Citation Nr: 21064174 Decision Date: 10/19/21 Archive Date: 10/19/21 DOCKET NO. 17-67 221 DATE: October 19, 2021 REMANDED Entitlement to service connection for asbestosis is remanded. Entitlement to service connection for a disorder manifested by fatigue, claimed as secondary to asbestosis, is remanded. Entitlement to service connection for an acquired psychiatric disorder, to include anxiety and depression, claimed as secondary to asbestosis, is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1967 to December 1968. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a rating decision issued in December 2014 by a Department of Veterans Affairs (VA) Regional Office. In July 2021, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the record. At such time, the Veteran waived Agency of Original Jurisdiction (AOJ) consideration of the evidence associated with the record since the issuance of the March 2018 supplemental statement of the case. 38 C.F.R. § 20.1305(c). 1. Entitlement to service connection for asbestosis. The Veteran contends that he currently has asbestosis as a result of in-service exposure to asbestos. In this regard, he asserts that, while stationed aboard the U.S.S. Gearing, he worked in the laundry room and was exposed to asbestos while washing, drying, and pressing clothing. At the Board hearing, he indicated that the room was a very small, compact area where temperatures rose to approximately 120 degrees. Additionally, the Veteran reports that he was exposed to asbestos from the magazine of the twin five-inch gun mount where visible particles fell each time guns were fired. The AOJ acknowledged that the Veteran had minimal asbestos exposure as a ship serviceman (laundry). In regard to his post-service asbestos exposure, the Veteran testified that his occupational exposure to asbestos as a block operator for the railroad and pipefitter/welder was minimal in comparison to his in-service exposure. The Veteran underwent a VA examination in January 2018, at which time the examiner found that his currently diagnosed asbestosis was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. In this regard, she noted that that there is no indication of asbestosis in his service treatment records and his exposure to asbestos during military service was minimal. Conversely, the examiner found that the Veteran's post-service occupational history, which includes exposure to asbestos while working as a steamfitter in steel mills, refineries, chemical plants, foundries, schools, and hospitals, resulted in more significant and contributory for risk of asbestos-related disorders. The Veteran also submitted two opinions by his private treatment provider, Dr. H.S. in April 2015 and April 2018. Dr. H.S. opined that the Veteran's asbestosis at least as likely as not manifested due to exposure to asbestos on the U.S.S. Gearing and developed over the 30 year time span. As rationale, it was noted that the U.S.S. Gearing was built in 1944 and naval vessels built during this era were highly exposed to asbestos, which could be found almost anywhere on the vessel. However, the Board finds such opinions inadequate for the purposes of determining service connection. In this regard, the January 2018 VA examiner did not address the Veteran's contentions regarding the nature and reported significance of his in-service exposure to asbestos while working in the laundry room and when guns were fired, or his alleged minimal post-service occupational asbestos exposure. She also did not consider the multiple articles submitted by the Veteran in January 2015 addressing asbestos found in Naval ships and the prevalence of asbestos-related illness among Navy Veterans. Furthermore, in the April 2015 and April 2018 opinions, Dr. H.S. did not address the Veteran's post-service occupational exposure to asbestos, or provide a complete rationale for her opinion. Consequently, the Board finds a remand is necessary to obtain an addendum opinion that addresses such matters. 2. Entitlement to service connection for a disorder manifested by fatigue, claimed as secondary to asbestosis. 3. Entitlement to service connection for an acquired psychiatric disorder, to include anxiety and depression, claimed as secondary to asbestosis. The Veteran asserts that he has a disorder manifested by fatigue and an acquired psychiatric disorder, to include depression and anxiety, as secondary to his asbestosis. In this regard, the Board notes that the evidence does not show, and the Veteran does not contend, that such disorders had their onset during service, or are directly related to any aspect of his military service. Rather, he reports feeling tired, depressed, and anxious as a result of his asbestosis. Consequently, such claims are inextricably intertwined with the remanded claim of entitlement to service connection for asbestosis. See Parker v. Brown, 7 Vet. App. 116 (1994); Harris v. Derwinski, 1 Vet. App. 180 (1991) (issues are inextricably intertwined when a decision on one issue would have a significant impact on another issue). Therefore, consideration of such secondary service connection claims must be deferred pending the outcome of the claim for service connection for asbestosis. The matters are REMANDED for the following action: Return the record, and a copy of this remand, to the VA examiner who conducted the January 2018 respiratory examination. If she is not available, the record should be provided to an appropriate medical professional so as to render the requested opinion. Following a review of the record, the examiner should offer an opinion as to whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran's currently diagnosed asbestosis is related to his military service, to include his acknowledged exposure to asbestos while serving aboard the U.S.S. Gearing. In offering such opinion, the examiner should consider and discuss (1) the nature and significance of the Veteran's reported in-service exposure to asbestos while working in the laundry room and when guns were fired, and his contention that his post-service occupational exposure to asbestos as a block operator for the railroad and pipefitter/welder was minimal in comparison to that during his military service, (2) the April 2015 and April 2018 opinions from Dr. H.S. relating the Veteran's asbestosis to his in-service asbestos exposure as naval vessels built during the relevant area (1944) were highly exposed to asbestos, which could be found almost anywhere on the vessel, and (3) the articles submitted in January 2015, which indicate the high risk of asbestos-related illnesses among Navy Veterans. A rationale for any opinion offered should be provided. A. JAEGER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Waite 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.