Citation Nr: 21066973 Decision Date: 11/03/21 Archive Date: 11/03/21 DOCKET NO. 17-25 743 DATE: November 3, 2021 ORDER The appeal as to the claim of entitlement to service connection for bronchitis is moot, and the claim is dismissed for lack of jurisdiction. The claim of entitlement to service connection for sinusitis, to include as due to an undiagnosed illness or medically unexplained chronic multi-symptom illness (MUCMI) or due to exposure to particulate matter as a result of Persian Gulf War Service, is granted. The claim of entitlement to service connection for complete loss of sense of smell, to include as due to a chronic undiagnosed illness, or MUCMI, or due to exposure to particulate matter as a result of Persian Gulf War Service, and to include as secondary to a service-connected disability, is granted. The claim of entitlement to service connection for periodontal disease (also claimed as paradentosis and gingivitis), to include as due to an undiagnosed illness, or MUCMI, or due to exposure to particulate matter as a result of Persian Gulf War Service, is denied. REMANDED The claim of entitlement to service connection for allergic bronchopulmonary aspergillosis (ABPA), to include as due to an undiagnosed illness, or MUCMI, or due to exposure to particulate matter as a result of Persian Gulf War Service, is remanded. The claim of entitlement to service connection for asthma to include as due to undiagnosed illness, or MUCMI, or exposure to particulate matter as a result of Persian Gulf War Service, is remanded. FINDINGS OF FACT 1. The Veteran's claim of entitlement to service connection for bronchitis was granted in a rating decision issued by the Agency of Original Jurisdiction (AOJ) in June 2021, with an effective date of August 27, 2014. 2. The Veteran is presumed exposed to fine, particulate matter during service in Southwest Asia during the Persian Gulf War. 3. The Veteran's sinusitis became manifest to a degree within 10 years from the date of separation from service that included the period of service in Southwest Asia. 4. The Veteran's loss of smell has been attributed to service-connected sinusitis, and there is no competent evidence that it is a disorder due to an undiagnosed illness, a MUCMI, or due to exposure to particulate matter. 5. The Veteran's claimed periodontal disease did not manifest during, or as a result of, active military service, and it is not due to an undiagnosed illness, a MUCMI, or exposure to particulate matter. CONCLUSIONS OF LAW 1. The Board lacks jurisdiction over the claim of service connection for bronchitis because that claim has been granted and rendered moot. 38 U.S.C. §§ 7104 (a), 7105; 38 C.F.R. §§ 19.7, 19.55, 20.101, 20.200, 20.202, 20.204. 2. The criteria to establish service connection for sinusitis on a presumptive basis due to exposure to particulate matter have been met. 38 U.S.C. §§ 1110, 5107; §§ 3.102, 3.303, 3.317, 86 Fed. Reg. 42724 (August 5, 2021), to be codified at 38 C.F.R. § 3.320. 3. The criteria to establish service connection for complete loss of sense of smell, to include as secondary to service-connected disabilities have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.159, 3.303, 3.310. 4. The criteria to establish service connection for periodontal disease, to include as due to an undiagnosed illness, a MUCMI, or due to exposure to particulate matter as a result of service in Southwest Asia have not been met. 38 U.S.C. §§ 1101, 1110, 1131, 5107; 38 C.F.R.§§ 3.102, 3.303, 3.304, 3.317. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran had honorable active-duty service with the United States Army from July 1974 to November 1991. The Board acknowledges the lengthy service of the Veteran. Among other commendations, the Veteran was awarded a Combat Infantry Badge, a Southwest Asia Service Medal with 3 Bronze Service Stars, and a Kuwait Liberation Medal. The Veteran had service in Southwest Asia (Saudi Arabia) from January 1991 to May 1991. These matters are before the Board of Veterans' Appeals (Board) from an April 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) that denied service connection for bronchitis, loss of sense of smell, sinusitis, ABPA, asthma, and periodontal disease. The Veteran was scheduled for a Board hearing in December 2019. However, the hearing worksheet shows the scheduled hearing was cancelled. As the record does not contain any additional requests for a Board hearing from the Veteran or his representative, the Board deems the Veteran's request for a hearing to be withdrawn and is proceeding with adjudication. See 38 C.F.R. § 20.702. The Veteran's claims were remanded by the Board in April 2020 for addendum opinions that considered the Veteran's service treatment