Citation Nr: 21063919 Decision Date: 10/18/21 Archive Date: 10/18/21 DOCKET NO. 14-04 467 DATE: October 18, 2021 REMANDED Entitlement to a rating in excess of 30 percent prior to December 21, 2010 and in excess of 60 percent from December 21, 2010 for asthma is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1981 to June 1985. This matter is before the Board of Veterans' Appeals (Board) on appeal from an October 2011 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). A Board hearing was held before the undersigned in November 2018. A transcript of the hearing is of record. This matter was previously before the Board in September 2017 and February 2020 when it was remanded for further development. Entitlement to a rating in excess of 30 percent prior to December 21, 2010 and in excess of 60 percent from December 21, 2010 for asthma is remanded. Although the additional delay is regrettable, the Board finds another remand is required before a decision can be made on the Veteran's claim. In the February 2020 Board remand, the Board directed the Agency of Original Jurisdiction (AOJ) to schedule the Veteran for a VA examination to assess the current nature and severity of his asthma. Following examination of the Veteran, the Board asked a VA examiner to provide an opinion regarding whether the Veteran's asthma requires daily use of systemic (oral or parenteral) high dose corticosteroids or immunosuppressive medications. In providing the opinion, the examiner was asked to consider the Veteran's use of Albuterol, Budesonide, Cyclosporine, Epi-Pen, Fluticasone Prop, Montelukast, Fexofenadine, Flonase, Mometasone, Formoterol, Methylpred, Asmanex, and explain whether these medications are taken to treat the Veteran's asthma or another condition. However, in the subsequent May 2020 VA examination and opinion, the examiner did not address all of the listed medications and whether they were used daily, to treat the Veteran's asthma, and constitute systemic high dose corticosteroids or immunosuppressive medications. In light of this, the Board finds remand is required to ensure substantial compliance with the Board's prior remand directives. See Stegall v. West, 11 Vet. App. 268 (1998) (holding that where the remand orders of the Board are not substantially complied with, the Board errs as a matter of law when it fails to ensure substantial compliance). The Board also notes that the February 2020 Board remand asked that the AOJ obtain outstanding treatment records in Vista Imaging from SLUCARE or St. Louis University, including but not limited to those identified in December 2013, February 2014, and April 2014. If the records were not able to be obtained, the AOJ was directed to ask the Veteran to submit VA Form 21-4142 for St. Louis University to authorize VA to obtain the records. In February and March 2020, the Veteran was sent development letters asking that he submit VA Form 21-4142 to allow VA to obtain records from St. Louis University. In April 2020, the Veteran submitted the form identifying SLUCARE medical group and records from SLUCARE were obtained; however, the records provided do not contain any records of treatment for the dates referenced in the Veteran's VA treatment records. Additionally, VA treatment records added to the file do not contain the referenced Vista Imaging records. As the claim is being remanded anyway, the Board finds another attempt to obtain the referenced records should be made. The matters are REMANDED for the following action: 1. Obtain treatment records in Vista Imaging from "SLUCARE" (SLUCARE Medical Group or St. Louis University), including, but not limited to, those identified in December 2013, February 2014, and April 2014 VA treatment records. If the records cannot be obtained from Vista Imaging, then ask the Veteran to complete another VA Form 21-4142 to authorize VA to obtain the records. Make two requests for the authorized records unless it is clear after the first request that a second request would be futile. 2. Obtain an addendum opinion from a VA examiner other than the May 2020 examiner. The Veteran's claims file must be made available to the examiner for review. An examination should only be scheduled if the examiner deems one is necessary to provide the requested opinion. The examiner is asked to consider the Veteran's use of Albuterol, Budesonide, Cyclosporine, Epi-Pen, Fluticasone Prop, Montelukast, Fexofenadine, Flonase, Mometasone, Formoterol, Methylpred, and Asmanex and provide an opinion on the following: (a) Explain whether each of the medications are currently required (or has been required at any time during the current appeal), to treat the Veteran's asthma, to treat another condition, or to treat asthma along with other condition(s). (b) If the medication is used to treat the Veteran's asthma (or to treat asthma along with another condition), then opine on the following: (i) Whether the medication is used daily or intermittently (at least three times per year); and (ii) Whether the medication constitutes daily inhalational or oral bronchodilator therapy or inhalational anti-inflammatory medication; systemic (oral or parenteral) corticosteroids; or systemic (oral or parenteral) high dose corticosteroids or immuno-suppressive medications. A complete rationale for all opinions must be provided. If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why an opinion would require speculation. The clinician must indicate whether there was any further need for information or testing necessary to make a determination. M. SORISIO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Jiggetts 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.