Citation Nr: 21063472 Decision Date: 10/14/21 Archive Date: 10/14/21 DOCKET NO. 17-31 797 DATE: October 14, 2021 REMANDED Entitlement to service connection for a respiratory disorder, to include chronic obstructive pulmonary disease (COPD), is remanded. Entitlement to service connection for a back disorder is remanded. REASONS FOR REMAND The Veteran, who is the appellant, had active service from July 1975 to April 1979. This matter came before the Board of Veterans' Appeals (Board) on appeal from an August 2014 Department of Veterans Affairs (VA) Regional Office (RO) rating decision. The instant matter was previously before the Board in February 2019, where the issues on appeal were remanded for additional development. As the instant decision again remands the issues on appeal for additional development, the Board need not address remand compliance at this time. See Stegall v. West, 11 Vet. App. 268, 271 (1998). In September 2020 the Veteran requested a post-remand hearing before the Board; however, in a subsequent January 2021 letter, the Veteran withdrew the hearing request. As such, the Board finds that there is no outstanding hearing request before it at this time. 1. Service Connection for a Respiratory Disorder is Remanded VA's duty to assist includes, in appropriate cases, the duty to conduct a thorough and contemporaneous medical examination which is accurate and fully descriptive. Floyd v. Brown, 9 Vet. App. 88, 93 (1996). VA must afford a veteran a medical examination and/or obtain a medical opinion when it is necessary to make a decision on the claim. 38 U.S.C. § 5103A(d) 38 C.F.R. § 3.159(c)(4). By way of history, throughout the course of this appeal the Veteran has advanced having a respiratory disorder that is purported to be related to in-service X-ray exposure and/or hazardous chemical exposure due to in-service responsibilities as a dental specialist. Per a September 2016 private opinion letter, a private physician noted "possible Agent Orange exposure" during service, and in February 2019, the Board remanded the issue of service connection for a respiratory disorder for an examination and opinion. Specifically, the VA examiner was to opine as to whether a respiratory disorder was related to service, to include the purported X-ray and herbicide exposure. Review of the record does not reflect that the Veteran served in the Republic of Vietnam, or had any other foreign service, and the Veteran has not argued as such. Rather, at the January 2020 VA respiratory examination, the Veteran conveyed living in a trailer on the flight line during service, and that the herbicide Agent Orange was sprayed to control vegetation around the flight line, leading to the Veteran's exposure to the herbicide. To date, VA has not received the Veteran's service personnel records, and no formal finding has been issued on the question of whether the Veteran was exposed to the herbicide Agent Orange during service. As such, the Board finds remand to obtain the outstanding service personnel records and for the issuance of a formal finding concerning herbicide exposure to be warranted. Further, the Board notes that COPD is an obstructive lung disease; however, per the report from the January 2020 VA respiratory examination, testing indicated that the Veteran may have a restrictive lung disease. It was suggested that lung volumes be obtained to determine whether the Veteran, in fact, had a restrictive lung disease. To date, no such testing has been completed. As such, the Board finds remand to be necessary for a new VA respiratory examination to clarify all the respiratory disorders. 2. Service Connection for a Back Disorder is Remanded The Veteran argues that a currently diagnosed back disorder is related to an in service motor vehicle accident. At the conclusion of the January 2020 VA back examination, the VA examiner opined that it was less likely than not that a currently diagnosed back disorder was related to service. Unfortunately, the VA examiner did not provide a sufficient rationale for this opinion. See Jones v. Shinseki, 23 Vet. App. 382 (2010) (holding that an opinion without any rationale against which to evaluate the probative value of a determination is inadequate). Considering the other evidence of record, and the fact that remand for a new VA respiratory examination is necessary, the Board will direct that, on remand, a new VA back examination and opinion be performed. The matters are REMANDED for the following action: 1. The Agency of Original Jurisdiction (AOJ) should contact the National Personnel Records Center (NPRC), or other appropriate records custodian, and obtain the Veteran's service personnel records. Once the service personnel records have been received, a formal finding concerning in-service herbicide exposure should be issued. Specifically, the formal finding should address whether herbicides, to include Agent Orange, were used near any of the flight lines at any of the bases at which the Veteran was stationed during service. 2. Contact the Veteran and request information as to any outstanding private treatment (medical) records concerning respiratory and/or back disorders. Upon receipt of the requested information and the appropriate releases, the AOJ should contact all identified health care providers and request that they forward copies of all available treatment records and clinical documentation for the relevant time period on appeal pertaining to the treatment of the disorders, not already of record, for incorporation into the record. If identified records are not ultimately obtained, the Veteran should be notified pursuant to 38 C.F.R. § 3.159(e). 3. Associate with the record all VA treatment records pertaining to the treatment of the Veteran's respiratory and/or back disorders, not already of record, for the period from January 2020. 4. Schedule the appropriate VA examinations. A rationale for all opinions and a discussion of the facts and medical principles involved should be provided. The VA examiner should provide the following opinions: Respiratory Disorder A) The VA examiner should identify all respiratory disorders for which the Veteran is currently diagnosed, to include any obstructive and/or restrictive lung disorders. If the VA examiner finds that the Veteran does not have a current diagnosis of COPD, the VA examiner should address the evidence of record to the contrary. B) For each respiratory disorder diagnosed, offer an opinion to the following question: Is it at least as likely as not (50 percent or higher degree of probability) that the diagnosed respiratory disorder had its onset during a period of active service, to include as due to X-ray exposure and/or hazardous chemical exposure due to in-service responsibilities as a dental specialist? If the AOJ issues a formal finding indicating that the Veteran was likely exposed to herbicides during service, then the VA examiner should also opine as to whether a respiratory disorder may be due to such herbicide exposure. Back Disorder Is it at least as likely as not (50 percent or higher degree of probability) that a diagnosed back disorder had its onset during a period of active service, to include as due to the November 1977 in-service motor vehicle accident? 5. Then, readjudicate the remanded issues. J. PARKER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E. Blowers, 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.