Citation Nr: 18152457
Decision Date: 11/23/18	Archive Date: 11/21/18

DOCKET NO. 14-38 432A
DATE:	November 23, 2018
REMANDED
The issue of entitlement to service connection for the cause of the Veteran’s death is remanded.
REASONS FOR REMAND
The Veteran served on active duty from November 1961 to November 1982.  He passed away in September 2013; the Appellant is his surviving spouse. 
This matter comes to the Board of Veterans’ Appeals (Board) from a November 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Milwaukee, Wisconsin that denied the benefit sought on appeal.
Service connection for the cause of the Veteran’s death is remanded 
A September 2013 certificate of death shows that the cause of the Veteran’s death was determined to be acute respiratory failure secondary to septic shock.  The certificate of death listed several conditions contributing to the Veteran’s death, to include lymphoma and pneumonia.  The Appellant asserts that the Veteran developed a breathing condition as a result of in-service exposure to asbestos.  For this reason, she asserts that service connection for the cause of his death is warranted.
Military personnel records listed the Veteran’s military occupational specialty as “avian electronics technician.”
Service treatment records document a treatment history of bronchitis and upper respiratory infections.  For example, July 1973, November 1976, September 1981, January 1982, July 1982, and September 1982 service treatment records documented an impression of bronchitis. May 1974, January 1979, April 1979, May 1979, November 1980, January 1981, and November 1982 service treatment records documented an impression of upper respiratory infection.  Additionally, February 1980 service treatment record recorded a diagnosis of “shortness of breath” and March 1982 service treatment record noted an impression of “asthmatic bronchitis.” 
Post-service medical records include a June 2005 treatment record documenting a diagnosis of acute bronchitis.  
The Veteran testified, in April 2011, that he first experienced trouble breathing while he was in service.  He affirmed that he had symptoms of coughing, wheezing, and bronchitis at discharge.  Moreover, he contended that his breathing problems manifested after separation as a chronic condition, with intermittent periods of coughing. He stated that he experienced symptoms of this condition “three or four months ago.”  Further, he attributed his breathing condition to his in-service asbestos exposure: “I have had exposure to asbestos . . . you know and even though the airplanes had asbestos in them and [sic] on ships they had asbestos . . . .”
Given the possible relationship between the in-service diagnoses of bronchitis and upper respiratory conditions, the Veteran’s complaints of a chronic respiratory condition, and acute respiratory failure, the Board finds that an additional medical opinion should be obtained prior to adjudication of the claim.
The matter is REMANDED for the following action:
1. If there is outstanding evidence, the Appellant should be invited to submit such evidence, including medical literature or nexus opinions. The Appellant should be provided an appropriate amount of time to submit this evidence.
2. Obtain an opinion from a qualified clinician addressing whether it is at least as likely as not (50 percent probability or more) that the Veteran’s death was related to underlying respiratory condition as opposed to septic shock. Please explain why or why not, specifically considering and discussing the Veteran’s medical history, the Veteran’s lay statements, and the certificate of death.
If you determine that a respiratory condition was the more likely cause of death, it is at least as likely as not (i.e., a probability of 50 percent or more) that the Veteran’s acute respiratory condition, or other respiratory condition (e.g. pneumonia), was related to his service, to include the in-service treatment for bronchitis and upper respiratory infections for which he was treated therein, as well as the Veteran’s reports of in-service asbestos exposure?  Please explain why or why not. 
(Continued on the next page)


 
S. C. KREMBS
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	I. Altendorfer, Associate Counsel