Citation Nr: 18142874 Decision Date: 10/17/18 Archive Date: 10/16/18 DOCKET NO. 16-04 054 DATE: October 17, 2018 REMANDED Entitlement to service connection for back disability is remanded. Entitlement to service connection for asthma as a result of asbestos exposure is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from May 2001 to July 2003. 1. Entitlement to service connection for back disability is remanded. 2. Entitlement to service connection for asthma as a result of asbestos exposure is remanded. The Board finds that additional development is needed prior to final adjudication of the issues on appeal. First the Board finds that new examinations are needed. The Veteran was afforded a VA examination in June 2014 for her claimed back disability. The examiner, in rendering a negative nexus opinion, noted that the Veteran reported low back pain in 2005 but not thoracic back pain. However, the Veteran is claiming service connection for a back disability, so the lack of reported pain in a section of the back is not dispositive of the issue especially if there are reports of pain on other sections of the back, such as the low back in this case. Moreover, the examiner also reasoned that there was no diagnosis of a chronic back disability while in service; however, the lack of a diagnosis in service is an inadequate basis for a negative opinion. Further, the examiner did not indicate whether she considered the Veteran’s assertions of continued symptomology and accordingly this examination is inadequate. See Barr v. Nicholson, 21 Vet. App. 303 (2007). Therefore, the June 2014 medical opinion is inadequate. In addition, the Veteran was afforded a second examination for her claimed back disability in July 2018. This examiner also failed to address the Veteran’s assertions of continued symptomology while drawing a negative inference from the lack of records of ongoing treatment. Furthermore, the examiner’s opinion is internally inconsistent and requires clarification as the examiner checked a box indicating that “the claimed conditions was at least as likely as not incurred in or caused by the claimed in-service injury, event, or illness” but in the narrative response she opined that “it is less likely than not the current back condition is due to military service…”. Therefore, the July 2018 examination is inadequate and a new VA examination is needed. Moreover, the Veteran has never been afforded a VA examination for her claimed asthma, accordingly, remand is necessary for an examination to answer medical questions presented by the record. See McLendon v. Nicholson, 20 Vet. App. 79 (2006). Finally, the Veteran claims exposure to asbestos. She states that while stationed at Fort Bragg, North Carolina that she primarily worked in a warehouse that was known to contain asbestos. See Statement in correspondence, June 2014. Upon remand, VA should attempt to verify the Veteran’s claims of exposure to asbestos. The matters are REMANDED for the following action: 1. The RO must take appropriate action to develop evidence of whether the Veteran was exposed to asbestos during service, to include requesting information from the appropriate resources regarding her military occupational specialty, assigned duties, and locations of service. 2. Afford the Veteran an appropriate VA examination to determine whether her currently diagnosed asthma is related to her military service. All pertinent symptomatology and findings must be reported in detail and any indicated diagnostic tests and studies must be accomplished. The claim file must be made available to the examiner, and the examiner must specify in the examination report that these records have been reviewed. The examiner must elicit from the Veteran and record in the examination report a full history. After a review of the evidence of record, to include the Veteran’s statements, the examiner must provide an opinion as to whether any degree of the currently diagnosed asthma was at least as likely as not caused by or aggravated by service to include any confirmed exposure to asbestos in service. In rendering the opinion, the examiner must discuss any and all lay statements submitted by the Veteran. The examiner must provide a complete rationale for all opinions expressed. If the examiner cannot provide the requested opinion without resorting to speculation, it must be so stated, and the examiner must provide the reasons why an opinion would require speculation. The examiner must indicate whether there was any further need for information or testing necessary to make a determination. The examiner must indicate whether an opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. 2. Afford the Veteran an appropriate VA examination to determine whether her currently diagnosed back disability(ies) is/are related to her military service. All pertinent symptomatology and findings must be reported in detail and any indicated diagnostic tests and studies must be accomplished. The claim file must be made available to the examiner, and the examiner must specify in the examination report that these records have been reviewed. The examiner must elicit from the Veteran and record in the examination report a full history. After a review of the evidence of record, to include the Veteran’s statements, the examiner must identify any and all back disabilities diagnosed at any point during the appeal period. For each back disability diagnosed, the examiner is to provide an opinion as to whether the disability is at least as likely as not caused by or aggravated by service. In rendering the opinion, the examiner must consider all lay statements of record including the Veteran’s assertions of continued problems with his back since service. The examiner must provide a complete rationale for all opinions expressed. If the examiner cannot provide the requested opinion without resorting to speculation, it must be so stated, and the examiner must provide the reasons why an opinion would require speculation. The examiner must indicate whether there was any further need for information or testing necessary to make a determination. The examiner must indicate whether an opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. 3. If upon completion of the above actions the claim remains denied, the case should be returned to the Board after compliance with appellate procedures. E. I. VELEZ Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD D. Baronofsky Associate Counsel