Citation Nr: 18154933 Decision Date: 12/04/18 Archive Date: 11/30/18 DOCKET NO. 16-57 846 DATE: December 4, 2018 REMANDED Entitlement to service connection for a respiratory disorder, to include asthma, is remanded. REASONS FOR REMAND The Veteran had two periods of active duty service – he served in the United States Navy from September 23, 1997 to September 22, 2001 and then in the United States Air Force from May 16, 2002 to June 14, 2006. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Portland, Oregon. He also had federal civil service in the Oregon Air National Guard from June 15, 2006 until April 7, 2015. Regrettably, a remand is necessary for this issue 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. § 5103A; 38 C.F.R. § 3.159. This matter is REMANDED for the following actions: 1. Initially, the Board notes that the Veteran had federal civil service in the Oregon Air National Guard for a period of six years following his discharge from active duty service. Specifically, he worked as a full-time Air Guard Technician, 2A7X3, Aircraft Structural Maintainer, from June 15, 2006 until he was forced to retire due to his respiratory disorder on April 7, 2015. See October 2014 Air Force Formal Physical Evaluation Board (FPEB) Memorandum. The electronic claims file contains the Enlistment/Reenlistment Documents showing that the Veteran enlisted in the Oregon Air National Guard for a period of 6 years, 0 months, and 0 days, of which 0 years and 0 weeks were to be considered an Active Duty Obligation and 0 years and 0 weeks were to be served in the Reserve Component of the service. While it does not appear that the Veteran’s federal civil service included any periods of active duty for training (ACDUTRA) or inactive duty for training (INACDUTRA), there are several references in the record to “drill pay.” Additionally, the Veteran is seeking service connection for asthma which was found to be the primary reason that he was forced to retire from the Oregon Air National Guard. See October 2014 Air Force Formal Physical Evaluation Board (FPEB) Memorandum. In pertinent part, the Veteran contends that his prolonged exposure to paints, solvents, and thinners while working as an Air Guard Technician, 2A7X3, Aircraft Structural Maintainer, resulted in his asthma which was first diagnosed in August 2013. See May 2016 notice of disagreement. Accordingly, the RO must contact the Veteran and ask him to identify whether he had any periods of ACDUTRA or INACDUTRA during his six years of federal civil service with the Oregon Air National Guard. To the extent possible, the Veteran should provide specific dates of ACDUTRA or INACDUTRA service if applicable. If the Veteran identifies periods of ACDUTRA or INACDUTRA service: The RO must obtain the Veteran’s complete service personnel records, to include all documents pertaining to his service in the Oregon Air National Guard. The RO must verify all ACDUTRA and INACDUTRA dates for alleged service in the Oregon Air National Guard from June 15, 2006 to April 7, 2015. If necessary, a request should be made to the Defense Finance and Accounting Service (DFAS). Document all requests for information as well as all responses in the claims file. Thereafter, the RO should take appropriate action to further develop the claim on appeal and ensure that VA’s duties to notify and assist have been met, to include having a VA examiner comment on the impact of the Veteran’s prolonged exposure to paints, solvents, and thinners while working as an Air Guard Technician, 2A7X3, Aircraft Structural Maintainer, if it is determined that such exposure occurred while the Veteran was participating in ACDUTRA or INACDUTRA service. If the Veteran does not identify periods of ACDUTRA or INACDUTRA service: VA will assume that the Veteran’s employment with the Oregon National Guard was strictly “federal civil service” and did not include any periods of ACDUTRA or INACDUTRA service. 2. Contact the Veteran and ask him to identify whether there are any outstanding VA or private medical records reflecting treatment for his claimed asthma. If such records are identified, then obtain those records and associate them with the electronic claims file. To expedite this action, the Veteran is encouraged to submit any additional VA or private medical records in his possession. 