Citation Nr: 18157002
Decision Date: 12/11/18	Archive Date: 12/11/18

DOCKET NO. 18-47 412
DATE:	December 11, 2018
REMANDED
Entitlement to service connection for chronic obstructive pulmonary disease (COPD) and emphysema, to include as due to exposure to asbestos and ionizing radiation is remanded.
REASONS FOR REMAND
The Veteran served on active duty from June 1958 to November 1961.
In March 2016, the Veteran’s private physician opined that the Veteran’s COPD was likely related to previous cigarette smoking.  Additionally, in May 2017, a VA examiner opined that the Veteran’s emphysema is less likely than not (less than 50 percent probability) incurred in or caused by asbestos exposure during service.  The examiner attributed that Veteran’s COPD (emphysema) to long time smoking history.  
In April 2018, the Veteran underwent a Cat (CT) scan.  The radiologist confirmed the Veteran’s COPD diagnosis.  The radiologist noted a 0.6 x 0.4 cm left lobe solid noncalcified nodule, indeterminate; severe emphysema; and distal esophageal wall thickening, nonspecific.  The radiologist stated that further evaluation to exclude underlying mass was recommended.
In October 2018, the Veteran submitted a statement from a physician.  The physician stated that while in the Navy, the Veteran had a history of radiation and asbestos exposure.  The physician stated that the April 2018 chest CT scan showed evidence of bilateral pleural plaque with some calcification, consistent with prior asbestos exposure.  He further stated that the pleural plaque was not interpreted in the radiologist’s interpretation; however, the pleural plaque was apparent to the physician and could be verified by an independent radiologist.  The physician opined that the bilateral pleural plaque with calcification is more likely than not related to asbestos exposure during the Veteran’s military service.
Based on the radiologist’s statement, i.e., further evaluation to exclude underlying mass was recommended and the physician’s statement, i.e., the April 2018 chest CT scan showed pleural plaque that was apparent to the physician and could be verified by an independent radiologist, the Board finds that a remand is necessary to determine if the Veteran has any underlying masses, to include pleural plaque.  
The matter is REMANDED for the following action:
1.   Obtain and associate all outstanding VA and private treatment records with the claims file.
2.   Based on the April 2018 imaging study, a VA radiologist must read and interpret the April 2018 chest CT scan and determine if the Veteran has pleural plaque.  Additionally, complete any further development deemed necessary, to include a new examination to exclude any underlying masses.



3.   Then, readjudicate the issue on appeal.  If the benefit sought on appeal remains denied, furnish the Veteran and his representative a supplemental statement of the case and afford them the opportunity to respond before the file is returned to the Board for further consideration.

 
MICHAEL LANE
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	T. Henry, Associate Counsel