records. The requested action has been undertaken. Accordingly, there has been substantial compliance with the prior remand instructions. See D'Aries v. Peake, 22 Vet. App. 97 (2008) (holding that only substantial, and not strict, compliance with the terms of a Board remand is required pursuant to Stegall v. West, 11 Vet. App. 268 (1998)). Appeal as to the claim of entitlement to service connection for bronchitis In this case, the Veteran's claim of service connection for bronchitis was granted in a rating decision issued by the AOJ in June 2021. As a general matter, the grant of a claim of service connection constitutes an award of full benefits sought on an appeal of the denial of a service connection claim. Seri v. Nicholson, 21 Vet. App. 441, 447 (2007); see also Grantham v. Brown, 114 F.3d 1156 (Fed. Cir. 1997) (where an appealed claim for service connection is granted during the pendency of the appeal, a second Notice of Disagreement must thereafter be timely filed to initiate appellate review of "downstream" issues such as the compensation level assigned for the disability or the effective date of service connection). The Board may dismiss any appeal which fails to allege specific error of fact or law in the determination being appealed. 38 U.S.C. §§ 7105; 38 C.F.R. §§ 20.202. Here, as a result of the AOJ's action, there no longer remains a case or controversy with respect to this claim. Therefore, the Board lacks jurisdiction over this issue because it has been granted and rendered moot on appeal. 38 U.S.C. §§ 7104, 7105; 38 C.F.R. §§ 19.7, 19.55, 20.101, 20.200, 20.202. Therefore, dismissal of this claim is warranted. Service Connection Generally, to establish service connection there must be competent evidence showing: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the in-service injury incurred or aggravated during service. 38 U.S.C. § 1110, 1131; 38 C.F.R. § 3.303. To establish secondary service connection the VA must find 1) that there is a current disability that is not service connected; and 2) that there is at least one service- connected disability; and 3) evidence that the non-service-connected disability is either, a) proximately due to or the result of a service-connected disability; or b) aggravated beyond its natural progress by a service-connected disability. 38 C.F.R. § 3.310; see also Allen v. Brown, 7 Vet. App. 439 (1995). When service connection is thus established for a secondary condition, the secondary condition shall be considered a part of the original condition. 38 C.F.R. § 3.310 (a). Service connection may also be established for a chronic disability resulting from an undiagnosed illness which manifests either during active service in the Southwest Asia Theater of operations during the Persian Gulf War or to a degree of 10 percent or more not later than December 31, 2026. 38 U.S.C. § 1117; 38 C.F.R. § 3.317; 86 Fed. Reg. 51,001 (September 14, 2021). The term "Persian Gulf Veteran" means a veteran who served on active military, naval, or air service in the Southwest Asia Theater of operations during the Persian Gulf War. 38 C.F.R. § 3.317 (d)(1). The Southwest Asia Theater of operations includes Iraq, Kuwait, Saudi Arabia, the neutral zone between Iraq and Saudi Arabia, Bahrain, Qatar, the United Arab Emirates, Oman, the Gulf of Aden, the Gulf of Oman, the Persian Gulf, the Arabian Sea, the Red Sea, and the airspace above these locations. 38 C.F.R. § 3.317 (d)(2). A 'qualifying chronic disability' means a chronic disability resulting from any of the following (or any combination of any of the following): an undiagnosed illness; a medically unexplained chronic multi-symptom illness (MUCMI) (such as chronic fatigue syndrome, fibromyalgia, and irritable bowel syndrome) that is defined by a cluster of signs or symptoms; and any diagnosed illness that the Secretary determines. 38 U.S.C. § 1117; 38 C.F.R. § 3.317 (a)(1)(i). Objective indications of a chronic disability include both "signs," in the medical sense of objective evidence perceptible to an examining physician, and other, non-medical indicators that are capable of independent verification. Disabilities that have existed for six months or more and disabilities that exhibit intermittent episodes of improvement and worsening over a six-month period will be considered chronic. The six-month period of chronicity will be measured from the earliest date on which the pertinent evidence establishes that the signs or symptoms of the disability first became manifest. A chronic disability resulting from an undiagnosed illness shall be rated using evaluation criteria from the VA's Schedule for Rating Disabilities for a disease or injury in which the functions affected, anatomical localization, or symptomatology are similar. 