Citation Nr: 21001095 Decision Date: 01/07/21 Archive Date: 01/07/21 DOCKET NO. 190221-5393 DATE: January 7, 2021 REMANDED Entitlement to service connection for chronic obstructive pulmonary disease (COPD) is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1977 to June 1981. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2018 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO) which denied service connection for COPD. In May 2018, the Veteran opted into the modernized review system, also known as the Appeals Modernization Act (AMA), by submitting a Rapid Appeals Modernization Program (RAMP) opt-in election form. See 38 C.F.R. § 3.2400(c)(1). At that time, he requested a higher-level review of his claim. In September 2018 the RO conducted the higher-level review and continued to deny the claim for service connection. In February 2019, the Veteran filed a Decision Review Request: Board Appeal (Notice of Disagreement) and requested direct review from the Board. In a September 2019 decision, the Board denied the Veteran’s claim. The Veteran appealed the issue to the Court of Appeals for Veterans Claims (Court). In a June 2020 Order, the Court vacated the Board’s September 2019 decision and adopted the parties’ Joint Motion for Remand (JMR) for reconsideration of the Veteran’s claim. The case has been returned to the Board for compliance with the directives contained in the June 2020 JMR and Order. Further development is required before the Board may address the issue on the merits. Service Connection - COPD The Veteran contends that his current COPD is attributable to chest pain and difficulty breathing, probable exposure to asbestos, and possible exposure to jet fuel fumes, all during service. In the September 2018 higher level review rating decision, the following favorable findings were made: service treatment records showed complaints of chest pain and chest congestion; the Veteran’s DD-214 shows a military occupational specialty (MOS) of AD (Aviation Machinist Mate) in the Navy which has a probable exposure of asbestos exposure during military service; a possibility of exposure to jet fuel/fumes during military service while working as an Aviation Machinist Mate in the Navy; and VA medical records and examination reports revealing diagnoses of COPD. These findings are binding on the Board. In the JMR, it was noted that the Board relied on November 2016 and August 2018 VA examination reports, finding these to be probative, but that the Board erred as it did not address the Veteran’s statements that he wanted to see a lung specialist or a pulmonary doctor. See November 2017 statement. Additionally, the Board did not address the Veteran’s complaints to the VA when the provider who conducted his August 2018 examination was not a specialist. See January 2019 Report of General Information. The JMR also noted the Veteran’s contentions that the VA examiners failed to provide sufficient rationale regarding the relationship between his COPD and in-service exposure to asbestos and jet fuels. He asserted that the examiners offered no medical explanation regarding the significance of the gap between in-service symptoms and exposures and official diagnosis. The Veteran argued that the August 2018 VA examiner failed to adequately explain her opinion where he was a non-smoker, but had exposure to other irritants. The Board was instructed to address these contentions on remand. With regard to the Veteran’s arguments that the VA examiners did not provide adequate rationale for their opinions, the Board finds remand is necessary in order to obtain an addendum opinion that provides a sufficient rationale addressing the time between his in-service exposure and diagnosis. This is particularly important given the Veteran’s claim of asbestos exposure, as VA guidance has provided that the latency period for asbestos-related diseases varies from 10 to 45 or more years between first exposure and development of disease, and that an asbestos-related disease can develop from brief exposure to asbestos. In addition, while the August 2018 examiner noted that COPD was caused by cigarette smoke, exposure to irritants and “so on,” she did address whether jet fuel fumes would be considered an irritant causing COPD. For the purposes of the examination, the Board finds that exposure to asbestos and jet fuel fumes should be conceded. With regard to the Veteran’s request to have an examination performed by a pulmonary specialist, the Board finds that it would be advantageous given the intricacies of the Veteran’s claim to obtain an opinion from a pulmonologist or similarly qualified specialist who can provide the necessary addendum opinion and rationale. The matters are REMANDED for the following action: Obtain an opinion from a pulmonologist or similarly qualified specialist for the Veteran’s COPD. The examiner must review the claims file. Please opine as to whether it is at least as likely as not that the Veteran’s COPD is related to service, to include chest pain and congestion/shortness of breath in service, exposure to jet fuel fumes, and asbestos. The examiner should note that VA guidance provides that the latency period for asbestos-related diseases varies from 10 to 45 or more years between first exposure and development of disease, and an asbestos-related disease can develop from brief exposure to asbestos. For the purposes of this opinion, in-service exposure to jet fuel fumes and asbestos is conceded. The examiner must provide a thorough rationale for any opinion rendered. If the examiner is unable to provide an opinion without resort to speculation, he or she should explain why this is so and what if any additional evidence would be necessary before an opinion could be rendered. M. Mills Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Harrigan Smith 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.