Citation Nr: 18142309 Decision Date: 10/16/18 Archive Date: 10/15/18 DOCKET NO. 15-40 103 DATE: October 16, 2018 REMANDED Entitlement to service connection for a lung disorder, to include chronic obstructive pulmonary disease (COPD), claimed as due to exposure to herbicide agents and/or asbestos, is remanded. Entitlement to service connection for basal cell carcinoma, claimed as due to exposure to herbicide agents and/or asbestos, is remanded. Entitlement to service connection for an acquired psychiatric disorder, claimed as posttraumatic stress disorder (PTSD), is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1963 to May 1968. This matter comes before the Board of Veterans Appeals (Board) on appeal from a rating decision issued in March 2014 by a Department of Veterans Affairs (VA) Regional Office. 1. Entitlement to service connection for a lung disorder, to include COPD, claimed as due to exposure to herbicide agents and/or asbestos. 2. Entitlement to service connection for basal cell carcinoma, claimed as due to exposure to herbicide agents and/or asbestos. The record reflects a current diagnosis of a lung disorder, identified as COPD, and basal cell carcinoma of the forehead, nose, and upper chest. Further, such also shows that the Agency of Original Jurisdiction (AOJ) has acknowledged the Veteran’s exposure to herbicide agents coincident with his service in the Republic of Vietnam at Cam Ranh Bay from May 1967 to May 1968 and his likely exposure to asbestos based on his military occupational specialty of Machinist’s Mate. Consequently, the Board finds that a remand is necessary in order to afford the Veteran VA examinations so as to determine the nature and etiology of his claimed lung disorder and basal cell carcinoma, to include whether such are related to his in-service exposure to herbicide agents and/or asbestos. 3. Entitlement to service connection for an acquired psychiatric disorder, claimed as PTSD. The Veteran contends that he has an acquired psychiatric disorder, to include PTSD, as a result of his service in Vietnam where he experienced frequent mortar attacks. As such report is consistent with the circumstances, conditions, and hardships of his service involving military combat operations in Vietnam, such stressor was considered verified by the AOJ in December 2013. Furthermore, the Board finds that the nature of such claimed stressor is likewise consistent with the Veteran’s fear of hostile military activity. In connection with his claim, the Veteran was afforded a VA examination in September 2013. At such time, the examiner found that the Veteran’s symptoms did not meet the diagnostic criteria for PTSD pursuant to the criteria set forth in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), and he did not have a mental disorder that conformed with the DSM-IV criteria. However, a June 2014 VA treatment record reflects that a psychiatrist indicated that, while further evaluation was needed to determine whether the Veteran met the criteria for a PTSD diagnosis, he did meet the criteria for “Other Unspecified Trauma/Stressor Related Disorder” and possibly depression. In October 2014, the Veteran met with a psychologist whose notes indicate that Veteran did not meet the criteria for PTSD, but his symptoms appeared to be “clinically significant” and caused him some functional impairment. Furthermore, effective August 4, 2014, VA amended the portion of its Schedule for Rating Disabilities dealing with mental disorders and its adjudication regulations to remove outdated references to the DSM-IV and replaced them with references to the updated Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). See 79 Fed. Reg. 149, 45094 (August 4, 2014); 80 Fed. Reg. 14,308 (Mar. 19, 2015) (final). As the Veteran’s appeal was certified in July 2016, his claim is governed by the DSM-5. Therefore, the Board finds that a remand is necessary in order to afford the Veteran a new VA examination to determine whether he has a current diagnosis of an acquired psychiatric disorder pursuant to the DSM-5 and, if so, whether such is related to his military service. The matters are REMANDED for the following action: 1. Afford the Veteran an appropriate VA examination to determine the current nature and etiology of his lung disorder. The record, to include a complete copy of this Remand, must be made available to the examiner and all indicated tests and studies should be conducted. Thereafter, the examiner should address the following inquiries: (A) Identify all current lung disorders, to include COPD. (B) For each currently diagnosed lung disorder, offer an opinion as to whether such is at least as likely as not (i.e., a 50 percent or greater probability) is related to the Veteran’s military service, to include his acknowledged in-service exposure to herbicide agents and/or asbestos. A rationale for any opinion offered should be provided. 2. Afford the Veteran an appropriate VA examination to determine the current nature and etiology of his basal cell carcinoma. The record, to include a complete copy of this Remand, must be made available to the examiner and all indicated tests and studies should be conducted. Thereafter, the examiner should offer an opinion as to whether the Veteran’s diagnosed basal cell carcinoma is at least as likely as not (i.e., a 50 percent or greater probability) is related to his military service, to include his acknowledged in-service exposure to herbicide agents and/or asbestos. A rationale for any opinion offered should be provided. 3. Afford the Veteran for a VA examination to determine the nature and etiology of his acquired psychiatric disorder. The examination must be completed by a VA psychiatrist or psychologist, or a VA psychiatrist or psychologist with whom VA has contracted. The record, to include a complete copy of this Remand, must be made available to the examiner and all indicated tests and studies should be conducted. (A) The examiner should identify all of the Veteran’s acquired psychiatric disorders that meet the DSM-5 criteria. (B) If a diagnosis of PTSD is rendered, the examiner should state whether such diagnosis is the result of an in-service stressor, to include the Veteran’s verified stressor of experiencing frequent mortar attacks while serving in Cam Ranh Bay and/or his acknowledged fear of hostile military activity coincident with his service in Vietnam. (C) For each diagnosed acquired psychiatric disorder other than PTSD, the examiner should offer an opinion as to whether it is at least as likely as not (50 percent or greater probability) that any such disorder is related to the Veteran’s military service, to include his service in Vietnam. A rationale should be provided for any opinion offered A. JAEGER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD E. Gardner Gaye, Associate Counsel