Citation Nr: 19102575 Decision Date: 01/11/19 Archive Date: 01/09/19 DOCKET NO. 15-06 252A DATE: January 11, 2019 REMANDED Entitlement to service connection for mild obstructive defect (claimed as pulmonary function disease), as due to environmental hazards, is remanded. REASONS FOR REMAND The Veteran served in the Army National Guard, with active duty service from June 2004 to November 2005. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a February 2013 rating decision issued by a Regional Office (RO) of the United States Department of Veterans Affairs (VA). The Veteran provided testimony before the undersigned Veterans Law Judge at a July 2018 videoconference hearing. A copy of the hearing transcript has been associated with the Veteran’s electronic claims file. At the hearing, the Veteran submitted website articles describing, in general, environmental toxins and particulates that veterans of the Persian Gulf War were exposed to during service, as well as photographs from his time serving at Forward Operating Base Caldwell in Iraq. The Veteran testified that during his Iraq service he was exposed to dust in the air, soot from a nearby brick factory, and smoke from burning trash. The Veteran seeks entitlement to service connection for a pulmonary disorder. In February 2013, the Veteran underwent a VA examination. Following a review of the evidence, the examiner diagnosed the Veteran with a mild obstructive defect indicative of early chronic obstructive pulmonary disorder (COPD), and opined that this disability was most likely due to the Veteran’s remote history of cigarette smoking. The Veteran maintains that he smoked less than one pack of cigarettes per day from ages 17 to 19, and that he did not develop his current pulmonary disorder until more than 30 years after he ended his tobacco abuse. The VA examiner charted that the Veteran reported smoking one pack of cigarettes per day for 8 years and quit smoking in his early 20s. While the VA examiner noted the Veteran’s lay contention of in-service environmental toxin exposure from the brick factory, the rationale supporting the negative nexus opinion did not discuss the impact, if any, of this hazard on the development of the Veteran’s current pulmonary disability. Consequently, the Board finds this medical nexus opinion to be insufficient for adjudicative purposes. In July 2018, the Veteran’s private physician (Dr. BDS) and his VA clinician each provided a positive medical nexus opinion diagnosing the Veteran with COPD linked to his multiple environmental exposures while deployed in the Persian Gulf War. Unfortunately, these positive medical nexus opinions were conclusory without supporting rationale, and are deficient for adjudicative purposes. See Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) (holding that a medical opinion "must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions"); Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008) (holding that a medical opinion that contains only data and conclusions without any supporting analysis is accorded no weight). Given the above, the Board finds that a remand is warranted to obtain an addendum medical opinion that fully considers the Veteran’s lay statements. The Board also requests that the RO undertake appropriate efforts to obtain the Veteran’s private treatment records from Dr. BDS, as well as updated VA treatment records from February 2015 to the present. The matter is REMANDED for the following action: 1. Obtain the Veteran’s VA treatment records for the period from February 2015 to the present. 2. Ask the Veteran to complete a VA Form 21-4142 for the complete records from Dr. BDS. Make two requests for the authorized records from Dr. BDS, unless it is clear after the first request that a second request would be futile. 3. DO NOT proceed to the following directive until efforts to obtain the evidence identified above have been exhausted. 4. THEN, obtain an addendum medical opinion from a VA examiner regarding the etiology of the Veteran's current pulmonary disability. Following a complete review of the electronic claims file, the examiner is requested to opine on the following: Is it at least as likely as not (50 percent probability or greater) that the Veteran’s current pulmonary disability began in or is otherwise etiologically related to the Veteran’s active duty service? The examiner must consider and discuss the Veteran’s remote history of cigarette smoking (less than one pack per day from ages 17 to 19) and his exposure to environmental toxins, to include dust, soot from a brick factory, and smoke from trash burning, during his Persian Gulf War service. The examiner must provide a cogent rationale detailing which evidence or medical principles were relied upon in reaching a conclusion. The examiner is further requested to reconcile or distinguish his/her opinion with the two positive medical nexus statements received in July 2018. MICHELLE L. KANE Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Galante, Associate Counsel