Citation Nr: 20009622 Decision Date: 02/05/20 Archive Date: 02/05/20 DOCKET NO. 16-46 523 DATE: February 5, 2020 REMANDED Entitlement to service connection for a right lung nodule is remanded. REASONS FOR REMAND The Veteran had active service from December 1968 to September 1970. In September 2019, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the record. At the September 2019 Board hearing, the Veteran testified that he has received treatment for his right lung nodule from a private physician. He further indicated that the private physician has reviewed the relevant VA treatment records and has indicated that the Veteran’s right lung nodule could possibly be due to his presumed in-service exposure to herbicide agents. A remand is required to allow VA to assist the Veteran in obtaining the identified private treatment records and associate them with the record. In addition, a VA opinion was obtained in June 2016 using the Acceptable Clinical Evidence (ACE) process. The examiner reviewed the record, noted the service treatment records showing in-service left lower lobe pneumonia and upper respiratory infection, and stated that the Veteran’s current lung nodules are not secondary to the in-service upper respiratory infection or left lower lobe pneumonia. The examiner’s statement is conclusory and is not supported by any rationale. It is thus inadequate for decision-making purposes. See Stefl v. Nicholson, 21 Vet. App. 120, 123 (2007) (for a medical opinion to be adequate for decision-making purposes, it must be supported by a rationale and explanation for the conclusion reached). Therefore, if the additional records obtained on remand are not sufficient to render a positive decision in this appeal, or if no further records are obtained, then the Veteran should be provided a VA examination to determine the likely etiology of his right lung nodule. The matters are REMANDED for the following action: 1. Ask the Veteran to complete a VA Form 21-4142 for the private treatment he identified at the September 2019 Board hearing, to include treatment from the physician who reportedly indicated that the right lung nodule could possibly be due to the Veteran’s presumed in-service exposure to herbicide agents. Make two requests for the authorized records unless it is clear after the first request that a second request would be futile. If the identified records cannot be obtained, provide the Veteran with notification consistent with 38 C.F.R. § 3.159(e). 2. If the additional evidence obtained through the above efforts are not sufficient to render a decision, or if no additional records are obtained, schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of his right lung nodule. All required tests and examinations must be completed, to include a chest CT scan if deemed necessary to provide the requested opinions. The examiner must opine whether it is at least as likely as not (50 percent or greater probability) that the right lung nodule is related to an in-service injury, event, or disease, including the left lower pneumonia and upper respiratory infection diagnosed in the service treatment records. If the additional evidence obtained through item 1 above includes competent evidence indicating that the Veteran’s right lung nodule may be related to in-service exposure to herbicide agents, then the clinician must also opine whether it is at least as likely as not that the Veteran’s right lung nodule is related to presumed in-service herbicide agent exposure. MICHAEL MARTIN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. J. Anthony, 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.