Citation Nr: 18147030
Decision Date: 11/02/18	Archive Date: 11/02/18

DOCKET NO. 16-35 423
DATE:	November 2, 2018
REMANDED
Entitlement to service connection for a respiratory disorder, to include chronic obstructive pulmonary disease (COPD), is remanded. 
REASONS FOR REMAND
The Veteran served on active duty from July 1980 to November 2002. 
This case is before the Board of Veterans’ Appeals (Board) on appeal from a November 2014 rating decision of the Winston-Salem Department of Veterans Affairs (VA) Regional Office (RO). 
The Veteran seeks service connection for a respiratory disorder and contends that he has developed COPD due to in-service asbestos exposure. The Veteran’s service treatment records (STRs) confirm his in-service asbestos exposure. Therefore, the issue to be addressed in this case is whether the Veteran has a current respiratory disorder that is related to his in-service asbestos exposure. 
On October 2014 VA examination, the examiner concluded that the Veteran had never been diagnosed with a respiratory condition and therefore did not provide an etiological opinion for the Veteran’s claimed respiratory condition. However, the examiner also noted in her report that a chest x-ray conducted in August 2014 showed “moderate hyperexpansion of both lungs, suggesting COPD,” and did not address this conflicting evidence in her conclusion.
Additionally, the Veteran states that he was diagnosed with COPD at the Fayetteville VA Medical Center (VAMC) on March 3, 2015; however, there are no records of this diagnosis. Notably, the Veteran underwent another x-ray in January 2016, in which the VA physician found “overall no significant change in appearance of the chest including hyperinflated lungs compatible with COPD.”
Remand is warranted because, as noted, there is conflicting evidence as to whether the Veteran suffers from a respiratory disorder, to include COPD, and if so, whether it is related to his in-service asbestos exposure. Therefore, a clarifying medical opinion is needed. 
The matter is REMANDED for the following actions:
1. Obtain all relevant treatment records the Veteran has identified, to specifically include the March 2015 diagnosis of COPD at the Fayetteville VAMC. 
2. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any respiratory condition, to include COPD. The examiner is asked to:
(a)	Identify whether the Veteran has, or has had at any point during the pendency of this appeal (i.e., since 2003), a diagnosed respiratory disorder, to include COPD. In answering this question, the examiner must consider and discuss the Veteran’s August 2014 and January 2016 chest x-rays, medical results and impressions from these x-rays, the findings from other relevant diagnostic tests, and the October 2014 VA examination report.
(b)	For each respiratory disorder diagnosed, 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.  
The examiner should provide a complete rationale for each opinion given, and cite to the medical and competent lay evidence of record and explain the rationale for all opinions given. If after consideration of all pertinent factors it remains that the opinion sought cannot be given without resorting to speculation, it should be so stated and the provider must (to comply with governing legal guidelines) explain why the opinion sought cannot be offered without resorting to speculation.
 
A. ISHIZAWAR
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	A. Griffin, Associate Counsel