Citation Nr: 18143582 Decision Date: 10/23/18 Archive Date: 10/19/18 DOCKET NO. 15-09 508 DATE: October 23, 2018 REMANDED Entitlement to service connection for a chronic lung disorder, to include as due to chemical exposures and/or asbestos exposure is remanded. Entitlement to service connection for a thyroid disorder, to include as due to chemical exposures and/or asbestos exposure is remanded. Entitlement to service connection for esophageal cancer, to include as due to chemical exposures and/or asbestos exposure is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1982 to January 1986. He served in the United States Navy. The Veteran testified before the undersigned Veterans Law Judge during an October 2018 video conference hearing. The transcript from the hearing has not yet been associated with the file, as the case is being remanded under the Board’s “One Touch” program. The hearing transcript will still be processed and associated with the claims file in the ordinary course of business. At the October 2018 Board hearing, the Veteran contended his claimed disabilities were caused by chemical exposures during service, to include asbestos, fuel oil, and other chemicals. In a June 2013 Statement in Support of Claim, the Veteran reported that he was exposed to asbestos aboard the U.S.S. Barry DD 933 where he was assigned to engineering spaces as a boiler technician (BT), where his duties included installing and removing asbestos filled lagging also known as insulation and conducting internal maintenance on the boilers. He also reported that he was also assigned to the U.S.S. Edson DD 946 where he continued this duties as a BT. The Veteran’s DD-214 confirm his military occupational specialty (MOS) as a (BT) Electrical/Mechanical Equipment Repairman, an MOS which is classified as highly probable exposure to asbestos. As such, exposure to asbestos is conceded. Remand is required for new VA examinations. Where VA provides the Veteran with an examination in a service connection claim, the examination must be adequate. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). A medical opinion must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions. Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). Additionally, a medical opinion should address the appropriate theories of entitlement. Stefl, 21 Vet. App. at 120, 123-24. 1. Entitlement to service connection for a chronic lung condition to include as due to chemical exposures and/or asbestos exposure A November 2014 VA examination was conducted. The Veteran had a diagnosis of emphysema. The examiner opined that the Veteran’s chronic lung disorder was not caused by or a result of asbestos exposure but was a result of the Veteran’s long-standing history of tobacco use. However, the examination report did not address exposure to non-asbestos or consider the Veteran’s lay statements regarding his active duty service and exposure to asbestos and chemicals. Therefore, a new VA examination is warranted. 2. Entitlement to service connection for a thyroid disorder, to include as due to chemical exposures and/or asbestos exposure A November 2014 VA examination was conducted. The Veteran had a diagnosis of hypothyroidism. The examiner noted that the onset of hypothyroidism coincided with the Veteran’s esophagus condition and opined that the Veteran’s hypothyroidism was not caused by or a result of asbestos exposure and was a result of his radiation and the prolonged exposure to the effects of acid to the esophagus that caused a malignant change. The examination report failed to consider the Veteran’s lay statements regarding his active duty service and exposure to asbestos and chemicals. Therefore, a new VA examination is warranted. 3. Entitlement to service connection for esophageal cancer, to include as due to chemical exposures and/or asbestos exposure A November 2014 VA examination was conducted. The Veteran had a diagnosis of esophageal cancer. The examiner opined that the Veteran’s esophageal cancer was not caused by or a result of asbestos exposure, reasoning that the Veteran had long standing reflux that evolved into Barrett’s esophagus and finally cancer. The examiner further stated that prolonged exposure to the effects of acid to the esophagus caused this malignant change. However, the examination report failed to address exposure to non-asbestos chemicals or consider the Veteran’s lay statements regarding his active duty service and exposure to asbestos and chemicals. Therefore, a new VA examination is warranted. The matters are REMANDED for the following action: 1. Contact the appropriate VA Medical Center and obtain and associate with the claims file all outstanding records of treatment. If any requested records are not available, or the search for any such records otherwise yields negative results, that fact must clearly be documented in the claims file. Efforts to obtain these records must continue until it is determined that they do not exist or that further attempts to obtain them would be futile. The non-existence or unavailability of such records must be verified and this should be documented for the record. Required notice must be provided to the Veteran and his representative. 