38 C.F.R. § 3.317 (a) (2-5). Compensation shall not be paid if: (1) there is affirmative evidence that an undiagnosed illness was not incurred during active military, naval, or air service in the Southwest Asia theater of operations during the Persian Gulf War; (2) if there is affirmative evidence that an undiagnosed illness was caused by a supervening condition or event that occurred between the Veteran's most recent departure from active duty in the Southwest Asia Theater of operations during the Persian Gulf War and the onset of the illness; or (3) if there is affirmative evidence that the illness is the result of the Veteran's own willful misconduct or the abuse of alcohol or drugs. See 38 C.F.R. § 3.317 (c). Additionally, effective August 5, 2021, VA added 38 C.F.R. § 3.320 which, in relevant part, allows for a presumption of exposure to fine, particulate matter if a disease listed in paragraph (a)(2) becomes manifest to any degree (including non-compensable) within 10 years from the date of separation from service, that includes a qualifying period of service as defined in 38 C.F.R. § 3.320 (a)(4). The chronic diseases associated with exposure to particulate matter are: (i) Asthma, (ii) Rhinitis, (iii) Sinusitis, to include rhinosinusitis. 86 Fed. Reg. 42724 (August 5, 2021), to be codified at 38 C.F.R. § 3.320. The presumption of exposure includes a Veteran who has a qualifying period of service as defined as any period of active military, naval, or air service in the Southwest Asia Theater of operations, as defined in § 3.317(e)(2), during the Persian Gulf War as defined in § 3.2(i). VA must consider all favorable lay evidence of record. 38 U.S.C. § 5107. Lay testimony is competent to establish the presence of observable symptomatology, where the determination is not medical in nature and is capable of lay observation. Barr v. Nicholson, 21. Vet. App. 303 (2007). The Secretary shall consider all information and lay and medical evidence of record in a case and make appropriate determinations as to competence, credibility, and weight. 38 U.S.C. § 5107; 38 C.F.R. § 3.303; Washington v. Nicholson, 19 Vet. App. 362, 368 (2005). Competent lay evidence means any evidence not requiring that the proponent have specialized education, training, or experience, if it is provided by a person who has knowledge of facts or circumstances and conveys matters that can be observed and described by a lay person. 38 C.F.R. § 3.159. Although the Board has an obligation to provide reasons and bases supporting this decision, there is no need to discuss, in detail, the extensive evidence of record. Indeed, the Federal Circuit has held that the Board must review the entire record but does not have to discuss each piece of evidence. Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000). Therefore, the Board will summarize the relevant evidence where appropriate, and the Board's analysis below will focus specifically on what the evidence shows, or fails to show, as to the claim on appeal. When there is an approximate balance between positive and negative evidence, equipoise, the benefit of the doubt doctrine must apply in favor of the Veteran. But when the preponderance of the evidence weighs against the claims of the Veteran the claim will be denied on its merits, and when the preponderance of the evidence weighs for the claims of the Veteran the claim will be granted on its merits. In those cases, the benefit of the doubt doctrine is inapplicable. 38 U.S.C. § 5107; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Entitlement to service connection for sinusitis, to include as due to an undiagnosed illness, or a MUCMI or due to exposure to particulate matter as a result of Persian Gulf War Service The Veteran contends that he is entitled to service connection for sinusitis due to an undiagnosed illness, and/or MUCMI, and/or due to exposure to particulate matter during his Persian Gulf War Service. Specifically, the Veteran contends that his sinusitis was due to his exposure to particulate matter during his service in Southwest Asia. The Veteran has a current sinusitis diagnosis. The available service treatment records are negative for treatment or complaints involving the sinuses. The Veteran received a VA examination for his sinusitis in December 2015 which noted the Veteran's diagnosis of chronic sinusitis in 2006. The examiner found the onset was in 2005, and the Veteran had chronic sinus infections requiring several sinus surgeries. The examiner noted the Veteran's chronic sinusitis with pain and tenderness, with purulent discharge or crusting. The Veteran reported pain and tenderness over the frontal and maxillary sinuses. The March 2016 addendum opinion found the