Citation Nr: 20020105 Decision Date: 03/18/20 Archive Date: 03/18/20 DOCKET NO. 18-26 540 DATE: March 18, 2020 REMANDED Entitlement to service connection for a respiratory disability, to include chronic obstructive pulmonary disease (COPD) is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1969 to February 1973. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a January 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Boston, Massachusetts. The Veteran testified at a videoconference hearing before the undersigned in February 2020. A transcript is of record. 1. Entitlement to service connection for a respiratory disability, to include chronic obstructive pulmonary disease (COPD) is remanded. In February 2020, the Veteran submitted a November 2019 VA pulmonary note indicating that he had been seen in “PACC” for his respiratory concerns since June 2018. However, it does not appear that any records from PACC or other pulmonary notes have been associated with the claims file. As such, a remand is warranted to obtain outstanding and relevant VA treatment records. Additionally, in a January 2015 VA examination the examiner opined that the Veteran’s respiratory disability, which clearly and unmistakably existed prior to service, was not aggravated beyond its natural progression by service. However, while the Veteran reported shortness of breath in the January 1969 enlistment examination, he did not report asthma or COPD nor was either condition noted in the enlistment examination. As such, the Board finds that clarification is warranted to determine what evidence the examiner relied on to determine whether there was clear and unmistakable evidence that a respiratory disability, such as asthma and/or COPD, pre-existed service. Further, in July 2018 and February 2020, Dr. J. R. W., a VA physician, indicated that the Veteran’s respiratory disability was due to his in-service exposure to jet fuel. It was noted in a July 1969 occupational examination that the Veteran had been exposed to JP-4, MLK, and AV gas. As such, a supplemental VA opinion addressing the nexus between the Veteran’s respiratory disability and in-service exposure to fuel is warranted. The matters are REMANDED for the following action: 1. Obtain any outstanding VA treatment records, to include PACC records from June 2018. 2. Then, obtain a supplemental VA opinion from an appropriately qualified examiner. Only if deemed necessary to provide an opinion, should the Veteran be afforded a new VA examination for his respiratory disability. Provide the claims file, including a copy of this REMAND, to the examiner for review. The examiner should address the following: a. Is there clear and unmistakable evidence that the Veteran’s respiratory disability, to include asthma and COPD, pre-existed his active duty service? If the Veteran's current respiratory disorder is found to have preexisted his military service, the examiner must then state upon what factual evidence in the record this finding was made. b. If so, is there clear and unmistakable evidence that the Veteran’s pre-existing respiratory disability was not aggravated beyond the natural progression by his active duty service? In providing the above requested opinions, the examiner is advised that the evidentiary standard for whether a condition existed prior to service is "clear and unmistakable," which is a formidable evidentiary standard, requiring that the preexistence of a condition and the no-aggravation result be "undebatable." c. If the answer to (a) is no, then is it at least as likely as not (50 percent probability or more) that the Veteran’s respiratory disability had its onset in or is otherwise related to service, to include his in-service exposure to JP-4, MLK, and AV gas? In providing the above opinion, the examiner should consider the July 2018 and February 2020 records from Dr. J. R. W. indicating that the Veteran’s respiratory disability was due to his in-service exposure to jet fuel. In providing the opinion requested above, the examiner must consider statements of record from the Veteran and his wife regarding the onset and continuity of symptomatology pertaining to his respiratory disability since service, to include his extensive exposure to jet fuel in service. Dalton v. Nicholson, 21 Vet. App. 23 (2007). A complete rationale for all opinions must be provided. If the examiner cannot provide any requested opinion without resorting to speculation, it must be so stated, and the examiner must provide the reasons why an opinion would require speculation. LESLEY A. REIN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E. Ko, 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.