Citation Nr: 21001996 Decision Date: 01/12/21 Archive Date: 01/12/21 DOCKET NO. 17-46 287 DATE: January 12, 2021 REMANDED Entitlement to service connection for sarcoidosis is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from July 1979 to January 1987. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an October 2015 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a video hearing before the undersigned Veterans Law Judge in November 2019. This matter was remanded by the Board in January 2020 and has been returned for further appellate review. While on remand, the issues of service connection for left knee scar, lumbar intervertebral disc syndrome, and plantar fasciitis were granted. Thus, these issues are no longer on appeal. See Grantham v. Brown, 114 F. 3d 1156, 1158 (Fed. Cir. 1997). Entitlement to service connection for sarcoidosis is remanded. The Board regrets the additional delay, but remand is necessary to obtain an adequate medical opinion. Where VA provides the veteran with an examination in a service connection claim, the examination must be adequate. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). VA obtained another examination and opinion in July 2020. In providing a negative opinion, the examiner stated there were no signs and symptoms of sarcoidosis in service, but did not address relevant service treatment records (STRs), private records, or lay testimony. The STRs document the Veteran was treated for upper respiratory symptoms frequently throughout her period of service. Specifically, the Veteran was treated for coughing with varying diagnoses of bronchitis, sinusitis, viral infection, and pharyngitis/laryngitis in August 1979, July 1980, April 1981, February 1982, October 1982, February 1983, March 1983, May 1983, September 1983, January 1986, October 1986 and December 1986. Private treatment records show that sarcoidosis was diagnosed incidentally in November 2004 at a time the Veteran was asymptomatic. In December 2004, the provider wrote that the differential diagnosis included sarcoidosis, which could have been inactive and present for many years. In December 2015, the Veteran wrote that her sarcoidosis could have been present and undetected for many years. In May 2017, the Veteran wrote that she had respiratory problems on and off since discharge from the Navy, and no family history of sarcoidosis. The 2020 VA examiner did not adequately address the in-service, recurrent respiratory symptoms or the theory that sarcoidosis may have existed since service but was largely asymptomatic. Thus, remand is again required for an adequate addendum. The matters are REMANDED for the following action: Obtain an addendum opinion regarding the etiology of the claimed sarcoidosis from a VA examiner. The entire claims file must be made available to and be reviewed by the examiner. If an examination is deemed necessary, it shall be provided. An explanation for all opinions expressed must be provided. The examiner must provide an opinion regarding whether it is at least as likely as not (50 percent or greater probability) that sarcoidosis had onset in, or is otherwise related to, active service. The examiner must provide an opinion regarding whether it is at least as likely as not (50 percent or greater probability) that sarcoidosis had onset within one year of separation from service. The examiner must address the following: 1) STRs showing treatment for cough with varying diagnoses of bronchitis, sinusitis, viral infection, and pharyngitis/laryngitis in August 1979, July 1980, April 1981, February 1982, October 1982, 1982, February 1983, March 1983, May 1983, September 1983, January 1986, October 1986 and December 1986; 2) November and December 2004 private treatment records noting sarcoidosis may have been present and asymptomatic for some time; and 3) the Veteran’s assertions that sarcoidosis could have been present and undetected for many years, and that she had respiratory problems on and off since discharge from the Navy with no family history of sarcoidosis; 4) and all evidence discussed in the January 2020 remand and July 2020 VA examination report. K. MILLIKAN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Smith, 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.