Citation Nr: 18153218
Decision Date: 11/27/18	Archive Date: 11/27/18

DOCKET NO. 15-04 134
DATE:	November 27, 2018
REMANDED
Whether new and material evidence has been received to reopen a claim of service connection for asthma is remanded.
Entitlement to service connection for emphysema is remanded.
REASONS FOR REMAND
The appellant is a Veteran who served on active duty from October 4, 1966 to November 16, 1966.  These matters are before the Board of Veterans’ Appeals (Board) on appeal from a February 2013 rating decision.  
1. Whether new and material evidence has been received to reopen a claim of service connection for asthma.
In certain circumstances further development is required prior to consideration of whether new and material evidence has been received to reopen a claim.  This case presents such circumstances.  In November 2012 correspondence the Veteran alleged that his lung disability was aggravated by service.  An October 28, 1966 Medical Board record notes that the Veteran was seen with mild bronchial asthma that was not aggravated by service; it was recommended that the Veteran be separated from service due to a medical condition was disqualifying for induction.  It was noted that the Veteran was followed at a Colorado hospital for three to four years prior to admission (and that treatment included injections).  On October 28, 1966 examination, clinical evaluation of the lungs and chest found bronchial asthma.  The Veteran has alleged his asthma worsened in service.  In a claim of service connection on the basis that the claimed disability was aggravated by service, all evidence pertaining to the status of the disability is relevant evidence that must be considered.  Records of the Veteran’s treatment for asthma prior to, and following, service are not associated with the record, and are pertinent evidence that is outstanding.  If such records are available and suggest worsening of asthma in service, an advisory medical opinion in the matter would be warranted.  
2. Service connection for emphysema is remanded.
The Veteran claims that emphysema is secondary to his asthma.  In light of the alleged theory of entitlement, the claim of service connection for emphysema is inextricably intertwined with claim pertaining to asthma.  As the petition to reopen a claim of service connection for asthma is being remanded, consideration of service connection for emphysema must be deferred pending resolution of the asthma claim.  
The matters are REMANDED for the following:
1. Ask the Veteran to identify the providers of all evaluations and treatment he received for asthma prior to, and following, service (including any hospitalizations, procedures, and treatments), and to submit authorizations for VA to complete clinical records of the evaluations and treatment from the providers identified.  Obtain the complete clinical records of the evaluations, and treatment from the providers identified.
2. Then arrange for the Veteran’s record to be forwarded to an appropriate clinician for review and an advisory medical opinion addressing whether the record shows worsening of the Veteran’s asthma beyond its natural progression during (or as a result of) service.  The opinion must acknowledge the Veteran’s lay statements regarding worsening of asthma during service; the consulting provider should cite to clinical data that support the conclusion reached.  
If and only if the Veteran’s asthma found to have worsened beyond its natural progression during service, the consulting clinician should further opine whether it is at least as likely as not (a 50% or better probability) that the Veteran’s emphysema was caused or aggravated (the opinion must address aggravation) by his asthma.  
The consulting provider must include rationale with all opinions, citing to supporting factual data and/or medical literature, as deemed appropriate.  
 
GEORGE R. SENYK
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	N. Staskowski, Associate Counsel