Citation Nr: 20007752 Decision Date: 01/29/20 Archive Date: 01/29/20 DOCKET NO. 12-25 274 DATE: January 29, 2020 REMANDED Entitlement to service connection for chronic obstructive pulmonary disease (COPD) is remanded. REASONS FOR REMAND The Veteran had active duty service from June 1956 to June 1959. This matter comes before the Board of Veterans’ Appeals (Board) from a November 2010 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran’s claim was previously remanded in May 2018 in order to obtain an addendum medical opinion; one that considers not only the Veteran’s lay testimony, but also provides an adequate rationale to support its conclusion. Now associated with the Veteran’s claims file is a January 2019 VA addendum medical opinion. Entitlement to service connection for chronic obstructive pulmonary disease (COPD) is remanded. Upon review of the January 2019 VA examiner’s addendum medical opinion, the Board finds that its May 2018 remand directives were not substantially complied with, as the VA examiner did not consider the Veteran’s lay reports of dyspnea between service and 1975. See October 2017 VA examination (“He reports exertional dyspnea since active duty but did not seek medical treatment until 1975.”); see Stegall v. West, 11 Vet. App. 268 (1998). Accordingly, another remand is warranted to obtain an adequate medical opinion that considers the Veteran’s lay statements regarding his COPD condition. Id. The matters are REMANDED for the following action: Obtain an addendum medical opinion from the January 2019 VA examiner or an appropriate substitute regarding whether the Veteran’s COPD is at least as likely as not (1) began during active service, (2) manifested within one year after discharge from service, or (3) occurred during service with continuity of the same symptomatology since service. The VA examiner should review the Veteran’s claims file, as well as a copy of this remand, prior to rendering an opinion. Importantly, and for purposes of rendering the requested addendum medical opinion, the examiner should accept as true, and specifically address, the Veteran’s lay statements regarding (i) being exposed to gas while in training; and (ii) his reports of dyspnea between service and 1975. See May 2009 Statement in Support of Claim; October 2017 VA examination. The examiner should consider whether the current manifestations of COPD are consistent with any event, injury or disease in service, to include exposure to gas. In formulating the opinions, the term “at least as likely as not” does not mean “within the realm of possibility.” Rather, it means that the weight of the medical evidence both for and against the claim is so evenly divided that it is as medically sound to find in favor of the claim as it is to find against. The examiner is reminded that the Veteran is competent to report his own experiences and symptoms. Any opinions offered should be accompanied by the underlying reasons for the conclusions. If the examiner is unable to offer any of the requested opinions, a rationale should be provided for the conclusion that an opinion could not be provided without resort to speculation, together with a statement as to whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. See Jones v. Shinseki, 23 Vet. App. 382 (2011). K. J. ALIBRANDO Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S.R. Fey, 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.