2. Contact the Veteran and afford him the opportunity to identify by name, address and dates of treatment or examination any relevant medical records. Subsequently, and after securing the proper authorizations where necessary, make arrangements to obtain all the records of treatment or examination from all the sources listed by the Veteran which are not already on file. All information obtained must be made part of the file. All attempts to secure this evidence must be documented in the claims file, and if, after making reasonable efforts to obtain named records, they are not able to be secured, provide the required notice and opportunity to respond to the Veteran and his representative. 3. After any additional records are associated with the claims file, provide the Veteran with an appropriate examination to determine the etiology of chronic lung disorder. The entire claims file should be made available to and be reviewed by the examiner. Any indicated tests and studies must be accomplished and all clinical findings must be reported in detail and correlated to a specific diagnosis. An explanation for all opinions expressed must be provided. The examiner must elicit a full history of the Veteran’s active service, to include chemical exposures and/or asbestos exposure, and consider and address such history in all conclusions reached. (a.) First, the examiner must identify all lung disorders. (b.) Second, the examiner must provide an opinion regarding whether it is at least as likely as not (50 percent or greater probability) that the lung disorder had onset in, or is otherwise caused by, the Veteran’s military service, to include any exposure to chemical and/or asbestos exposure. The examiner must specifically address the Veteran’s conceded exposure to asbestos during his military service. 4. After any additional records are associated with the claims file, provide the Veteran with an appropriate examination to determine the etiology of thyroid condition. The entire claims file should be made available to and be reviewed by the examiner. Any indicated tests and studies must be accomplished and all clinical findings must be reported in detail and correlated to a specific diagnosis. An explanation for all opinions expressed must be provided. The examiner must elicit a full history of the Veteran’s active service, to include chemical exposures and/or asbestos exposure, and consider and address such history in all conclusions reached. (a.) First, the examiner must identify any thyroid condition. (b.) Second, the examiner must provide an opinion regarding whether it is at least as likely as not (50 percent or greater probability) that the thyroid condition had onset in, or is otherwise caused by, the Veteran’s military service, to include any exposure to chemical and/or asbestos exposure. The examiner must specifically address the Veteran’s conceded exposure to asbestos during his military service. 5. After any additional records are associated with the claims file, provide the Veteran with an appropriate examination to determine the etiology of esophageal cancer. The entire claims file should be made available to and be reviewed by the examiner. Any indicated tests and studies must be accomplished and all clinical findings must be reported in detail and correlated to a specific diagnosis. An explanation for all opinions expressed must be provided. The examiner must elicit a full history of the Veteran’s active service, to include chemical exposures and/or asbestos exposure, and consider and address such history in all conclusions reached. (a.) The examiner must provide an opinion regarding whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s esophageal cancer had onset in, or is otherwise caused by, the Veteran’s military service, to include any exposure to chemical and/or asbestos exposure. The examiner must specifically address the Veteran’s conceded exposure to asbestos during his military service. 6. Notify the Veteran that it is his responsibility to report for any scheduled examination and to cooperate in the development of the claims, and that the consequences for failure to report for a VA examination without good cause may include denial of the claims. 38 C.F.R. §§ 3.158, 3.655 (2018). In the event that the Veteran does not report for any scheduled examination, documentation must be obtained which shows that notice scheduling the examination was sent to the last known address. It must also be indicated whether any notice that was sent was returned as undeliverable. 7. Ensure compliance with the directives of this remand. If the report is deficient in any manner, the AOJ must implement corrective procedures. Stegall v. West, 11 Vet. App. 268, 271 (1998). K. MILLIKAN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD P. Nguyen, Associate Counsel