Citation Nr: 21062808
Decision Date: 10/12/21	Archive Date: 10/12/21

DOCKET NO. 18-45 176
DATE: October 12, 2021

REMANDED

Entitlement to service connection for the Veteran's cause of death is remanded.

REASONS FOR REMAND

Having reviewed the record, the Board finds remand is warranted for an addendum opinion.  The August 2018 VA opinion determined that it was less likely than not that Veteran's conceded exposure to particulate matter and/or burning oil well fires contributed to his death.  However, the examiner's opinion lacks clarity as to whether sarcoidosis is at least as likely as not related to conceded exposure.  Here, the examiner merely stated that sarcoidosis was asymptomatic several months prior to the Veteran's death and offered no additional rationale.  The Board finds remand is warranted for clarification, particularly in light of the appellant's assertion that the Veteran experienced symptoms since service.  On remand, an appropriate clinician must provide an opinion on whether sarcoidosis, noted as a contributory cause of death on the death certificate, is at least as likely as not related to conceded exposure to particulate matter and/or burning oil well fires.  In providing the opinion, the clinician should consider the Veteran's upper respiratory infections and any changes in vision during service.  Additionally, the clinician should consider post-service VA treatment records noting a complaint of sinus problems since Desert Storm in September 1993; a history of rhinitis for years and shortness of breath and wheezing with exertion and at night in July 1994; a December 1994 VA treatment record noting a complaint of continuous paroxysmal nocturnal dyspnea since Desert Storm; and a dermatology consult to evaluate a rash in view of questionable chest X-ray findings and ruling out a diagnosis of sarcoidosis in November 1996.  

The matters are REMANDED for the following action:

Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's sarcoidosis was at least as likely as not related to conceded exposure to particulate matter and/or burning oil well fires.  

In providing the opinion, the clinician should consider the following: in-service treatment for upper respiratory infections; any changes in vision during service; a September 1993 VA treatment record noting a complaint of sinus problems since Desert Storm; a July 1994 VA treatment record noting a history of rhinitis for years and shortness of breath and wheezing with exertion and at night; a December 1994 VA treatment record noting a complaint of continuous paroxysmal nocturnal dyspnea since Desert Storm; and a November 1996 dermatology consult to evaluate a rash in view of questionable chest X-ray findings and ruling out a diagnosis of sarcoidosis.  

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Any opinions offered should be accompanied by the underlying reasons for the conclusions.

 

 

TANYA SMITH

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	S. Vang, 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.