Citation Nr: 18145479
Decision Date: 10/29/18	Archive Date: 10/29/18

DOCKET NO. 16-17 013
DATE:	October 29, 2018
REMANDED
Entitlement to service connection for asthma is remanded.
REASONS FOR REMAND
The Veteran served honorably in the United States Navy from October 1974 to October 1978, September 1994 to December 1994, and from January 2003 to November 2003. 
This issue comes before the Board of Veterans’ Appeal (Board) from an August 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Philadelphia, Pennsylvania.
Entitlement to service connection for asthma is remanded.
The Veteran contends he has had breathing difficulties since an in-service motor vehicle collision in November 1975 and that his breathing difficulties are a direct result of the collision. 
The Veteran’s January 1976 service treatment record reveals that he was in a November 1975 motor vehicle collision, resulting in bilateral blunt chest trauma and bilateral hemopneumothorax. During the pendency of this appeal, the Veteran was service-connected for residual restrictive ventilatory defect. A July 2015 VA examination resulted in an asthma diagnosis, but the examiner concluded that it was not linked to the Veteran’s active duty service because no medical literature exists to support a pneumothorax condition causing asthma. An opinion was not provided regarding aggravation. The Board finds that a remand is required to determine if the Veteran’s asthma is aggravated by his service-connected restrictive ventilatory defect.
The matter is REMANDED for the following action:
1. Obtain updated VA and/or private treatment records to the extent possible. If any such records are unavailable, the Veteran’s claim file must be clearly documented to that effect and the Veteran notified in accordance with 38 C.F.R. § 3.159(e). 
2. Obtain a VA medical opinion from a medical professional with appropriate expertise. The reviewer should review the Veteran’s claims file, including a copy of this remand. If the reviewer determines that an opinion cannot be provided without an examination, the Veteran should be scheduled for one. Based on a review of the record, and a new examination if necessary, the reviewer must address the following: 
Whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran’s asthma condition is caused or aggravated by his service-connected restrictive ventilatory defect. The term “at least as likely as not” does not mean within the realm of medical possibility, but rather that the medical evidence both for and against a certain conclusion is so evenly divided that it is as medically sound to find in favor of such a conclusion as it is to find against it. 
For the purposes of secondary service connection, the reviewer is advised that aggravation is defined as “any increase in disability.” See Allen v. Brown, 7 Vet. App. 439, 448 (1995).
A complete rationale must be provided for all opinions presented. If the medical professional cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation for why an opinion cannot be rendered. In so doing, the medical professional shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question(s).
 
G. A. WASIK
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	J. Massey, Associate Counsel