Citation Nr: 18148183
Decision Date: 11/07/18	Archive Date: 11/07/18

DOCKET NO. 17-58 643
DATE:	November 7, 2018
REMANDED
Entitlement to service-connection for a lung disease (diagnosed as asbestos-related pleural disease) is remanded.
REASONS FOR REMAND
The Veteran served on active duty in the United States Air Force from October 1956 to September 1976.  This matter comes to the Board of Veterans Appeals (Board) on appeal from an October 2014 rating decision from a Department of Veterans Affairs (VA) Regional Office (RO).
1. Entitlement to service-connection for a lung condition (diagnosed as asbestos related pleural disease) is remanded.
The Veteran’s service treatment records (STRs) contain significant treatment for lung pain, bronchitis, and other respiratory infections beginning in June 1963 and continuing through his retirement examination in 1976.  Current CT scans demonstrate the presence of lung nodules and prior asbestos exposure, and his statements regarding asbestos exposure during active duty are consistent with the circumstances of his service. 38 U.S.C. § 1154(a). Additionally, he reports that his lung pain has persisted since his discharge, that he has never smoked cigarettes, and that he was employed as an insurance salesman and postal worker after his discharge from active duty.  Based on this evidence, an examination and medical opinion are warranted on remand, and outstanding treatment records should be secured.
The matter is REMANDED for the following action:
1. Obtain all outstanding VA treatment records.
2. With any necessary assistance from the Veteran, obtain any outstanding relevant private treatment records.
3. Then schedule the Veteran for a VA examination to determine the nature and etiology of any diagnosed lung disease. The claims file should be made available to and should be reviewed by the examiner.
(a.) The examiner should consider the following:
i.	The Veteran’s STRs, which show consistent treatment for respiratory conditions and pain beginning in 1963 through his discharge in 1976;
ii.	VAMC treatment records, which show consistent complaints of chest/lung pain;
iii.	The May 2013 VA chest CT scan noting “asbestos-related pleural disease;” 
iv.	The September 2013 statement from a private radiologist that the Veteran’s lung condition suggests prior asbestos exposure; 
v.	The Veteran’s August 2014 statement about his exposure to asbestos;
vi.	The Veteran’s September 2017 statement regarding his work history after discharge; and
vii.	The Veteran’s August 2018 statement that he has never smoked cigarettes and specifically his recollection about seeing fine dust collecting on the equipment he used when asbestos material was being replaced;
(b.) For each lung disease diagnosed, the examiner should opine as to whether it is at least as likely as not (50 percent probability or higher) that such disease had its onset during active service or is otherwise related to service, to include his documented in-service chronic respiratory pain and bronchitis and conceded in-service exposure to asbestos.
In addressing these questions, the examiner must discuss: (i) the Veteran’s STRs showing recurrent treatment for chronic respiratory conditions; (ii) the Veteran’s in-service exposure to asbestos; (iii) the report that the Veteran has never smoked cigarettes; and (iv) the Veteran’s post-service work history.
A complete rationale must be provided for any opinion expressed.  If the examiner is unable to opine without resorting to speculation, it is imperative that he or she provide a basis for this conclusion (e.g. lack of sufficient information/evidence, the limits of medical knowledge, etc.). 

 
S. BUSH
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	G.Rouse, Associate Counsel