Citation Nr: 18153422 Decision Date: 11/27/18 Archive Date: 11/27/18 DOCKET NO. 13-18 460 DATE: November 27, 2018 REMANDED Entitlement to service connection for asthma is remanded. Entitlement to service connection for hypertension, to include as secondary to asthma, is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1988 to June 1995. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an October 2010 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida. In April 2017, the Veteran testified at a hearing before the undersigned Veterans Law Judge (VLJ). A transcript of that hearing has been associated with the claims file. In September 2017, the Board remanded this matter for further development. That development having been completed, this matter has returned to the Board for further appellate review. 1. Entitlement to service connection for asthma is remanded. Pursuant to the Board’s September 2017 remand, the Veteran was afforded a VA examination to determine the etiology of her asthma. The Board directed the examiner to opine whether the Veteran’s asthma was related to any incident of service, including her exposure to sandstorms and toxic gases from the burning of human waste with mo-gas and diesel. See September 2017 Board Remand. The October 2017 VA examiner opined that the Veteran’s asthma was less likely than not related to her service. In reaching this opinion the examiner stated that asthma is a disease with a clear and specific etiology and less likely due to a specific exposure event. See October 2017 Respiratory Conditions Disability Benefits Questionnaire (DBQ). The Board finds this opinion inadequate, as it does not take into account the Veteran’s statements regarding her multiple exposures over her deployment. See June 2013 Correspondence; April 2017 Hearing Transcript; November 2017 Correspondence. In this regard, the Veteran has stated and testified that she was exposed to sandstorms and toxic gases from the burning of human waste with mo-gas and diesel on multiple occasions, not one specific exposure. Further, the examiner did not take into account the Veteran’s statements regarding her respiratory symptomatology during and after her active duty service. Therefore, on remand, the Veteran should be afforded a new VA examination, which addresses her statements regarding her repeated in-service exposures to sandstorms and toxic gases, and her symptomatology, both during and after service. See Washington v. Nicholson, 19 Vet. App. 362 (2005) (holding that a veteran is competent to report what occurred during service because he is competent to testify as to factual matters of which he has first-hand knowledge); Barr v. Nicholson, 21 Vet. App. 303, 307-08 (2007) (holding that lay testimony is competent to establish the presence of observable symptomatology); Layno v. Brown, 6 Vet. App. 465, 470 (1994); Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007); Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). See also Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006); Smith v. Derwinski, 1 Vet. App. 235, 237-38 (1991) (credibility determinations are within the purview of the Board). 2. Entitlement to service connection for hypertension, to include as secondary to asthma, is remanded. As the Veteran’s claim of entitlement to service connection for hypertension is inextricably intertwined with her service connection claim for asthma, it is being deferred pending the development requested herein. See 38 C.F.R. § 4.16(a); Harris v. Derwinski, 1 Vet. App. 180, 183 (1991) (two issues are “inextricably intertwined” when they are so closely tied together that a final decision on one issue cannot be rendered until a decision on the other issue has been rendered); Ephraim v. Brown, 82 F.3d 399 (Fed. Cir. 1996) (claims are inextricably intertwined when they have common parameters, such as when the outcome of one may affect the outcome of the other. And to avoid piecemeal adjudication of these types of claims, they should be considered together). Finally, as this matter is being remanded, the Veteran’s updated VA treatment records should be obtained. The matters are REMANDED for the following action: 1. Make arrangements to obtain the Veteran’s VA treatment records, dated from August 2017, forward. 2. Thereafter, schedule the Veteran for an appropriate VA examination to determine the nature and etiology of her asthma. The entire claims file, to include a copy of this REMAND, must be made available to the examiner in conjunction with the opinion. The examiner must confirm in the examination report that he or she has reviewed the folder in conjunction with the examination. The examiner should elicit a full history from the Veteran. The examiner must provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s asthma had its clinical onset during service, or is related to any in-service disease, event, or injury, to include her repeated exposures to sandstorms and toxic gases from burning human waste with mo-gas and diesel. In providing this opinion, the examiner must acknowledge and consider the Veteran statements reflecting her in-service exposures, as well as her respiratory symptomatology, both during and after service. P.M. DILORENZO Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S. M. Stedman, Associate Counsel