 1967; he also stated that he had first received treatment 5 or 6 years after service from a physician for complaints of a productive cough, shortness of breath, wheezing and chest pain. The veteran also testified that chest X-rays were taken in 1967, and possibly prior to that, at the VA Medical Center in Kansas City, Missouri. We note that the only treatment records which had been obtained pertain to the veteran's VA hospitalization in June 1987 and VA outpatient treatment in March 1990 and March 1991, as well as private treatment records from the late 1980's and early 1990's. In this regard, we note that the private physicians were only requested to provide reports of the veteran pertaining to treatment on or about 1991. We further note that the veteran's representative, at the hearing on appeal, stated that the veteran was unable to obtain medical documentation of his condition following service or within one year after separation from service, and that some of the veteran's physicians were either deceased or their records could not be obtained. In light of the veteran's contentions and the clinical evidence currently of record, we believe that further medical development, as specified below, should be completed prior to reaching a decision on this issue. In addition, we note that the veteran, through his correspondence and testimony, has asserted that he has a chronic sinus disorder which he attributes to the inhalation of smoke and fumes during service. The Board is obliged to address all issues which are reasonably raised from a liberal reading of all documents, correspondence and testimony submitted prior to the Board's decision. EF v. Derwinski, 1 Vet.App. 324 (1991). The Board finds that in light of the veteran's statements a claim has been raised for service connection for a sinus disorder. The Board finds that the case should be returned to the RO so that the aforementioned issue can be developed and adjudicated. Accordingly, the case is REMANDED to the RO for the following actions: 1. The RO should contact the veteran and request that he provide the names and addresses of all health care providers who have treated him for a sinus disorder and a lung disorder, since separation from service, as well as the approximate dates of treatment. Then, after any necessary authorization is obtained from the veteran, the RO should attempt to obtain copies of all treatment records identified by the veteran which have not been previously requested and are not currently of record. In the event an identified physician is deceased, the RO should attempt to obtain the records from the custodian of the physician's records. 2. The RO should arrange for VA examinations to be performed by specialists in pulmonary diseases and ear, nose and throat diseases. The pulmonary specialist should determine the nature and extent of any current lung disorder. All indicated studies should be performed, including a chest X-ray and pulmonary function studies. The examiner should review the record and provide an opinion as to whether the current lung disorder(s) is(are) related to the veteran's inhalation of smoke and fumes when he served as a fire fighter during service. The rationale for the opinion should be set out in detail. In addition, the examination performed by an ear, nose and throat specialist should determine the nature and extent of any current sinus disorder. All indicated studies should be performed. In addition, the examiner should review the record and provide an opinion as to whether the current sinus disorder(s) is(are) related to the veteran's inhalation of smoke and fumes when he served as a fire fighter during service. The rationale for the opinion should be set out in detail. For each examination, the claims folder should be made available to the examiner prior to the examination. 3. Then, the RO should readjudicate the claim for service connection for a lung disorder and adjudicate the claim for service connection for a sinus disorder. If the veteran disagrees with any of the decisions of the RO and if otherwise appropriate, a supplemental statement of the case should be issued for all issues in appellate status and the veteran and his representative should be provided an opportunity to respond. Then, the case should be returned to the Board for further consideration, if otherwise in order. By this REMAND, the Board intimates no opinion as to either of the final outcomes warranted. No action is required of the veteran, until he is contacted by the RO. BOARD OF VETERANS' APPEALS WASHINGTON, D.C. 20420 * JOHN J. CASTELLOT, SR., M.D. ROBERT E. SULLIVAN *38 U.S.C.A. § 7102(a)(2)(A) (West 1991) permits a Board of Veterans' Appeals Section, upon direction of the Chairman of the Board, to proceed with the transaction of business without awaiting assignment of an additional Member to the Section when the Section is composed of fewer than three Members due to absence of a Member, vacancy on the Board or inability of the Member assigned to the Section to serve on the panel. The Chairman has directed that the Section proceed with the transaction of business, including the issuance of decisions, without awaiting the assignment of a third Member. (CONTINUED ON NEXT PAGE) Under 38 U.S.C.A. § 7252 (West 1991), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Veterans Appeals. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 57 Fed. Reg. 4126 (1992) (to be codified as 38 C.F.R. § 20.1100(b)).