Citation Nr: 18143620 Decision Date: 10/19/18 Archive Date: 10/19/18 DOCKET NO. 16-14 799 DATE: REMANDED Entitlement to service connection for a respiratory disability, to include chronic obstructive pulmonary disease (COPD), claimed as secondary to exposure to asbestos, lead paint and/or other chemicals is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from June 1975 to May 1979. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a November 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Indianapolis, Indiana. The Veteran testified before the undersigned Veterans Law Judge (VLJ) at a June 2018 Board video conference hearing. A transcript of that hearing has been associated with the claims file. Entitlement to service connection for a respiratory disability, to include chronic obstructive pulmonary disease (COPD), claimed as secondary to exposure to asbestos, lead paint and/or other chemicals is remanded. In October 2013, VA obtained a medical opinion without the benefit of in in-person examination. In the March 2016 Statement of the Case (SOC), the RO noted that the Veteran served as a Seaman before becoming a Ship Serviceman and, as such, conceded the possibility of the Veteran’s exposure to asbestos. The Veteran testified at the June 2018 Board hearing that while in the Navy he served aboard the USS Jouett CG-29 at the Long Beach, California Naval Shipyard. The Veteran stated that he was assigned to the deck division wherein he scraped, sanded and applied lead-based paint, thus exposing him to paint dust and fumes from lead-based paint. The veteran then stated that asbestos was being removed and replaced from the ship. The Veteran stated that he was also exposed to other chemicals that were used to remove paint. The Veteran stated that he has never been given a physical examination by the VA and asserted that an “ACE” examination is not an appropriate means of providing a medical opinion. The Veteran stated that since the 2013 VA opinion he has been twice taken to the emergency room with breathing issues and that he has chronic bronchitis. The Veteran then stated that he has daily chest tightness, shortness of breath, congestion and green phlegm. The Veteran also stated that he has been diagnosed with sleep apnea and recent testing was suggestive of a partial lung collapse. The Veteran then stated that while stationed on his second ship, the USS Buchanan, he slept on the top bunk and that “there was constant stuff coming down that would be on [his] bunk all the time” and that moving the 5-inch gun on the deck would “shuck[] the asbestos loose from the pipes on the ship”. The Veteran denied any asbestos exposure after his Naval service but did endorse smoking while in the service, but only for 4 or 5 years. The Board finds that the Veteran's statements regarding exposure to lead paint to be credible and consistent with his duties aboard ship. Therefore, with regard to the claimed respiratory disability, the Board will presume the Veteran had in-service exposure to lead paint. See 38 C.F.R. § 3.303 (a). Based on the above, the Board finds that a remand to obtain private treatment records and then an in-person VA examination is required. The matter is REMANDED for the following action: 1. Obtain the Veteran’s VA treatment records for the period from March 2018 to the Present. 2. Ask the Veteran to complete a VA Form 21-4142 for all private treatment providers for his claimed respiratory condition. Make two requests for the authorized records from all private treatment providers for his claimed respiratory condition, unless it is clear after the first request that a second request would be futile. 3. After, and only after, completion of steps one and two above, schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any respiratory disability, to include COPD. The examiner must opine whether it is at least as likely as not related to an in-service injury, event, or disease, including exposure to asbestos, lead paint and/or other chemicals. The examiner must address the Veteran’s testimony in the June 2018 Board hearing regarding his exposure to asbestos, lead paint and chemicals used to remove lead paint, as well as the current state of his respiratory health. All opinions provided must be thoroughly explained, and a complete and detailed rationale for any conclusions reached should be provided (a bare conclusory statement will be deemed inadequate). The examiner is reminded that the term “as likely as not” does not mean “within the realm of medical possibility,” but rather that the evidence of record is so evenly divided that, in the examiner’s expert opinion, it is as medically sound to find in favor of the proposition as it is to find against it. It is not sufficient to base an opinion on a mere lack of documentation of complaints in the service or post-service treatment records. 4. After completing the requested actions, and any additional development deemed warranted, readjudicate the claims in light of all pertinent evidence and legal authority. If the benefits sought remain denied, furnish to the Veteran a Supplemental Statement of the Case and afford them the appropriate time period for response before the claims file is returned to the Board for further appellate consideration. Michael Pappas Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD B. P. Keeley, Associate Counsel