3. After the completion of the actions requested in directives 1 and 2 above, the Veteran should be afforded a VA examination to ascertain the nature and etiology of his claimed asthma. In advance of the examination, the RO should provide the electronic claims file and a copy of this Remand to an appropriate VA examiner. After reviewing the evidence of record and evaluating the Veteran, the examiner must address the following: The VA examiner must identify all respiratory disorders found on evaluation. If asthma is not found on evaluation, the examiner must reconcile that finding with prior diagnosis of “intrinsic asthma, uncertain etiology” that was made in August 2013. For all respiratory disorders diagnosed on examination, the examiner must opine as to whether any of those disorders are “at least as likely as not” related to an in-service injury, event, or disease, to include treatment for respiratory problems during his two periods of active duty service in the Navy and Air Force. Significantly, the Veteran and his representative have identified the following exposures and respiratory problems while on active duty: The Veteran was seen at sick call on August 6, 1998, for chest pains that he had been experiencing for three to four weeks, with pain on inhalation. Lt. J.K. diagnosed costochondritis. The Veteran reported to sick call onboard the U.S.S. Saipan on September 22, 1998, with complaints of chest wall pain for one to two months. C.J.D., MD, diagnosed costochondritis and thoracic dysfunction. On November 26, 1998, the Veteran reported midsternal chest pain and sick call, accompanied by shortness of breath, sweats, lightheadedness, and with episodes lasting from a few seconds to 30 minutes in duration. The Veteran was treated on August 11, 2000 at sick call onboard the U.S.S. Saipan. The Veteran reported constant pain in the right chest wall, and shortness of breath on exertion. Provider advised the Veteran to return if the pain worsened. On September 2, 2000, the Veteran reported to sick call with chest pains after physical exercise onboard the U.S.S. Saipan. Diagnosis was costochondritis. On June 19, 2001, during his separation physical from the Navy, the Veteran reported pain or pressure in his chest that increases with movement or deep breaths. On May 26, 2005, a diagnostic x-ray was taken of the Veteran’s chest. Frontal and lateral chest radiographs demonstrated ill-defined hazy opacity over the left mid-lung, laterally, which localizes to the posterior and superior portion of the left lower lobe. Dr. M. opined, “Airspace disease confined to the superior portion of the left lower lobe. This may reflect infiltrate or alveolar process.” A diagnostic x-ray was taken of the Veteran’s chest on May 29, 2005, which revealed continued hazy density within the superior segment of the left lower lobe. This is mildly increased compared with the prior study. Dr. M. opined, “Findings consistent with known infiltrate within the superior segment of the left lower lobe.” A diagnostic chest x-ray, taken June 2, 2005, revealed pulmonary infiltrates still present. See December 2016 Statement of Accredited Representative; Service Treatment Records (STRs) and service personnel records from active duty service in the United States Navy and United States Air Force. Additionally, while in the Air Force, the Veteran asserts that he was exposed to Cadmium at the Kunsan Air Base in Korea between May 2004 and May 2005, that he was diagnosed with pneumonia at McChord Air Force Base in Washington, and that he was exposed to paints, solvents, and thinners while performing his duties in Aircraft Structural Maintenance while on active duty in the Air Force. See November 2016 VA Form 9, DD-214 for Navy service, and DD-214 for Air Force service. The examiner’s opinion should address the objective medical evidence of record, as well as the Veteran’s lay statements. Adequate supporting rationale must be provided for all medical conclusions reached. If periods of ACDUTRA or INACDUTRA service are identified: The RO should provide the examiner with the appropriate instructions for addressing exposure to exposure to paints, solvents, and thinners while working as an Air Guard Technician, 2A7X3, Aircraft Structural Maintainer, during those periods of service. If periods of ACDUTRA or INACDUTRA service are not identified: It is important for the examiner to limit his or her opinion to only address the two periods of active duty service. Specifically, the examiner should only consider the claimed exposures and/or respiratory problems identified by the Veteran during his service in the Navy from September 23, 1997 to September 22, 2001, and from his service in the Air Force from May 16, 2002 to June 14, 2006. The examiner should not consider any exposures or respiratory problems during the period of federal civil service in the Oregon Air National Guard from June 15, 2006 to April 7, 2015. JOHN J. CROWLEY Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. L. Marcum, Counsel