Citation Nr: 21064960 Decision Date: 10/22/21 Archive Date: 10/22/21 DOCKET NO. 18-25 491 DATE: October 22, 2021 REMANDED Entitlement to service connection for a bilateral eye disability, to include as due to asbestos exposure is remanded. Entitlement to service connection for a bilateral lung disability, to include as due to asbestos exposure is remanded. Entitlement to service connection for a bilateral sinus disability, to include as due to asbestos exposure is remanded. Entitlement to service connection for skeletal arthritis of the entire joint system, to include as due to asbestos exposure is remanded. Entitlement to service connection for colon cancer, to include as due to asbestos exposure is remanded. Entitlement to service connection for hypertension, to include as due to asbestos exposure is remanded. Entitlement to service connection for a prostate disability, to include as due to asbestos exposure is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1971 to February 1973. This matter came before the Board of Veterans Appeals (Board) on appeal from a January 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veteran's Law Judge during a February 2020 hearing. The transcript of the hearing is of record. A June 2020 Board decision dismissed the issues of service connection for low back and bilateral knee, hip and foot disabilities as withdrawn at the hearing and remanded the remaining issues on appeal for further development. 1. Entitlement to service connection for a bilateral eye disability, to include as due to asbestos exposure The June 2020 Board remand asked for outstanding private treatment records to be obtained, specifically noting that private treatment had been reported at the hearing. At the February 2020 Board hearing, the Veteran reported that he began receiving treatment at the Southeast Texas Eye Association about 5 years after service. October 2008 VA treatment records noted a history of glaucoma and treatment with a private ophthalmologist. The Veteran then submitted private treatment records from the Southeast Texas Eye Association, however the submission only contained records dating from March 2019. As the record indicates that there may be outstanding private treatment records and there is no indication in the file that the records are unavailable, remand is required to allow VA to obtain authorization and request these records. 2. Entitlement to service connection for a bilateral lung disability, to include as due to asbestos exposure The June 2020 Board remand requested a VA respiratory examination to determine the nature and etiology of any current respiratory disability, to include whether it was due to conceded in-service asbestos exposure. A November 2020 VA examination did not diagnose a respiratory disability. The examiner stated that no diagnosis was warranted as the "Veteran does not have a respiratory condition. There is no evidence of asbestos exposure or previous diagnosis within the c-file." This statement indicates that the examiner did not presume asbestos exposure as directed and also suggests that the negative finding regarding asbestos was a factor in the lack of diagnosis. Remand for a new examination is therefore required in order to ensure that the conceded asbestos exposure is properly considered. The Board also notes that PFTs were not performed at the November 2020 examination due to COVID-19 restrictions. Upon remand, PFTs should be performed if not contraindicated due to current safety concerns. 3. Entitlement to service connection for a bilateral sinus disability, to include as due to asbestos exposure 4. Entitlement to service connection for skeletal arthritis of the entire joint system, to include as due to asbestos exposure 5. Entitlement to service connection for colon cancer, to include as due to asbestos exposure 6. Entitlement to service connection for hypertension, to include as due to asbestos exposure 7. Entitlement to service connection for a prostate disability, to include as due to asbestos exposure The June 2020 Board remand conceded asbestos exposure in service and requested VA examinations regarding the nature and etiology of the Veteran's sinus, skeletal arthritis, colon cancer, hypertension, and prostate disabilities. The remand directives specifically asked the examiner to address whether the disabilities were caused by the Veteran's conceded in-service asbestos exposure and to provide a detailed rationale for all opinions. VA examinations for the Veteran's sinus, skeletal arthritis, colon cancer, hypertension, and prostate disabilities were provided in November 2020. The examiner found that each of the diagnosed disabilities was not due to service, noting that the file did not show claims of the disabilities during service, and also found that the disabilities were not due to asbestos exposure. However, each of the opinions lacked a rationale for the finding regarding asbestos and are therefore inadequate. A medical examination report must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. See Nieves- Rodriguez v. Peake, 22 Vet. App. 295 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). As the opinions regarding asbestos exposure were inadequate, remand for new VA opinions is required. The matters are REMANDED for the following action: 1. Ask the Veteran to complete a VA Form 21-4142 for Eye Centers of Southeast Texas. Make two requests for the authorized records unless it is clear after the first request that a second request would be futile. 2. Schedule the Veteran for an appropriate VA examination, to determine the etiology of any current bilateral lung, bilateral sinus, skeletal arthritis of the entire joint system, colon cancer, hypertension, and prostate disabilities. The examiner should review the file and provide a complete rationale for all opinions expressed. For any current bilateral lung, bilateral sinus, skeletal arthritis of the entire joint system, colon cancer, hypertension and prostate disability found to be diagnosed, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that any such disability is related to the Veteran's active service, to include whether it is due to the conceded in service asbestos exposure. For the purposes of the nexus opinion, the examiner should assume that the Veteran was exposed to asbestos in service. In providing the opinion, the examiner should consider and discuss any lay statements of record, to include the Veteran's statements regarding the onset and persistence of his symptoms. If the examiner finds that such statements do not support a finding of nexus, the basis for the finding should be clearly explained. 3. If upon completion of the above action the appeal remains denied, the case should be returned to the Board after compliance with appellate procedures. E. I. VELEZ Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Arnold 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.