Citation Nr: 18155197 Decision Date: 12/03/18 Archive Date: 12/03/18 DOCKET NO. 17-17 123A DATE: December 3, 2018 REMANDED Entitlement to service connection for a respiratory condition, to include as due to asbestos exposure, is remanded. Entitlement to service connection for vertigo, to include as secondary to service-connected bilateral hearing loss and tinnitus, is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1951 to April 1955, with additional Reserves service. These matters are before the Board of Veterans’ Appeals (Board) on appeal from a January 2013 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Board has recharacterized the claim for service connection based on the evidence of record. See Brokowski v. Shinseki, 23 Vet. App. 79 (2009). The Veteran initially requested a Board hearing, but subsequently withdrew his request in November 2018. 1. Entitlement to service connection for a respiratory condition, as due to asbestos exposure, is remanded. The Veteran seeks service connection for a respiratory condition due to exposure to asbestos while serving aboard the U.S.S. LSM 316 and Eldorado. Specifically, he contends that while serving on the U.S.S. LSM 316, in his duties as a .40 mm anti-aircraft machine gunner, he was exposed to asbestos because the entire ship was lined with it. See July 2010 Statement in Support of Claim and April 2017 Form 9. He also contends that he was exposed to asbestos from the bulkheads aboard the U.S.S. Eldorado while performing his duties as a Print Shop Technician. Id. In a December 2012 VA memorandum, the RO informed the Veteran that his service treatment records were unavailable after several attempts to locate them. The available military personnel records show that he served on both the U.S.S. LSM 316 and Eldorado. The RO made a finding in the January 2013 rating decision that the Veteran was minimally exposed to asbestos in service based on his position as a seaman. The Board notes that an “Unsigned Medical Opinion with no rationale” was received August 17, 2012 and cited in the February 2017 statement of the case (SOC), but this is not associated with the file. Upon remand, this record should be associated with the claim file for the Board’s review. Also, the Veteran should be asked to provide any and all records associated with his settlement from the Santa Fe Railroad for Asbestosis, which was reportedly based on exposure to asbestosis during civilian employment. In August 2012, the Veteran was afforded a VA contract examination. The examiner provided a diagnosis of restrictive airway disease and opined it was less likely than not related to service. Subsequent VA and private medical records show the Veteran was more recently diagnosed with an obstructive lung disease- COPD. A new opinion considered the likelihood of a causal relationship between this condition and service would be helpful to the Board. 2. Entitlement to service connection for vertigo, to include as secondary to service-connected bilateral hearing loss and tinnitus, is remanded. The Veteran seeks service connection for vertigo. He asserts that it is secondary to his service-connected bilateral hearing loss and tinnitus. The Veteran has not been afforded a VA examination to assess the nature of his reported dizziness and whether it is related to his military service or, caused or aggravated by his service-connected bilateral hearing loss and tinnitus conditions. See McLendon, 20 Vet. App. at 84. The claim is remanded for this purpose. These matters are REMANDED for the following actions: 1. Associate the document identified in the February 2017 SOC as “Unsigned Medical Opinion with no rationale” received August 17, 2012. Also, update the file with treatment records from the South Texas HCS since November 2017. 2. Ask the Veteran to complete a VA Form 21-4142 for any outstanding treatment records related to his claims. Also, ask that he submit or provide authorization to obtain any and all records associated with his settlement from his former civilian employer, the Santa Fe Railroad for asbestosis. Make two requests for the authorized records, unless it is clear after the first request that a second request would be futile. 3. After the prior development is complete, obtain an addendum medical opinion on the nature and etiology of his respiratory conditions noted in the records, to include COPD, mesothelioma, and restrictive lung disease. The claims folder must be made available and reviewed by the appropriate examiner. The need for an in-person physical examination is left to the examiner’s discretion. a) The examiner is asked to identify all respiratory conditions present, to include asbestosis. If the examiner finds that the Veteran does not have asbestosis, he or she must explain why the asbestosis diagnosis of record is not valid. b) For each such disability, the examiner must opine whether is at least as likely as not (a 50 percent or greater probability) that such condition is had onset in service or is related to an in-service injury, event, or disease to include asbestos exposure. A fully-explained rationale for the requested opinions must be provided. The examiner should address whether the onset and course of any diagnosed respiratory disorder is consistent with a history of asbestos exposure during service, taking into consideration the Veteran’s entire pre- and post-service occupational history and asbestos exposure. The examiner is advised that it has been determined that the Veteran was minimally exposed to asbestos in service based on his position as a seaman. If the examiner feels that the requested opinions cannot be rendered without resorting to speculation, he or she must explain why this is so. 4. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of his claimed vertigo. The claims folder should be reviewed, including a copy of this Remand. a) Identify whether the Veteran has vertigo or a related vestibular condition manifested as dizziness. b) For each diagnosed condition, is it at least as likely as not (a 50 percent or greater probability) the disability was incurred in, or is otherwise related to, the Veteran’s active service? c) Is it at least as likely as not that any identified condition is (1) proximately due to the service-connected bilateral hearing loss or tinnitus disabilities, or (2) aggravated beyond its natural progression by the service-connected disabilities? In answering this question, two opinions are required: one for proximate causation and a second for aggravation. If aggravation is found, then, to the extent possible, the examiner should attempt to establish a baseline level of severity for the vertigo disability prior to aggravation by the service-connected bilateral hearing loss and tinnitus disabilities. A fully-explained rationale for the requested opinions should be provided. If the examiner feels that the requested opinions cannot be rendered without resorting to speculation, he or she must explain why this is so. D. JOHNSON Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Tang, Associate Counsel