Citation Nr: 18153202 Decision Date: 11/28/18 Archive Date: 11/27/18 DOCKET NO. 16-41 647 DATE: November 28, 2018 REMANDED Entitlement to service connection for a respiratory disorder, to include interstitial pneumonia and/or idiopathic pulmonary fibrosis, is remanded. REASONS FOR REMAND The Veteran served in the United States Army from September 1972 to June 1975, and from November 1990 to May 1991, during which time she is shown to have service in Southwest Asia. This appeal to the Board of Veterans’ Appeals (Board) arose from an August 2014 rating decision in which the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran was afforded a VA examination for her respiratory condition in July 2014, which revealed a diagnosis of idiopathic pulmonary fibrosis. An x-ray performed in conjunction with the examination revealed thickening of the interstitium affecting both lower lobes, with the left greater than right. The Veteran reported productive cough which last roughly one to two weeks. In addition, she reported chronic pain in the right lateral chest and flank area, described as achy and exacerbated by inhaling. The examiner opined that the Veteran’s lung condition is less likely than not related to environmental exposures in Southwest Asia. The examiner reasoned: there were no documented in-service respiratory complaints; there was no abnormality on the Veteran’s chest x-ray; the Veteran only served in Southwest Asia for four months; and, the Veteran served as an administrate specialist in which she reported wearing a hazmat suit and gas mask every day. The Board has carefully considered the VA examiner’s opinion that the Veteran’s idiopathic pulmonary fibrosis is not related to her active duty service in Southwest Asia. However, the examiner’s rationale contains an inaccuracy in that there were no documented in-service respiratory complaints, as the service treatment records indicate treatment for respiratory symptoms such as coughing, congestion, and cold-like symptoms in December 1990. Accordingly, the Board finds that the examiner’s opinion is factually inaccurate and therefore is inadequate. A remand is necessary in order to obtain aa VA examination and medical opinion that adequately addresses the facts of this case. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007); Kowalski v. Nicholson, 19 Vet. App. 171, 179 (2005) (a VA examination must be based on an accurate factual premise). On remand, the Board also finds that any outstanding private and VA treatment records should also be obtained. See 38 U.S.C. § 5103A(b), (c); 38 C.F.R. § 3.159(b); see also Sullivan v. McDonald, 815 F.3d 786 (Fed. Cir. 2016) (where the Veteran “sufficiently identifies” other VA medical records that he or she desires to be obtained, VA must also seek those records even if they do not appear potentially relevant based upon the available information); Bell v. Derwinski, 2 Vet. App. 611 (1992). The matter is REMANDED for the following action: 1. Obtain any and all VA treatment records not already associated with the claims file from the Chicago VA Medical Center, or any other VA medical facility that may have treated the Veteran and associate those documents with the claims file. 2. Ask the Veteran to identify any private treatment that she may have had for her respiratory disorders, which is not already of record. After securing the necessary releases, attempt to obtain and associate those identified treatment records with the claims file. If any identified records cannot be obtained and further attempts would be futile, such should be noted in the claims file and the Veteran should be notified so that she can make an attempt to obtain those records on her own behalf. 3. Ensure that the Veteran is scheduled for a VA examination with an appropriate examiner who has not previously participated in this case in order to determine whether she has any current respiratory disorder that are related to her service. The claims folder must be made available to and be reviewed by the examiner. All tests deemed necessary should be conducted and the results reported in detail. Following examination of the Veteran and review of the claims file, the examiner should state any and all respiratory disorders found, to include interstitial pneumonia and/or idiopathic pulmonary fibrosis. The examiner should additionally address whether any reports of respiratory symptomatology which is not otherwise accounted for by a diagnosed condition is a qualifying chronic disability due to either an undiagnosed illness or a chronic multisymptom illness under the provisions of 38 C.F.R. § 3.317. For any identified respiratory disorders and/or undiagnosed respiratory symptoms found, including any resolved disorders, the examiner should opine whether such at least as likely as not (50 percent or greater probability) began in service or is otherwise the result of military service, to include her service in Southwest Asia under the provisions of 38 C.F.R. § 3.317. The examiner should specifically address the noted treatment for respiratory complaints in December 1990, and indicate whether such symptoms are initial manifestations of the noted respiratory disorders during service. The examiner should additionally address the Veteran’s contentions that her respiratory disorders and/or symptomatology is due to taking pills for chemicals such as nerve gas during service caused her respiratory problems. In addressing the above, the examiner should consider the Veteran’s lay statements regarding onset of symptomatology and any continuity of symptomatology since onset and/or since discharge from service. The examiner should also consider any other pertinent evidence of record, as appropriate. All findings should be reported in detail and all opinions must be accompanied by a clear rationale. MARTIN B. PETERS Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD W. Wells, Associate Counsel