Citation Nr: 21003855 Decision Date: 01/25/21 Archive Date: 01/25/21 DOCKET NO. 17-30 556 DATE: January 25, 2021 REMANDED Entitlement to service connection for a respiratory and/or pulmonary condition is remanded. Entitlement to service connection for high blood pressure, second to a respiratory condition, is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1979 to July 1980. This matter comes before the Board of Veterans’ Appeals (Board) from an October 2016 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran’s claims were most recently before the Board in July 2019 wherein the Board denied the Veteran’s claims for service connection. The Veteran appealed those denials to the United States Court of Appeals for Veterans Claims. In March 2020, through a Joint Motion for Partial Remand (JMPR), the Court vacated the July 2019 Board decision with respect to the claims of entitlement to service connection for a respiratory condition and high blood pressure and remanded them for further action consistent with the JMPR. The claims have now returned to the Board. 1. Entitlement to service connection for respiratory and/or pulmonary condition is remanded. As explained in the JMPR, the Veteran asserts that he should be service-connected for respiratory and/or pulmonary issues on two bases. First, that he had a noted in-service medical visit for bronchitis and obstructive airway disease, one month prior to discharge. Second, that as a result of an in-service incident inhaling a heavy amount of diesel exhaust, he has developed respiratory issues after service. The JMPR noted that the Veteran submitted three letters in June 2017, one of which is from a K.W., R.N., a nurse. See three documents labeled “Buddy/Lay Statement” received June 20, 2017. These statements address the Veteran’s respiratory functioning shortly after service and continuing thereafter. The Board finds the statement from K.W to be competent to address the Veteran’s medical conditions at the time because she possesses the medical expertise and training to diagnosis medical conditions. The Veteran’s treating doctors also submitted letters outlining the Veteran’s lung conditions. See documents labeled “Medical Treatment Record—Non-Government Facility”, received July 19, 2018 and July 27, 2018. The Board finds a medical opinion is required to address whether the respiratory and/or pulmonary condition in-service or the in-service event caused or is otherwise related to the Veteran’s current respiratory and/or pulmonary condition. The clinician rendering the opinion should also address the article and statement submitted by the Veteran. See two documents labeled “Correspondence, received June 2, 2020. 2. Entitlement to service connection for high blood pressure, second to a respiratory condition, is remanded. The Veteran contends that his high blood pressure is related to his respiratory condition. As a decision on the remanded issue of service connection for respiratory issues could significantly impact a decision on the issue of service connection for high blood pressure, the issues are inextricably intertwined. A remand of the claim for service connection for high blood pressure is required. On remand, an opinion should address whether the Veteran’s diagnosed respiratory and/or pulmonary conditions could cause or aggravate the Veteran’s blood pressure condition. The opinion should address the article submitted by the Veteran. See document labeled Third Party Correspondence, received June 2, 2020, pages 5-14. The matters are REMANDED for the following action: 1. Obtain a medical opinion from a qualified medical professional on the etiology of the Veteran’s current respiratory and/or pulmonary condition and its relationships to service. The clinician should answer the following questions: a. What respiratory and/or pulmonary issues does the Veteran currently have? b. Is it at least as likely as not that the Veteran’s current respiratory and/or pulmonary issues are related to the Veteran’s diagnosis of bronchitis and obstructive airway disease during service? c. Is it at least as likely as not that the Veteran’s current respiratory and/or pulmonary issues are related to the Veteran’s exposure to large amounts of diesel exhaust during service? The clinician should consider the records provided by the Veteran in support of his position, to include the statement from K.W., R.N., a nurse. See three documents labeled “Buddy/Lay Statement” received June 20, 2017; See documents labeled “Medical Treatment Record—Non-Government Facility”, received July 19, 2018 and July 27, 2018; See two documents labeled “Correspondence”, received June 2, 2020. 2. Obtain a medical opinion from a qualified medical professional on the etiology of the Veteran’s current high blood pressure and its relationships to service. The clinician should answer the following questions: a. What blood pressure issues does the Veteran currently have? b. Is it at least as likely as not that the Veteran’s blood pressure condition is caused or aggravated by the respiratory/pulmonary issues. Note that aggravation means any incremental increase in disability in non-service-connected disabilities (i.e., any additional impairment of earning capacity) resulting from service-connected conditions. Bethany L. Buck Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board I. M. Hitchcock 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.