Citation Nr: 20005380 Decision Date: 01/23/20 Archive Date: 01/22/20 DOCKET NO. 15-30 995A DATE: January 23, 2020 REMANDED Entitlement to service connection for cause of the Veteran's death is remanded. REASONS FOR REMAND The Veteran had active duty service from January 1942 to November 1945. He died in August 2003 and the appellant is his surviving spouse. This matter comes to the Board of Veterans' Appeals (Board) from a June 2013 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In October 2019, the appellant testified before the undersigned VLJ at a Board hearing; a transcript of the hearing has been associated with the Veteran's record. Entitlement to service connection for cause of the Veteran's death is remanded. The appellant seeks service connection for her husband's death, contending that he was exposed to asbestos during his active service. The Veteran died in August 2003 with the primary cause of death as sepsis, pneumonia, and pulmonary fibrosis; and although significant conditions contributing to death but not resulting in the underlying cause included renal failure. The Veteran served in the United States Coast Guard; his military occupational specialty was chief radio technician. Evidence in the record indicates that the Veteran was stationed aboard many ships and had temporary duty assignments that may have exposed him to asbestos. The appellant asserts the Veteran’s duties included significant involvement with the installation, maintenance, repair, and management of electronic equipment. The Board has determined that in light of evidence presented at the Veteran’s hearing in October 2019, the AOJ should further develop and document the claimed in-service exposure to asbestos. After reviewing the claims file, the Board has determined that service personnel records and service treatment records need to be obtained, and no narrative from the service department confirmed whether the Veteran's duties in service would have exposed him to asbestos. The appellant also testified at the October 2019 hearing that the Veteran had significant respiratory problems when she me him in 1995. During the hearing, the appellant noted that the Veteran did not have a diagnosis at that time, but she encouraged him to seek medical assistance. The appellant explained that the November 2016 VA opinion was based solely on the latency period between service and the date of diagnosis for pulmonary fibrosis, without consideration of the fact that the Veteran had years of respiratory problems prior to his death in 2003. Also, there is not a full accounting of the types of ships the Veteran served on during his service, including cutters, which may indicate even more significant exposure to asbestos and lead during service. In summary, the Board has determined that another VA medical opinion is needed to ascertain the etiology of the cause of the Veteran's death, including in-service exposure to asbestos. 38 C.F.R. § 3.159; see also McLendon v. Nicholson, 20 Vet. App. 79, 86 (2006). The matters are REMANDED for the following action: 1. Obtain the Veteran's complete service treatment records and service personnel records. 2. Conduct all development necessary to adjudicate the appellant's claim for service connection for the Veteran's death, to include exposure to asbestos. (For asbestos exposure see M21-1MR, Part IV, Subpart ii, Chap. 1, Sec. H, Para. 29; Part IV, Subpart ii, Chap. 2, Sec. C, Para. 9). Development should include asking the service department, the National Personnel Records Center, or any other appropriate organization having access to historical information regarding inservice exposure to hazardous chemicals, such as asbestos, to provide any relevant evidence or information as to whether the Veteran may have been exposed to hazardous chemicals, such as asbestos, while serving aboard many ships or in performance of his duties as chief radio technician. Any records obtained should be associated with the file. If no such records are available, this should also be indicated in the file. All efforts to obtain any such employment records must be documented in the file. The AOJ should make two attempts to obtain these records once authorization is obtained, unless the first attempt reveals that further attempts would be futile. If no records are obtained, the AOJ should notify the appellant of the records that could not be obtained, notify the appellant of the steps taken to obtain the records, and notify the appellant that she may submit any such records in her possession. 3. After the records development is completed, obtain a new VA medical opinion for the claim of service connection for the cause of the Veteran's death. The record should be made available to the VA medical opinion provider. All pertinent findings must be reported in detail. A complete rationale for all opinions must be provided. VA medical opinion provider is asked whether it is at least as likely as not (i.e., a 50 percent probability or more) that the Veteran's fatal sepsis, pneumonia, and pulmonary fibrosis had its onset during service or is causally and etiologically related to service, considering the evidence, and accepted medical principles pertaining to the history, manifestation, clinical course, and the character of those disabilities. The VA medical opinion provider should specifically offer an opinion as to whether it is at least as likely as not that the sepsis, pneumonia, and pulmonary fibrosis was due to in-service exposure to hazardous chemicals, such as asbestos, and comment on the Veteran's in-service exposure and as a chief radio technician aboard the ship. The VA medical opinion provider is advised that an in-service occupational exposure does not need to be the sole cause or predominate cause of the pulmonary fibrosis, but, instead, the VA medical opinion provider is asked to determine if it is a contributing cause of the Veteran's death. The VA medical opinion provider is also asked to consider that a lay person is competent to describe symptoms at the time which supports a later diagnosis by a medical professional. Lay evidence concerning both occurrence and continuity of symptoms after service, if credible, is ultimately competent, regardless of the lack of contemporaneous medical evidence. A thorough rationale is requested for any opinion provided. Michael J. Skaltsounis Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. R. Montalvo, 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.