Citation Nr: 21005144
Decision Date: 01/29/21	Archive Date: 01/29/21

DOCKET NO. 13-09 778
DATE: January 29, 2021

REMANDED

Service connection for a pulmonary disability, to include chronic obstructive pulmonary disease (COPD), is remanded.

REASONS FOR REMAND

The Veteran served on active duty with the United States Navy from March 1964 to January 1968.  This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a February 2012 rating decision by a Regional Office (RO) of the United States Department of Veterans Affairs (VA).

The matter was previously before the Board in March 2015, at which time it was remanded for further development. Addendum opinions were obtained in April 2015 and June 2015.  In November 2019, the Board again remanded the issue of entitlement to service connection for a pulmonary disability, to include asbestosis and COPD, in order to obtain VA treatment records. The requested records were subsequently associated with the file, and the matter is again before the Board.   Substantial compliance with the Board’s prior remand orders is demonstrated. See Dyment v. West, 13 Vet. App. 141, 146-47 (1999); Stegall v. West, 11 Vet. App. 268, 271 (1998).  

However, further clarification is necessary prior to adjudication of this issue.  In the June 2008 private medical opinion, the Veteran was diagnosed with COPD and asbestosis.  Subsequent VA examiners noted such, but found that a diagnosis of asbestosis was not in fact warranted, based on more recent CT scans.  The CT scan was the “gold standard” of diagnostic tools in asbestos cases, and the June 2008 finding had not had access to such.  Accordingly, the sole currently diagnosed pulmonary condition is COPD.

Examiners have opined that COPD is not caused or aggravated by “asbestosis” in light of the actual diagnosis of that disease, and have indicated that smoking is the major cause of COPD.  The Veteran has a history of smoking two packs of cigarettes a day for ten years (a 20 pack year history), quitting in approximately 1972.  However, no doctor has opined as to whether the Veteran’s established asbestos exposure directly caused or aggravated COPD, as opposed to causing asbestosis which then impacted COPD.  Remand for such an opinion is required.

The matters are REMANDED for the following action:

1. Obtain an addendum opinion from a suitably qualified clinician; the claims file must be reviewed in conjunction with such.  The need for an additional in-person examination is left to the discretion of the medical professional offering the addendum opinion.  

The clinician must opine as to whether it is at least as likely as not (50 percent probability or higher) that the Veteran’s diagnosed COPD is caused or aggravated by service, to include in-service asbestos exposure.  The examiner must discuss whether COPD is an asbestos-related disease.  While a history of smoking is established, the examiner must address whether asbestos played any role at all in the development or severity of COPD.

A full and complete rationale is required for all opinions expressed.  

2. Then, readjudicate the claim on appeal.  If the benefit sought remains denied, issue a supplemental statement of the case and then return the matter to the Board, if otherwise in order.

 

 

WILLIAM H. DONNELLY

Veterans Law Judge

Board of Veterans’ Appeals

Attorney for the Board	S.P. Faris

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.