Citation Nr: 18146301 Decision Date: 10/31/18 Archive Date: 10/31/18 DOCKET NO. 16-24 295 DATE: October 31, 2018 REMANDED Entitlement to service connection for emphysema, to include as due to asbestos exposure, is remanded. Entitlement to an initial compensable disability rating for pleural plaques is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1963 to September 1965. 1. Entitlement to service connection for emphysema, to include as due to asbestos exposure, is remanded. Although a VA examination of the Veteran’s emphysema was provided in September 2015, the examiner did not include any rationale for his opinion that emphysema was related to the Veteran’s prior smoking history. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007); Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 301 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). In that examination, the Veteran reported a history of smoking one pack of cigarettes a day for 25 years and that he quit smoking in 1982. In his May 2016 VA Form 9, the Veteran reported he quit smoking in 1982 and did not smoke “that much” previously, stating he was not a chain smoker. Therefore, the claim for entitlement to service connection for emphysema should be remanded to provide a supplemental VA opinion with supporting rationale regarding this matter. McLendon v. Nicholson, 20 Vet. App. 79, 83 (2006); Locklear v. Nicholson, 20 Vet. App. 410 (2006); see Waters v. Shinseki, 601 F.3d 1274, 1276 (2010); Allen v. Brown, 7 Vet. App. 439, 448 (1995). 2. Entitlement to an initial compensable disability rating for pleural plaques is remanded. Since the last September 2015 VA examination, the Veteran has reported his pleural plaques disability is worse than that which is provided for under the current rating assigned. Specifically, in a May 2016 statement accompanying his VA Form 9, he reported new symptoms of shortness of breath with little exertion and in a June 2018 statement, he reported having calcifications in the lungs and was going to have a consultation with respect to his lung condition later the same month. In addition, a May 2015 VA outpatient treatment report noted multiple bilateral calcified pleural nodules and pulmonary function testing (PFT) showed mild reversible obstructive disease, although the PFT results were not included in the report. Therefore, a new VA examination is necessary to adequately determine the current severity of the Veteran’s pleural plaques and the functional effects of such disability. Snuffer v. Gober, 10 Vet. App. 400 (1997); Caffrey v. Brown, 6 Vet. App. 377 (1994); VAOPCGPREC 11-95 (April 7, 1995); see also 38 C.F.R. § 3.327. As the record reflects the Veteran has received continuing treatment at VA, any outstanding and current ongoing medical records should also be obtained. 38 U.S.C. § 5103A(c); see also Bell v. Derwinski, 2 Vet. App. 611 (1992). The matters are REMANDED for the following action: 1. Obtain and associate with the claims file all outstanding pertinent VA and private medical records the Veteran adequately identifies. 2. Upon receipt of all additional records, the claims folder and a copy of this remand are to be made available to and reviewed by an appropriate VA examiner, to determine the current nature and etiology of the Veteran’s emphysema. The examination report is to contain a notation that the examiner reviewed the claims file, including the Veteran’s lay statements regarding his smoking history and the exposure to asbestos while working as a boiler technician in service, as established by the record. The examiner is then asked to answer the following: Whether it is at least as likely as not (50 percent or greater probability) that emphysema was incurred during the Veteran’s active service, or was otherwise caused by or related to the Veteran's military service, including the established exposure to asbestos while working as a boiler technician. It is essential the examiner provide explanatory rationale for opinions on these determinative issues, citing to specific evidence in the file supporting conclusions. 3. Upon receipt of all additional records, schedule the Veteran for a VA examination of his pleural plaques. The claims folder and a copy of this remand are to be made available to and reviewed by the examiner in connection with the examination. The evaluation of the pleural plaques should consist of all necessary testing, including pulmonary function tests (PFTs). The examiner is asked to comment on the following: (a). The degree of severity and the functional effects of this disability on his activities of daily living and capacity for work. (b). The results of the PFTs, including Forced Vital Capacity (FVC) percent predicted and Diffusion Capacity of the Lung for Carbon Monoxide by the Single Breath Method (DLCO (SB)) percent predicted (c). The maximum exercise capacity expressed in ml/kg/min oxygen consumption and whether such is accompanied by cardiorespiratory limitation, or whether the Veteran’s pleural plaques are productive of: cor pulmonale or pulmonary hypertension, or; require outpatient oxygen therapy. It is essential the examiner provide explanatory rationale for opinions on these determinative issues, citing to specific evidence in the file supporting conclusions. JENNIFER HWA Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Saira Spicknall, Counsel