Citation Nr: 20007790 Decision Date: 01/31/20 Archive Date: 01/29/20 DOCKET NO. 18-46 196A DATE: January 31, 2020 REMANDED Service connection for the Veterans' cause of death is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1955 to August 1957 in the United States Navy. He died in October 2016. The Appellant is his surviving spouse. The matter comes before the Board of Veterans’ Appeals (Board) on appeal from a rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In July 2019, the Appellant testified before the undersigned Veterans Law Judge (VLJ). A hearing transcript is associated with the claims file. Entitlement to service connection for cause of death (DIC). The Veteran’s death certificate shows that the immediate cause of death was cardiogenic shock, acute hypoxic respiratory failure, end-stage cardiomyopathy, and long-term complications of mesothelioma. The Appellant contends that the Veteran’s death was caused by a chronic lung disability that he developed as a result of exposure to asbestos while stationed aboard the U.S.S. Cassin Young and/or working in the Navy Yard. The Appellant testified that she first noticed lung problems with the Veteran in 1974, describing it as a series of chronic bad colds with cough. She noted that the Veteran did not want to go to the doctor and so no diagnosis was obtained at that time. She testified that the medical records show lung problems in 1986 after the Veteran went for treatment. The Veteran’s DD 214 reflects his primary operational specialty as Seaman (SN). Personnel records reveal this occupation involves a low risk of asbestos exposure. Service treatment records reflect no complaints or findings for abnormal pathology of the lung or cardiovascular system. An August 1957 separation examination was normal clinical evaluation of the lungs and heart. In support of the claim, the Appellant submitted a July 2018 letter from the Vice-President of the Veteran’s former place of employment. It indicated that the Veteran worked under regulated safety conditions during his time of employment. He noted that while the Veteran worked as an asbestos abatement supervisor, he was required to comply by United States Environmental Agency Protection Agency standards and wear personal protective equipment and “HEPA” respiratory protection. She also submitted a private medical opinion from Veteran’s private physician, Dr. H.D. linking the Veteran’s cause of death to in-service asbestos exposure. A July 2018 statement from the Appellant’s representative noted that the Veteran’s personnel records indicate he had alternative duty as a fireman, completed gunnery training, and worked as a messman, which increase his likely exposure to asbestos while in service. September 2017 and February 2018 VA medical opinions reflect that it was less likely than not that the Veteran’s cause of death was etiologically related to service. The Appellant submitted partial medical records in support of the appeal, which reflect relevant treatment for the Veteran’s lung/pulmonary disorder by various physicians (Drs. Cugell, Sider, Godson, Solorzano, and McShane). However, the complete private treatment records of these medical providers have not been requested or obtained. Also, Dr. H.D. indicated in his opinion that he treated the Veteran from September 2011 to January 2016 for lung disorder as support for his opinion. However, his medical treatment records have not been requested or obtained. Therefore, to ensure that VA has met its duty to assist, remand is necessary to obtain outstanding private treatment records. 38 C.F.R. § 3.159(c)(1). Accordingly, the matter is REMANDED for the following action: 1. Ask the Appellant to complete a VA Form 21-4142 for all non-VA medical providers that treated the Veteran for lung disorder/symptoms since service discharge to include Drs. Cugell, Sider, Godson, Solorzano, and McShane and Dominguez along with Florida Hospital Fish. Make two requests for the authorized records from all identified sources, unless it is clear after the first request that a second request would be futile. 2. Obtain an addendum medical opinion on whether it is at least as likely as not that the Veteran’s mesothelioma had its onset in service or within one year after discharge, or is otherwise caused by an in-service injury or disease, to include the reported asbestos exposure. All the evidence should be considered along with (a) a July 2018 letter from the Vice-President of the Veteran’s former place of employment and (b) the representative July 2018 statement noting that the Veteran’s personnel records indicate he had alternative duty as a fireman, completed gunnery training, and worked as a messman, suggesting an increased likelihood of exposure to asbestos while in service. 3. Ensure that the VA medical opinion obtained includes a complete rationale for the conclusions reached. The medical opinion must support the conclusions reached with an analysis that is adequate for the Board to consider and weigh against other evidence of record; medical opinions must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. If an opinion cannot be expressed without resort to speculation, ensure that the clinician so indicates and discusses why an opinion is not possible, to include 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. C.A. SKOW Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. A. Macek, 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.