Citation Nr: 20043736 Decision Date: 06/29/20 Archive Date: 06/29/20 DOCKET NO. 17-36 598 DATE: June 29, 2020 REMANDED Entitlement to service connection for lung disease, including chronic obstructive pulmonary disease (COPD), to include as due to exposure to asbestos is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1951 to June 1952. The Veteran died in August 2019 of natural causes, including end-stage COPD. The appellant is the Veteran’s surviving spouse. In 2016, the Veteran was diagnosed with chronic obstructive pulmonary disease (COPD). See Medical Treatment Record-Non-Government Facility received in March 2017. The Veteran stated that during active service, he was stationed at Hanscom, Fort Dix, Mitchell Field, and Kessler Air Force Bases. He stated that he was housed in the barracks which were constructed with asbestos. See Correspondence received in July 2015. Additionally, he stated that he inhaled asbestos dust and fibers when he maintained the aircrafts on the flight line and from electrical wiring handled at radar stations. See id. at 2-3. In June 2016, the Veteran submitted a nexus opinion. See Medical Treatment Record-Government Facility. However, the Board notes that the examiner did not provide a rationale for the opinion. See id. In March 2018, the Veteran submitted another opinion. See Motion to Advance on Docket received in March 2018 at 4. However, the examiner did not provide an opinion linking the Veteran's military service to his current diagnosis. The Veteran was afforded a VA examination in March 2019. The examiner diagnosed the Veteran with COPD. During the examination, the Veteran reported he began smoking cigarettes at 18 years of age and quit at 33 years of age. He reported smoking a pack to a pack and a half of cigarettes per day. The examiner opined that it was less likely than not that the Veteran’s COPD was related to service. The examiner noted that according to the American Lung Association, 85-90 percent of COPD cases are caused by cigarette smoking, and based on this the examiner concluded the Veteran’s COPD was related to his previous cigarette smoking. The March 2018 private provider opined that the Veteran experienced “severe lung damage requiring supplemental oxygen which is greater than would be expected with his short-term very remote history of smoking.” This opinion was not addressed by the VA examiner. Accordingly, the March 2019 VA examiner’s opinion is inadequate. The Board finds that an addendum opinion from a VA examiner addressing the contention that the Veteran’s lung condition was more severe than would be expected given his remote smoking history. The Board notes that the Veteran indicated he smoked cigarettes for a period of 15 years, which appears inconsistent with the private provider’s premise that the Veteran’s cigarette usage was “short-term.” However, based on the Veteran’s age, he reportedly stopped smoking cigarettes in the mid-1960s, many decades prior to his COPD diagnosis and the VA examiner did not address this issue of remote smoking usage. The Board observes several private opinions have been submitted. Several of these opinions contain no or very limited rationale for their medical conclusions. None of the private opinions specifically explained how the Veteran’s lung disease is related to asbestos, nor reconcile this finding with the fact that the Veteran’s death certificate reported that tobacco use contributed to his death. The appellant and representative are free to submit new evidence, including private medical opinion/s, explaining any potential etiological link between the Veteran’s lung disease and his military service. The matters are REMANDED for the following action: 1. Obtain an addendum VA opinion to determine the etiology of the late Veteran’s lung disease. The complete record, to include a copy of this remand and the claims folder, must be made available to and reviewed by the examiner in conjunction with the examination. The examination report must include a notation that this record review took place. Based on a review of the entire record, the examiner should respond to the following: Whether it is at least as likely as not (probability of 50 percent or greater) that the Veteran’s lung disease had its onset in service or is otherwise related to any in-service disease, event, or in jury. The supporting rationale for all opinions expressed must be provided. The examiner should specifically address the private opinions in the record, including the notation in one that the Veteran’s lung condition was more severe than would be expected given his remote history of smoking. The examiner should also address and discuss the private opinion that the Veteran’s lung condition was more likely than not due to asbestos exposure, specifically his service at Hanscom from April 3, 1951 to August 8, 1951. 2. Then, readjudicate the issue on appeal. If the benefit sought remains denied, furnish the Veteran and his representative a Supplemental Statement of the Case and afford them the opportunity to respond before the file is returned to the Board for further consideration. MICHAEL LANE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board N. Keogh, 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.