Citation Nr: 18146055
Decision Date: 10/30/18	Archive Date: 10/30/18

DOCKET NO. 16-46 680
DATE:	October 30, 2018
REMANDED
Entitlement to service connection for a respiratory disorder, claimed as emphysema, is remanded.
REASONS FOR REMAND
The Veteran had active duty service from March 1968 to March 1970.
Entitlement to service connection for a respiratory disorder, claimed as emphysema, is remanded.
The Veteran contends he was exposed to asbestos during service and now has a respiratory/lung disorder as a result.  As previously noted by the RO, the Veteran’s exposure has been conceded.  See July 2016 Statement of the Case (noting that the Veteran has been shown to have a probable exposure to Asbestos based on his occupation in the Navy).
The Veteran was afforded two respiratory examinations; none of which are adequate.  Specifically, an October 2012 VA examination report states that chest x-rays from September 2012 showed “small bilateral subcentimeter pulmonary nodules, possibly granulomata but warranting further evaluation.  Recommend CT of the thorax.”  The Veteran was then afforded another VA examination in October 2013.  The report indicates that a computed tomography (CT) was done and the findings were consistent with prior granulomatous disease including calcified granulomas in the lungs.  A diagnosis of chronic obstructive pulmonary disease (COPD) was also noted.  The VA examiner did not provide a medical opinion as to the cause of the disabilities and instead stated that the Veteran’s c-file had not been sent for her review.  Later VA treatment records seem to suggest that the Veteran has COPD as well as emphysema.  As such, a remand is required for an addendum VA medical opinion to clarify the Veteran’s respiratory diagnoses and provide a medical opinion regarding the cause of such diagnoses.
The matter is REMANDED for the following action:
1. Obtain an addendum opinion from an appropriate clinician regarding the Veteran’s respiratory disorders.  
The need for an in-person examination is left to the discretion of the examining clinician.  The Veteran’s entire claims file must be made available for the clinician’s review.
The examiner is asked to:
(1)	Identify all diagnosed respiratory disorders; and 
(2)	For each diagnosed respiratory disorder, the examiner is asked to opine: whether it is at least as likely as not due to the Veteran’s service, to include his conceded asbestos exposure.
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A complete rationale for any opinion rendered must be provided.
 
H.M WALKER
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	Martha R. Luboch, Associate Counsel