Citation Nr: 18151009
Decision Date: 11/19/18	Archive Date: 11/16/18

DOCKET NO. 16-28 029
DATE:	November 19, 2018
REMANDED
Entitlement to service connection for chronic obstructive pulmonary disease (COPD), to include as due to in-service asbestos exposure, is remanded.

REASONS FOR REMAND
The Veteran served in the United States Navy from February 1965 to March 1968.
This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a January 2016 rating decision (RD) of the Phoenix, Arizona, Regional Office (RO) of the Department of Veterans Affairs (VA). VA records show that the Veteran requested a Travel Board hearing in July 2016, but withdrew his request in December 2016.
The Veteran contends his COPD was either incurred in active service or as a result of his service-connected pulmonary scarring due to asbestos exposure. While in the United States Navy, the Veteran worked as a boiler room technician aboard the U.S.S. Providence. His exposure to asbestos has been conceded. Indeed, service connection for pulmonary scarring secondary to asbestos exposure has been established. 
A VA examination was conducted in December 2015 to determine the nature and etiology of his respiratory disorder. Following review of the claims file, examination, and interview of the Veteran, the examiner determined that the Veteran had parenchymal scarring as a sequela of asbestos exposure. He also had some mild restriction consistent with asbestos exposure. However, with respect to obstruction seen on pulmonary function testing, the examiner stated that it was not due to asbestos exposure but rather his history of cigarette smoking. No findings were made with respect to whether the Veteran’s COPD was aggravated by his asbestos exposure and/or the related parenchymal scarring. See El Amin v. Shinseki, 26 Vet. App. 136, 140 (2013). Such is particularly problematic as the Veteran has presented treatise evidence that suggests that COPD may be aggravated by asbestos exposure and/or asbestos-related lung disability.
If VA undertakes the effort to provide the Veteran with a medical examination, it must ensure that such exam is an adequate one. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). A remand is necessary.
The matter is REMANDED for the following action:
Schedule the Veteran for an examination with an appropriate clinician to determine the nature and etiology of his COPD. After a review of the claims file, consideration of the lay evidence, and examination, the examiner should address the following: 
a.	Is it at least likely as not that the Veteran’s COPD had its onset inservice or is otherwise etiologically related to his recognized asbestos exposure.
b.	Is it at least likely as not that the Veteran’s COPD is proximately due to or the result of his service connected pulmonary scarring (asbestos-related lung disease).
c.	Is it at least likely as not that the Veteran’s COPD aggravated by his service connected pulmonary scarring (asbestos-related lung disease).
A fully articulated rationale must be provided for all opinions expressed. If the examiner is unable to provide the opinions and supporting rationale, then he or she must indicate why
The clinician is specifically requested to address the treatise evidence submitted by the Veteran and all associated lay statements.
 
MICHAEL A. HERMAN
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	K. Meiners