Veteran had sinus issues and infections since the early 2000's with severe chronic infections in 1 year. The examiner found that the Veteran had a clear diagnosis of allergic sinus issues that resulted in chronic infectious issues and required sinus surgery. The examiner concluded there was no undiagnosed condition or multi-symptom illness undiagnosed or diagnosed that would be due to a specific exposure event during service in Southwest Asia. The Veteran received a VA medical opinion in October 2020 that found the Veteran's chronic sinusitis as a disease with a clear and specific etiology, typically caused by a virus, bacteria, or deviated septum. The examiner noted the Veteran was diagnosed with chronic sinusitis with an onset date of January 1995. The examiner found there was no evidence of medical records to suggest that sinusitis was caused by a specific exposure event and based on the medical records review found the Veteran's sinusitis was not related to the Veteran's service in Southwest Asia. The examiner also noted the Veteran's records indicated no chronic sinusitis during service and therefore his sinusitis was less likely than not incurred in or caused by service. The Veteran's private records include an October 1996 diagnosis of bilateral maxillary sinusitis and reflect continued treatment of sinus issues in 2006, 2008, 2011, and 2014. The Veteran's records also noted a diagnosis of chronic pan-sinusitis in June 2006 with a slowly progressing nasal respiration impairment bilaterally for years. In 2011 the Veteran was found to have a complete obstruction of his right frontal sinus and partial obstruction of his left frontal sinus, complete obstruction of sphenoidal sinus, with partial obstruction of the remaining paranasal sinuses. The Board finds that the Veteran has met the presumption of exposure to particulate matter for his service connection claim of sinusitis. The Veteran was in the Southwest Asia theater of operations in 1991. He received a diagnosis of bilateral maxillary sinusitis in October 1996. A qualifying disease will not be presumed service-connected if there is affirmative evidence that (1) the disease was not incurred during or aggravated by a qualifying period of service; or (2) the disease was caused by a supervening condition or event that occurred between the veteran's most recent departure from a qualifying period of service and the onset of the disease; or (3) the disease is the result of the veteran's own willful misconduct. Willful misconduct means an act involving conscious wrongdoing or known prohibited action. It involves deliberate or intentional wrongdoing with knowledge of, or wanton and reckless disregard of its probable consequences. 38 C.F.R. § 3.1 (n)(1). There is no affirmative evidence that the disease was not incurred in service. The Board finds the VA medical opinions to be inadequate. As the medical opinions occurred before the effective date of the new Section 3.320, the examiners were unable to consider the Veteran's presumed exposure to particulate matter and therefore are not probative. There is also no evidence that the disease was caused by a supervening condition or event or is the result of the Veteran's willful misconduct. As the Veteran's sinusitis manifested to a degree within 10 years of his qualifying period of service in Southwest Asia during the Persian Gulf War, and he is presumed to have been exposed to particulate matter based on his service in Southwest Asia during the Persian Gulf War, service connection for sinusitis is granted. Entitlement to service connection for complete loss of sense of smell, to include as due to a chronic undiagnosed illness, a MUCMI, exposure to particulate matter, or a service-connected disability The Veteran contends that his loss of sense of smell is due to a chronic undiagnosed illness, or MUCMI, or due to exposure to particulate matter during his Service in Southwest Asia. He also contends that his loss of sense of smell is secondary to a service-connected disability. Specifically, the Veteran contends that his loss of sense of smell is due to the now service-connected sinusitis and/or his ABPA. The Veteran has a diagnosed loss of sense of smell and has met the first element of secondary service connection. The available service treatment records are negative for treatment or complaints of loss of smell. The Veteran received a December 2015 VA examination for loss of sense of smell. He noted the Veteran's reported history of diminished smell starting in 1990 and current inability to smell. He diagnosed complete loss of sense of smell. He opined that the loss of sense of smell was "at least as likely as not" due to the Veteran's chronic sinus infection and respiratory infections. In