Citation Nr: 18154411
Decision Date: 11/29/18	Archive Date: 11/29/18

DOCKET NO. 16-55 463
DATE:	November 29, 2018
REMANDED
Entitlement to a rating in excess of 30 percent for bronchial asthma is remanded.
Entitlement to service connection for rheumatoid arthritis, to include as secondary to bronchial asthma.
REASONS FOR REMAND
1. Entitlement to a rating in excess of 30 percent for bronchial asthma is remanded.
The claims file does not include the Veteran’s post service private or VA treatment records.  On remand, any outstanding private and VA treatment records should be associated with the record.
VA has a duty, when appropriate, to conduct a thorough and contemporaneous examination of the Veteran that considers records of prior examinations and treatment.  See Green v. Derwinski, 1 Vet. App. 121 (1991).  A review of the claims file reveals that the Veteran was afforded a VA examination in June 2014 – over 4 years ago.  In the November 2016 VA Form 9, the Veteran reported that a doctor told him that a 60 percent rating was appropriate for his bronchial asthma.   The Veteran’s statement suggests that his asthma is more disabling than reflected in her most recent VA examination.  As such, a current examination is necessary.  See Caffrey v. Brown, 6 Vet. App. 377, 381 (1995) (VA was required to afford a contemporaneous medical examination where examination report was approximately two years old).
2. Entitlement to service connection for rheumatoid arthritis is remanded. 
The Veteran asserts that his rheumatoid arthritis is secondary to his asthma.  See November 2016 VA Form 9.  Specifically, he asserts that rheumatoid arthritis and its associated inflammation can affect the entire body, including the lungs.  Notably, the Veteran has not been afforded a VA examination for his rheumatoid arthritis.  On remand an examination addressing both direct and secondary service connection is warranted. 
The matter is REMANDED for the following action:
1. Contact the Veteran and ask that he provide a release for VA to secure records of treatment he received from any private medical treatment providers not already associated with the record.  The Veteran is to be notified of any unsuccessful efforts in this regard, to allow him the opportunity to obtain and submit those records for VA review.
2. Obtain the Veteran’s VA treatment records.
3. Arrange for the Veteran to undergo a VA examination to determine the current nature and severity of his rheumatoid arthritis. The examiner should issue medical opinions as to the following: 
(a) Whether it is at least as likely as not (50 percent probability or higher) that his rheumatoid arthritis has its onset in service, manifested to a compensable degree within one year of separation, or is otherwise related to service. 
(b) Whether it is at least as likely as not (50 percent probability or higher) that his rheumatoid arthritis was caused or aggravated by (i.e., permanently worsened beyond the natural progression) by his service-connected bronchial asthma.
The examiner is asked to explain the reasons behind any opinions expressed and conclusions reached
4. Arrange for the Veteran to undergo a VA examination to determine the current severity of his bronchial asthma.
5. Readjudicate the appeal. 

 
R. FEINBERG
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	J.A. Williams, Associate Counsel