Citation Nr: 18142169 Decision Date: 10/16/18 Archive Date: 10/12/18 DOCKET NO. 10-02 470 DATE: October 16, 2018 REMANDED Entitlement to service connection for a respiratory/pulmonary condition other than a restrictive right lobe condition, to include chronic obstructive pulmonary disease (COPD), emphysema, obstructive sleep apnea, pulmonary embolism, pulmonary hypertension, asthma/bronchial asthma, and allergic rhinitis, is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1972 to October 1974. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an October 2008 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In January 2017, the Veteran and M.A.S. testified before the undersigned at a Board hearing in Detroit, Michigan. A transcript of that hearing has been associated with the virtual file and reviewed. This case was previously before the Board in June 2017, at which time it bifurcated the claim for a lung or respiratory condition to distinguish between a restrictive lung condition and other respiratory conditions. The Board granted service connection for a restrictive right lobe condition, to include elevation of the right hemidiaphragm, diaphragmatic paralysis, pneumothorax, and atelectasis, and remanded the claim of service connection for a respiratory condition other than a restrictive lung condition. Entitlement to service connection for a respiratory/pulmonary condition other than a restrictive right lobe condition, to include COPD, emphysema, obstructive sleep apnea, pulmonary embolism, pulmonary hypertension, asthma/bronchial asthma, and allergic rhinitis, is remanded. In November 2017, a VA examiner opined that the diagnosed lung conditions of COPD, emphysema, obstructive sleep apnea, pulmonary embolism, pulmonary hypertension, asthma/bronchial asthma, and allergic rhinitis are not related to the Veteran’s period of service, relying solely on the fact that they were diagnosed many years after service. Additionally, the examiner cited to medical literature in support of the opinion that the diagnosed conditions are not proximately related to the service-connected restrictive lung disability, but did not identify the medical literature relied on. Accordingly, the Agency of Original Jurisdiction (AOJ) should obtain an addendum opinion from a pulmonary specialist to determine the nature and etiology of the diagnosed pulmonary/respiratory conditions after obtaining any recent VA treatment records. The matter is REMANDED for the following actions: 1. Obtain the Veteran’s VA treatment records for the period from June 2017 to the present. 2. After completing directive #1, request that a VA pulmonologist/pulmonary specialist provide an opinion regarding the nature and etiology of COPD, emphysema, obstructive sleep apnea, pulmonary embolism, pulmonary hypertension, asthma/bronchial asthma, and allergic rhinitis. An in-person examination is not required unless deemed necessary by the clinician.   The specialist is to review the virtual file, including a copy of this Remand, then address the following: (a.) Whether it is at least as likely as not (50 percent or greater probability) that COPD manifested during or is otherwise related to the Veteran’s period of active service. (b.) Whether it is at least as likely as not (50 percent or greater probability) that COPD was caused by the service-connected restrictive lung disability. (c.) Whether it is at least as likely as not (50 percent or greater probability) that COPD has been aggravated (i.e., worsened beyond the normal progression of that disease) by the service-connected restrictive lung disability. (d.) Whether it is at least as likely as not (50 percent or greater probability) that emphysema manifested during or is otherwise related to the Veteran’s period of active service. (e.) Whether it is at least as likely as not (50 percent or greater probability) that emphysema was caused by the service-connected restrictive lung disability. (f.) Whether it is at least as likely as not (50 percent or greater probability) that emphysema has been aggravated (i.e., worsened beyond the normal progression of that disease) by the service-connected restrictive lung disability. (g.) Whether it is at least as likely as not (50 percent or greater probability) that obstructive sleep apnea manifested during or is otherwise related to the Veteran’s period of active service. (h.) Whether it is at least as likely as not (50 percent or greater probability) that obstructive sleep apnea was caused by the service-connected restrictive lung disability. (i.) Whether it is at least as likely as not (50 percent or greater probability) that obstructive sleep apnea has been aggravated (i.e., worsened beyond the normal progression of that disease) by the service-connected restrictive lung disability. (j.) Whether it is at least as likely as not (50 percent or greater probability) that pulmonary embolism manifested during or is otherwise related to the Veteran’s period of active service. (k.) Whether it is at least as likely as not (50 percent or greater probability) that pulmonary embolism was caused by the service-connected restrictive lung disability. (l.) Whether it is at least as likely as not (50 percent or greater probability) that pulmonary embolism has been aggravated (i.e., worsened beyond the normal progression of that disease) by the service-connected restrictive lung disability. (m.) Whether it is at least as likely as not (50 percent or greater probability) that pulmonary hypertension manifested during or is otherwise related to the Veteran’s period of active service. (n.) Whether it is at least as likely as not (50 percent or greater probability) that pulmonary hypertension was caused by the service-connected restrictive lung disability. (o.) Whether it is at least as likely as not (50 percent or greater probability) that pulmonary hypertension has been aggravated (i.e., worsened beyond the normal progression of that disease) by the service-connected restrictive lung disability. (p.) Whether it is at least as likely as not (50 percent or greater probability) that asthma/bronchial asthma manifested during or is otherwise related to the Veteran’s period of active service. (q.) Whether it is at least as likely as not (50 percent or greater probability) that asthma/bronchial asthma was caused by the service-connected restrictive lung disability. (r.) Whether it is at least as likely as not (50 percent or greater probability) that asthma/bronchial asthma has been aggravated (i.e., worsened beyond the normal progression of that disease) by the service-connected restrictive lung disability. (s.) Whether it is at least as likely as not (50 percent or greater probability) that allergic rhinitis manifested during or is otherwise related to the Veteran’s period of active service. (t.) Whether it is at least as likely as not (50 percent or greater probability) that allergic rhinitis was caused by the service-connected restrictive lung disability. (u.) Whether it is at least as likely as not (50 percent or greater probability) that allergic rhinitis has been aggravated (i.e., worsened beyond the normal progression of that disease) by the service-connected restrictive lung disability. Paul Sorisio Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J.A. Gelber, Associate Counsel