a March 2016 addendum, another examiner opined that the loss of smell was the result of the Veteran's chronic sinus issues. He again noted the Veteran's long history of sinus problems. In addition, he noted that sinusitis symptoms include nasal blockage and congestion, nasal drainage, facial pain or pressure, and loss of sense of small. The March 2016 VA clinician found the loss of smell to not be an undiagnosed condition or MUCMI and found the loss was not due to a specific exposure event experienced by the Veteran during service in Southwest Asia. He noted that this condition has a clear and distinct anatomy and pathophysiological etiologies. He explained that loss of sense of smell can result from a physical blockage of the nose or from damage to the olfactory cleft or nerve, and that sinusitis is a common obstructive cause. In the April 2020 decision, the Board found the December 2015 VA examination and March 2016 addendum opinion to be inadequate because the Veteran's service treatment records were not made part of the record until after the VA examination. Accordingly, the AOJ obtained an October 2020 opinion which found the Veteran's loss of smell did not develop in service as there was no documentation of loss of smell in the Veteran's service treatment records. The examiner also found that the loss of sense of smell was a diagnosis with a clear and specific etiology with the Veteran's chronic sinusitis contributing to nasal obstructions causing an increase in the loss of smell and not due to hazardous material exposure in Southwest Asia. The examiner found there was no evidence showing loss of smell as a result of ABPA with no evidence of medical literature suggesting ABPA caused permanent or chronic loss of smell. Similarly, a January 2021 examiner found that chronic sinusitis can contribute to nasal obstruction causing increased loss of smell. He opined that the Veteran's loss of smell disorder "is at least as likely as not" caused by his sinus disability. The Board gives the October 2020 and January 2021 opinions great probative value because it was based on a complete review of the record, to include available service treatment records, and contains a rationale. The Board acknowledges that the December 2015 VA examination and March 2016 addendum opinion with respect to direct service connection are inadequate. However, the fact that service treatment records were not available for review by those examiners does not render their secondary service connection opinion inadequate. Moreover, the March 2016 clinician provided a detailed rationale. Thus, the Board gives the December 2015 VA examination and March 2016 opinion probative value with respect to secondary service connection. The record shows that the Veteran's loss of smell was considered by the VA examiners to be a symptom of sinusitis. The evidence shows that the Veteran's loss of smell does not qualify as a chronic disability or undiagnosed illness; rather, it represents a symptom associated with sinusitis. The Veteran was first diagnosed with sinusitis after separation, and there is no evidence that he had sinusitis during service. Thus, the Board finds that the Veteran's claim of entitlement to service connection for loss of smell is neither related to active service nor is it due to an undiagnosed illness, MUCMI, or particulate matter due to service in the Persian Gulf. The preponderance of the evidence is in favor of finding that the Veteran's loss of sense of smell is due to his service-connected sinusitis. The Veteran's claim for service connection for complete loss of sense of smell is granted. Entitlement to service connection for periodontal disease, to include as due to an undiagnosed illness, or MUCMI, or due to exposure to particulate matter as a result of Persian Gulf War Service The Veteran has a current diagnosis of periodontal disease and has met the first element of service connection. The Veteran's service treatment records contained no complaints, treatment, or diagnosis of periodontal disease. The Veteran received dental treatment in service but was never diagnosed nor treated for periodontal disease. The Veteran received a VA examination in January 2016 that noted the diagnosis of periodontal disease with normal x-rays. A March 2016 addendum opinion noted that the Veteran's service treatment records were silent for any periodontal disease. The examiner found the Veteran's claimed disabilities of periodontal disease and gingivitis were diseases with a clear and specific etiology and diagnosis, the etiology being plaque. The examiner noted that there were certain risk factors that exacerbated the progression of periodontal disease and gingivitis, the two most common were noted as smoking