Citation Nr: 18154891 Decision Date: 12/04/18 Archive Date: 11/30/18 DOCKET NO. 15-33 782 DATE: December 4, 2018 REMANDED The claim of entitlement to service connection for a respiratory condition (claimed as a breathing condition), to include as due to an undiagnosed illness, is remanded. REASONS FOR REMAND The Veteran had honorable active duty service with the United States Army from January 2002 to May 2002, May 2013 to February 2014, August 2014 to April 2015. This matter is before the Board of Veteran’s Appeals (Board) from a June 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Winston-Salem, North Carolina. The claim of entitlement to service connection for a respiratory condition, to include as due to an undiagnosed illness, is remanded. The Veteran contends that he is entitled to service connection for a respiratory condition, to include as due to an undiagnosed illness, due to his exposures to hazards during his active duty service, specifically during his tour in Afghanistan from June 2013 to January 2014. The Veteran’s representative also contends that the VA examination provided in June 2014 did not adequately assess the Veteran’s respiratory issue and merely denied service connection because of the absence of abnormal pulmonary test results and ignored the Veteran’s lay statements of his exposure to burn pits, burning fecal material, and contaminated water. As well as the Veteran’s statements of decreased exercise tolerance with a burning feeling during strenuous activity that should be claimed as undiagnosed illness. Once the VA undertakes to provide an examination, it must provide an adequate one or, at a minimum notify the claimant why one will not be provided. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). When an opinion does not express the right degree of certainty, does not provide a rationale, or is conclusory, it is not adequate. See Steff v. Nicholson, 12 Vet. App. 120 (2007); Bloom v. West, 12 Vet. App. 187 (1999). The Veteran received a VA examination in June 2014; however, the VA examiner failed to provide a rationale determining whether the Veteran’s claimed respiratory condition was at least as likely as not or less likely as not caused by or otherwise etiologically related to his military service. The VA examination’s inadequacy leaves the Board with insufficient evidence to decide the claim. Although further delay is regrettable a remand is necessary in this case to ensure that due process is followed and that there is a complete record upon which to decide the Veteran’s claim so that he is afforded every possible consideration. 38 U.S.C. § 5103(A) (2012); 38 C.F.R. § 3.159 (2018). The matter is REMANDED for the following action: Obtain a VA medical opinion from an examiner with sufficient expertise to determine the nature and etiology of the Veteran’s claimed respiratory condition. The claims file must be made available to and be fully viewed by the examiner including a copy of this remand. It should be noted in the record that these items were reviewed. The examiner is asked to perform all indicated tests and studies and address the following: (a) Is there objective evidence perceptible to the examiner, or other non-medical indicators capable of independent verification that show a respiratory or breathing issue? (b) The examiner should also opine as to whether the Veteran’s reported respiratory or breathing issues represent an undiagnosed illness associated with the Veteran’s service in Persian Gulf, or, whether his reported chronic respiratory or breathing issues are associated with any other known clinical diagnosis, to include all possible respiratory conditions. Following a review of the casefile and remand, the examiner must state an opinion as to whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s claimed respiratory or breathing condition was caused by or is otherwise etiologically related to his military service. In doing so, the examiner must consider and discuss any lay statements of record indicating whether the respiratory issues of the Veteran are related to any exposure to burn pits, burning biohazards, dust, and other possible hazards that the Veteran may have been exposed to in service. The rationale for all opinions expressed must be provided. If the examiner is unable to provide any required opinions, he or she should explain why. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation stating why this is so. In so doing, the examiner shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information or that he or she has exhausted the limits of current medical knowledge in providing an answer to the particular question presented. Following completion of the foregoing, the Agency of Original Jurisdiction (AOJ) should review the record, perform any necessary development, and readjudicate the claim on appeal. If the appeal is denied, the AOJ should issue an appropriate Supplemental Statement of the Case (SSOC), afford the Veteran and his representative an opportunity to respond, and return the case to the Board. B. MULLINS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD C.A. Teich, Associate Counsel