Citation Nr: 21002284 Decision Date: 01/13/21 Archive Date: 01/13/21 DOCKET NO. 15-16 657 DATE: January 13, 2021 REMANDED Entitlement to service connection for granulomata claimed as lung condition due to asbestosis is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1973 to September 1977. In November 2018, the Veteran testified at a travel board hearing before the undersigned Veterans Law Judge (VLJ). A transcript of the hearing is associated with the record. The issue was previously before the Board in March 2019 and remanded for further development. Entitlement to service connection for granulomata claimed as lung condition due to asbestosis is remanded. The Veteran continues to assert he is warranted service connection for the lung disability. Asbestos exposure is conceded due to the Veteran’s duties in the Navy as a Machinist Mate. In response to the Board’s March 2019 remand, a medical opinion was obtained in November 2019, in which the VA examiner opined that the Veteran’s claimed granulomata was less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service exposure to asbestos. The previous VA examiner in March 2012 did not offer a nexus opinion on the grounds that to do so would require resorting to speculation. Additionally, the 2019 examiner failed to discuss the Veteran’s statements from the November 2018 hearing, where he recounted that his job as a “lagger” in the Navy from 1973 to 1977 was as an insulator. “I have records showing through my progress on how good of a “lagger” I was. I worked with pure asbestos and insulating materials insulating different heating elements. And I worked with pure asbestos digging my hands into it.” The Veteran spoke of shortness of breath and constant rashes while in service. The Veteran also recounted at the Board hearing how he told his urgent care doctor in November 2010 when he had bronchitis, what kind of work he did in the Navy, and the doctor ordered a chest x-ray. That x-ray revealed his granulomata. That doctor passed away two weeks before the Board hearing and was unable to provide an etiology opinion. During the same Board hearing the Veteran asked what testing is required to determine definitively the etiology of his granulomata? “Do they have an MRI that can actually tell that, or do they actually have to go in and take a sample off my lung to determine? I don’t know what is required for that” Because the 2019 examiner failed to discuss the Veteran’s statements describing his work with asbestos and concurrent symptoms as an insulator in the Navy, or answer his question about how one determines asbestos-related lung problems, the Board finds another opinion is necessary. 38 U.S.C. § 5103A(d) (2012); Barr v. Nicholson, 21 Vet. App. 303 (U.S. 2007). As such, remand for another medical nexus opinion is necessary. The matter is REMANDED for the following action: 1. Ask the Veteran if he located the 2010 urgent care treatment records relevant to his granulomata, and to provide authorizations to VA to request the records. Request any so identified records. 2. Associate any new civilian medical records and any VA treatment records dated since July 2020 with the electronic claims file. 3. Schedule the Veteran for a new examination to determine the etiology of the Veteran's granulomata if the examiner feels that is needed; otherwise, the examiner can base their opinions on the updated record. The examiner must have the appropriate expertise and be provided access to the electronic claims file and be different from the previous VA examiner who provided the November 2019 nexus opinion. The examiner must indicate review of the claims file in the examination report. Following a review of the claims file, the examiner should provide an opinion for the following question: Whether it is at least as likely as not (50% probability or greater) the Veteran's granulomata was incurred in service. The examiner must discuss the Veteran’s statements about his regular exposure to asbestos as an insulator in the Navy from 1973 to 1977. (Continued on the next page)   The examiner must also discuss the Veteran’s reports of shortness of breath and rashes during service. The examiner must provide a rationale for each opinion given. H. SEESEL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Black, 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.