and diabetes. The examiner documented the Veteran's history of smoking for many years. The examiner found that the Veteran's periodontal disease was not incurred in or caused by a specific exposure event experienced during his Southwest Asia service and that his smoking most likely contributed to the exacerbation of his periodontal disease. In the April 2020 decision, the Board found the December 2015 VA examination and March 2016 medical opinion to be inadequate as the Veteran's service treatment records were not of record. Thus, the AOJ obtained another medical opinion in March 2021. The examiner noted the January 2016 VA examination and March 2016 addendum opinion. The examiner found that periodontitis and gingivitis were diseases with clear and specific etiology and diagnoses, with the etiology being plaque. The examiner reported that once a diagnosis of periodontal disease was established it was never removed, never completely treated to be able to remove the diagnosis, and the condition required regular monitoring to prevent progression of the disease. The examiner found the Veteran's periodontitis was less likely incurred in or caused by a specific exposure event experienced during service in Southwest Asia. The Veteran's periodontal disease was diagnosed in 2016, noted as more than 25 years following separation from the military. The examiner concluded the Veteran had periodontal disease and it would not resolve while teeth existed in his mouth. The examiner found the periodontal disease was a diagnosable chronic disease with an etiology most likely associated with the Veteran's long history of smoking and not with events, treatment, or diagnosis during service and not likely incurred in or caused by service. The Board finds the Veteran's periodontal disease does not support a diagnosis of undiagnosed illness, a MUCMI, or a diagnosable chronic multi-symptom illness with a partially explained etiology. According to the March 2021 opinion the Veteran's symptoms are explained by a diagnosis of periodontal disease. The Veteran's service treatment records are devoid of any clear symptoms that are related to Gulf War Syndrome or chronic symptomatology during the Veteran's active service. In addition, the fact that the earliest post-service documentation of periodontal disease is dated more than two decades after the Veteran was discharged from service weights against a finding that this condition is directly related to service. See Maxson v. West, 12 Vet. App. 453, 459 of (1999), aff'd sub nom. Maxson v. Gober, 230 F.3d 1330, 1333 (Fed. Cir. 2000). Due to this lack of diagnosis in service, the lack of chronic symptomatology, and the VA examination above, the evidence suggests that the Veteran's symptoms did not manifest during, or as a result of active military service, to include his service in Southwest Asia. In addition, there is no medical evidence of record that any periodontal disease experienced by the Veteran is due to an undiagnosed illness or exposures from service in Southwest Asia. Rather, the evidence of record has related the Veteran's symptomatology to a known and diagnosed condition. Also, the Veteran is not entitled to service connection for a MUCMI. Under the proper interpretation of the law, an illness or disease is a MUCMI where either the etiology or pathophysiology of the illness is inconclusive. Conversely, a condition is not a MUCMI where both the etiology and the pathophysiology of the illness are partially understood. In the present case, the Veteran's periodontal disease has an etiology that is at least "partially understood," and as such, the Veteran's condition cannot be classified as a MUCMI. See 38 C.F.R. § 3.317 (a)(2)(ii). While the Veteran believes that his periodontal disease is related to service in the Persian Gulf War, as a lay person, the Veteran has not shown that he has specialized training sufficient to render such an opinion with regard to this condition. See Jandreau v. Nicholson, 492 F.3d 1372, 1376-77 (Fed. Cir. 2007) (noting general competence to testify as to symptoms but not to provide medical diagnosis). In this regard, the diagnosis or etiology of his claimed disability is a matter that is not capable of lay observation and requires medical expertise to determine. Accordingly, his opinion as to the diagnosis or etiology of his claimed disability is not competent or probative evidence. The Board finds the March 2021 opinion to be significantly more probative than the Veteran's lay assertions, as it is thorough in its review of the medical evidence of record and stated rationale. The evidence before the Board here indicates that the Veteran's claim must be denied as the preponderance of the evidence is against the claim, and the benefit of the doubt doctrine is inapplicable. