Citation Nr: 18152459 Decision Date: 11/23/18 Archive Date: 11/21/18 DOCKET NO. 16-41 542 DATE: November 23, 2018 REMANDED Entitlement to service connected a respiratory disorder, to include chronic obstructive pulmonary disease, and due to asbestos exposure is remanded. REASONS FOR REMAND The Veteran had active military service from May 1967 to November 1973. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an October 2015 decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Cleveland, Ohio. The Veteran contends he has chronic obstructive pulmonary disease due to his active duty military service. In this regard, a review of the Veteran’s personnel records shows that he served as a Navy hull tech. Such a job would have required that he make repairs to the ship, weld, and fix or change pipping. The Veteran stated at his October 2015 VA examination that he was treated for chronic obstructive pulmonary disease in 2005 with inhalers. The record shows that the appellant has been diagnosed with a respiratory disorder. Specifically, a July 2015 X- ray revealed stable pleural plaques with calcification consistent with asbestos exposure. In October 2018, the RO received a September 2018 letter from a VA physician who found that it was at least 50 percent likely that the appellant’s exposure to asbestos led to the development of his current lung disease. The physician also found that the appellant’s “substantial welding work” in the Navy contributed to his development of chronic obstructive pulmonary disease. While the Veteran was provided a VA examination in October 2015, that examination seemed to focus on whether the appellant was then suffering from asbestosis. Under Clemons v. Shinseki, 23 Vet. App. 1 (2009), VA cannot limit the claim to simply asbestosis. Hence, the October 2015 examination is inadequate for rating purposes. Further, that examination does not address the impact, if any, of the appellant’s 40-year history of smoking (see January 2014 VA outpatient record), and his history of working in the welding field postservice. Accordingly, a new examination is in order. The matter is REMANDED for the following action: 1. Contact the Veteran and request that he identify any and all health care providers who have treated him for any lung disorder since 2005. This specifically includes all VA treatment records dated since August 2016 which are relevant to this claim. If any records cannot be located, specifically document the attempts that were made to locate them, and explain in writing why further attempts to locate or obtain any government records would be futile. Then: (a) notify the claimant and his att1orney of the specific records that it is unable to obtain; (b) explain the efforts VA has made to obtain that evidence; and (c) describe any further action it will take with respect to the claims. The claimant must then be given an opportunity to respond. 2. Thereafter, schedule the Veteran for a VA examination by a physician to address the nature and etiology of any diagnosed lung disorder since October 2014. The examining physician must be provided access to the Veteran’s VBMS and Virtual VA files, and a copy of this remand. Following the examination the physician must address whether it is at least as likely as not that any respiratory disorder diagnosed at any time since October 2014, is related to the appellant’s active duty service. In addressing this question the physician must discuss the impact of the appellant’s presumed inservice exposure to asbestos and his exposure to fumes as a welder while on active duty. The physician must address the September 2018 opinion offered by a VA physician that was received in October 2018. The physician must also address whether it is more likely than not that any diagnosed respiratory disorder is caused by the appellant’s history of smoking and/or welding postservice. A complete and fully explanatory rationale must be provided for each and every opinion offered. If any opinion cannot be rendered without resorting to speculation, the examiner must state whether the need to speculate is caused by a deficiency in the state of general medical knowledge, i.e., no one could respond given medical science and the known facts, or by a deficiency in the record or the examiner, i.e., additional facts are   required, or the examiner does not have the needed knowledge or training. DEREK R. BROWN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Anthony L. Hines Associate Attorney