Citation Nr: 20003547 Decision Date: 01/16/20 Archive Date: 01/15/20 DOCKET NO. 15-26 311 DATE: January 16, 2020 REMANDED Entitlement to service connection for asthma is remanded. REASONS FOR REMAND The appellant is a Veteran who served on active duty from July 1961 to August 1982. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a January 2013 rating decision. In July 2018, a videoconference hearing was held before the undersigned; a transcript is in the record. In September 2018 the case was remanded for further development. [The issue of service connection for a low back disability, to include lumbosacral strain and degenerative disc disease (DDD) was also on appeal. An August 2019 rating decision granted service connection for a low back disability, rated 10 percent, effective April 27, 2011. Accordingly, that issue is no longer on appeal before the Board]. Entitlement to service connection for asthma. The Veteran has a current diagnosis of asthma, for which he receives ongoing treatment. On July 2019 VA respiratory disorders examination, the examiner opined that it was less likely than not that the Veteran’s asthma was incurred in or caused by his service. She explained that his service treatment records (STRs) did not note any treatment for asthma between 1961 and 1982 (his dates of service), asthma was not diagnosed until 1987, and although he served in Vietnam and was exposed to Agent Orange (AO), asthma is not a disease listed as presumed to be due to such exposure. The opinion is inadequate for rating purposes because the examiner did not explain why the Veteran’s asthma was not related to his AO exposure (other than it is not listed in 38 C.F.R. § 3.309(e) and did not identify a likely etiology for the asthma. Further a July 2018 private physician’s statement (noted as evidence reviewed on the July 2019 examination, but not discussed), the provider indicated that the Veteran reported that he experienced shortness of breath from the time of his retirement in 1982 until 1987. And in a December 2019 statement, the Veteran’s representative asserted that his asthma may be due to environmental exposures from serving as a fire control specialist (such as fire suppression chemicals) and from work at an ammunition dump. A remand to obtain an adequate medical advisory opinion that addresses all theories of entitlement raised and reflects review of the entire record is necessary. It also appears that the Veteran receives ongoing VA treatment for asthma; the most recent records of such treatment in the file are from November 2018. Updated treatment records may contain pertinent information, are constructively of record, and must be sought The matter is REMANDED for the following: 1. Secure for the record complete updated records of all VA evaluations and treatment the Veteran has received for his asthma since November 2018. 2. Then, following any further development indicated, including eliciting more detailed information from the veteran regarding the nature of his environmental exposures in service, compile a listing of the environmental hazards to which he was exposed in service. 3. Thereafter, return the Veteran’s record to the July 2019 VA examiner (or another appropriate physician if that provider is not available) for further review and an addendum medical opinion regarding the etiology of the Veteran’s asthma. [If further examination of the Veteran is deemed necessary for the opinion sought, such should be arranged.] The AOJ listing of the environmental hazards to which the Veteran is acknowledged to have been exposed in service must specifically be included in and reviewed by, the consulting provider. The consulting provider should: (a) Identify the most likely etiology for the Veteran’s asthma. Specifically, is it at least as likely as not (a 50 percent or greater probability) that it is related to his military service to include his acknowledged exposure to Agent Orange/herbicide agents and/or his reported exposures to other the other environmental exposures in service (identified in the listing compiled by the AOJ) while serving as a fire control specialist and working at an ammunition dump? The opinion provided must reflect consideration of the Veteran’s reported history of having shortness of breath throughout from his separation from service in August 1982 until his asthma was diagnosed in 1987. (b) If the asthma is determined to be unrelated to the Veteran’s service, identify the etiology for the asthma considered to be more likely (with explanation why that is so). The consulting provider should include rationale with all opinions. GEORGE R. SENYK Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Bayles, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.