Citation Nr: 18149780
Decision Date: 11/13/18	Archive Date: 11/13/18

DOCKET NO. 15-33 507
DATE:	November 13, 2018
REMANDED
Entitlement to service connection for sinusitis, to include as due to exposure to burn pits, is remanded.
REASONS FOR REMAND
The Veteran served on active duty from January 1995 to April 2001.
Upon review of the record, the Board finds that the issues must once again be remanded.  The Board sincerely regrets the additional delay caused by this remand, but wishes to assure the Veteran that it is necessary for a full and fair adjudication of the claim.
1. Entitlement to service connection for sinusitis is remanded.
The Board finds that a new examination and etiology opinion is warranted for the Veteran’s claim.  The Board finds the September 2017 VA opinion to be inadequate.  While the examiner provided a negative nexus opinion, the examiner neglected to address the Veteran’s December 1998 service treatment records (STRs) which noted a diagnosis of sinusitis and the Veteran’s lay statements of experiencing symptoms during service.  As the etiology opinion of the Veteran’s sinusitis is necessary to make a decision on the Veteran’s claim, and the opinion provided is inadequate, remand is required to obtain this opinion. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007) (once VA undertakes to provide a medical examination or opinion, it must ensure that the examination or opinion is adequate).
The matter is REMANDED for the following action:
1. Assist the Veteran in associating with the claims folder updated treatment records.
2. After any additional records are associated with the claims file, schedule the Veteran for a VA examination to determine the nature and etiology of the Veteran’s sinusitis.  The claims file should be made available to the examiner for review in connection with the examination.  Based on review of the record and conducting an examination of the Veteran, the examiner should respond to the following:
a)	The examiner should state whether it is at least as likely as not (a 50 percent probability or more) that the sinusitis began in service, was caused by active service, or is otherwise related to active service (to include exposure to burn pits).  The examiner should take a thorough history from the Veteran regarding the onset and pattern of her symptoms.
The examiner is advised that the Veteran is competent to report symptoms, treatment, and injuries, and that her reports must be taken into account in formulating the requested opinions.  The examiner is asked to comment on the Veteran’s December 1998 STRs which note a diagnosis of sinusitis, and the Veteran’s lay statements of burn pit exposure, a periodic cough in 1996/1997 in Korea, a worsening of the cough in 1998 while in the Middle East, and symptoms since her service.
The examiner must provide the rationale for all proffered opinions.  If the examiner is unable to provide any required opinion, he or she should explain why.  If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation as to why this is so.  If the inability to provide a more definitive opinion is the result of a need for additional information, the examiner should identify the additional information that is needed.
 
A. S. CARACCIOLO
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	R. Gandhi, Associate Counsel