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Therefore, the Veteran's claim for service connection for periodontal disease to include as due to an undiagnosed illness or MUCMI or due to exposure to particulate matter as a result of Southwest Asia service is not warranted. REASONS FOR REMAND Entitlement to service connection for ABPA, to include as due to an undiagnosed illness or MUCMI or due to exposure to particulate matter as a result of Persian Gulf War Service Entitlement to service connection for asthma to include as due to undiagnosed illness or MUCMI or exposure to particulate matter as a result of Persian Gulf War Service is remanded. The Veteran contends that he is entitled to service connection for ABPA and for asthma to include as due to undiagnosed illness, a MUCMI, or due to exposure to particulate matter as a result of his service in Southwest Asia. The December 2015 and March 2016 VA examiners found the Veteran had a history of ABPA and asthma diagnoses that had resolved, and ultimately found the two diagnoses to not qualify as undiagnosed conditions, nor MUCMI, and not due to specific exposure events from the Veteran's Southwest Asia service. The Veteran received a medical opinion in January 2021 for both conditions. The examiner noted the 2015 VA examination reported no objective evidence of a diagnosis of asthma, but found an active diagnosis of asthma in December 2008. Additionally, the examiner noted the Veteran's ABPA diagnosis in December 2008, but determined it had resolved by December 2015. As such these disabilities were found not to be incurred in service. The Board finds the VA examinations and medical opinions to be inadequate. A current disability diagnosed at any point within the appeal period, even if the disability resolves during the appeal period (becomes asymptomatic) may be subject to service connection. See McClain v. Nicholson, 21 Vet. App. 219 (2007). A remand is necessary for an addendum addressing whether the Veteran has had a diagnosis of asthma or ABPA at any time during the appeal period and, if so, whether such is related to his service, or due to an undiagnosed illness, a MUCMI, or exposure to particulate matter under the new 38 C.F.R. § 3.320. This matter is REMANDED for the following actions: 1.Forward the claims file to an appropriate VA examiner to obtain an addendum opinion on the nature and etiology of asthma and ABPA that the Veteran may have and during the period on appeal. After reviewing the claims file, the examiner should respond to the following: (a.) Is it at least as likely as not (i.e., a 50 percent probability or greater) that any diagnosed asthma and/or ABPA experienced by the Veteran since August 2014 (1) began during his period of active service, or (2) is related to an injury or disease during active service, including his presumptive exposure to particulate matter in Southwest Asia? (b.) Is it at least as likely as not (50 percent probability or greater) that any diagnosed asthma or ABPA experienced by the Veteran since August 2014 is due to (i) a diagnosable but medically unexplained chronic multi-symptom illness (MUCMI), (ii) an undiagnosed illness, (iii) a diagnosable chronic multisymptom illness with a partially explained etiology; or (iv) a disease with a clear and specific etiology and diagnosis. If the examiner determines that any diagnosed asthma or ABPA experienced by the Veteran since August 2014 is either a diagnosable chronic multi symptom illness with a partially explained etiology or a disease with a clear and specific etiology and diagnosis, then the examiner should opine whether it is at least as likely as not (50 percent probability or greater) that this condition was incurred in or caused by active duty service. A complete rationale must be provided for any and all opinions offered. If an opinion sought cannot be provided without resort to mere speculation, please state whether the need to speculate is caused by a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), or by a deficiency in the record (additional facts are required) or the examiner (the examiner does not have the requisite knowledge or training). 2. Following completion of the foregoing, the Agency of Original Jurisdiction (AOJ) should review the record, perform any necessary development, and readjudicate the claim on appeal. If the appeal is denied, the AOJ should issue an appropriate Supplemental Statement of the Case (SSOC), afford the Veteran and his representative an opportunity to respond, and return the case to the Board. REBECCA N. POULSON Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C.A. Teich, Associate 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.