Citation Nr: 20044099 Decision Date: 06/30/20 Archive Date: 06/30/20 DOCKET NO. 11-30 611 DATE: June 30, 2020 REMANDED Entitlement to service connection for a respiratory disorder, to include pulmonary emboli is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from January 1975 to December 1977. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2010 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge in a February 2017 video conference hearing. This case was previously before the Board in April when it was remanded for additional development. In June 2018, the Board requested the opinion of a medical specialist from the Veterans Health Administration (VHA). The requested opinion was received in August 2018. In a February 2019 decision, the Board denied service connection for a respiratory disorder, to include pulmonary emboli. The Veteran appealed the Board’s February 2019 decision to the United States Court of Appeals for Veterans Claims (Court). Pursuant to a January 2020 Court Joint Motion for Remand (Joint Motion), the Court vacated the Board’s February 2019 decision, and remanded the matter to the Board for further action. 1. Entitlement to service connection for a respiratory disorder, to include pulmonary emboli is remanded. The January 2020 Court Joint Motion found the Board erred by failing to satisfy the duty to assist by relying on an inadequate August 2018 medical advisory opinion that applied the wrong legal standard as to aggravation. The parties in the Joint Motion agreed that a remand was required for a new medical nexus opinion using the correct legal standard and addressing whether the Veteran’s service-connected heart disorder and hypertension, caused or aggravated, his respiratory disorder. Accordingly, this matter must be remanded to provide the Veteran an addendum opinion as to the nature and etiology of the Veteran’s respiratory disorder. The matters are REMANDED for the following action: Forward the Veteran’s claims file to a VA examiner to determine the nature and likely etiology of his respiratory disorder, to include pulmonary emboli. The entire claims file must be reviewed by the examiner. Following a review of the record, the examiner is asked to respond to the following: (a) Identify all respiratory impairment and diagnose all current respiratory disorders, to include asthma; pulmonary hypertension; pulmonary fibrosis; pulmonary emboli; adult respiratory distress syndrome; and regional interstitial lung disease. (b) The examiner should opine as to whether it is at least as likely as not that any respiratory disorder/impairment, to include asthma; pulmonary hypertension; pulmonary fibrosis; pulmonary emboli; adult respiratory distress syndrome; and regional interstitial lung disease, etc., is related to and/or had its onset during his period of service. In responding to this question, the opinion should be given regardless of whether they are related to in-service smoking. The Veteran’s treatment for respiratory problems during service, and his reports of respiratory problems since service must be specifically acknowledged and discussed. (c) Opine whether it is at least as likely as not that any respiratory disorder/impairment, to include asthma; pulmonary hypertension; pulmonary fibrosis; pulmonary emboli; adult respiratory distress syndrome; and regional interstitial lung disease, etc., is proximately due to his service-connected heart disorder, diagnosed as a bicuspid aortic valve, status post valve surgery, and/or hypertension. (d) Opine whether it is at least as likely as not that any respiratory disorder/impairment, to include asthma; pulmonary hypertension; pulmonary fibrosis; pulmonary emboli; adult respiratory distress syndrome; and regional interstitial lung disease, etc., has been aggravated by his service-connected heart disorder, diagnosed as a bicuspid aortic valve, status post valve surgery, and/or hypertension. A complete rationale should be given for all opinions and conclusions expressed. If unable to provide a medical opinion, provide a statement as to whether there is any 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. Please note that it is not necessary that the service-connected heart disorder and hypertension be diagnosed or even service-connected at the time the respiratory disorder/functional impairment is incurred to establish service connection, and reliance on this fact will render any secondary opinion inadequate. In providing the above-requested secondary opinions in (c) and (d), the examiner is asked to specifically address the April 2020 private medical opinion by Dr. M.B. submitted by the Veteran in May 2020. STEVEN D. REISS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Marley, 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.