Citation Nr: 21067801 Decision Date: 11/05/21 Archive Date: 11/05/21 DOCKET NO. 18-47 641 DATE: November 5, 2021 REMANDED Service connection for a lung disability claimed as a result of asbestos exposure is remanded. Service connection for a right knee disability is remanded. Service connection for a left knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1966 to December 1969. This matter comes to the Board of Veterans' Appeals (Board) on appeal from an August 2016 rating decision by a Regional Office (RO) of the Department of Veterans Affairs (VA). The Veteran, and M.W., testified before the undersigned Veterans Law Judge at a hearing held in September 2020. A transcript is of record. Although the Veteran's October 2018 substantive appeal only listed his lung disability as an issue for appeal, the Veteran rendered testimony regarding his knees at the Board hearing. Consequently, the Board has taken jurisdiction over the issues. Service connection for a lung disability claimed as a result of asbestos exposure is remanded. The Veteran asserts he has a lung disability due to asbestos exposure during military service. The RO has indicated that his military occupational specialty of boatswain mate is noted to have had a minimal probability for asbestos exposure. At his September 2020 Board hearing, the Veteran testified that based on his MOS in the Navy, there is a high probability that he was exposed to asbestos during service. He submitted medical records dated February 2019 which reflect a diagnosis of pneumoconiosis due to asbestos and other mineral fibers. The Veteran underwent a VA examination in July 2016. The examiner opined that the Veteran did not have a diagnosis of asbestosis, and that there was no evidence of pleural plaques or diffuse pleural thickening on a November 2015 CT scan. In a February 2019 record, Dr. Vaitkus wrote that a CAT scan in 2017 showed scars, calcified nodule, and ground glass consistent with asbestos from the Navy. The RO should obtain a VA addendum opinion that addresses the February 2019 private opinion as well treatment records that post-date the July 2016 VA opinion. Additionally, the Veteran testified that he receives treatment from Dr. Vaitkus, who is affiliated with Southwestern General Hospital and Ohio Chest Physicians, on a yearly basis. The RO should obtain updated records from him. Service connection for right and left knee disabilities is remanded. At his September 2020 Board hearing, the Veteran testified that during service (sometime in 1969) he fell down some stairs and hurt his knees. He stated that he reported to sick bay for a day, and that he has had continuous symptoms since that time (that he self-treated with creams and bandages). He stated that he did not seek post-service treatment until 2014 or 2015. He has submitted these treatment records from the Cleveland Clinic. The Veteran submitted a Disability Benefits Questionnaire from his private physician reflecting knee joint osteoarthritis. However, the Questionnaire did not include a nexus opinion. The Board cannot make a fully-informed decision on the issue of service connection because no VA examiner has opined whether the Veteran's knee disabilities are due to service. The RO should obtain an opinion addressing the matter of causal nexus. Given the Veteran's report of negative experiences with the VA (see Board hearing testimony), the RO should schedule an in-person examination only if necessary for the rendering of the opinion. The matters are REMANDED for the following action: 1. Obtain updated records from Dr. Vaitkus, who is affiliated with Southwestern General Hospital and Ohio Chest Physicians. 2. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's respiratory disability is at least as likely as not related to service, including exposure to asbestos. The examiner should review the relevant evidence in the file and provide a rationale to support the opinion(s). In providing the requested opinion and rationale, consider the Veteran's description of his symptoms and answer the following: do the Veteran's reports about his symptoms align with how the currently diagnosed disability is known to develop, or are the Veteran's reports generally inconsistent with medical knowledge or implausible? The examiner is advised that the Veteran's MOS of boatswain mate is noted to have had at least a minimal probability of asbestos exposure. The examiner should also consider the February 2019 opinion from Dr. Vaitkus who indicated a CAT scan in 2017 showed scars, calcified nodule, and ground glass consistent with asbestos from the Navy. The examiner is asked to reconcile, if possible, this clinical finding with the November 2015 CT scan. 3. Obtain an opinion from an appropriate clinician regarding whether the Veteran's knee disabilities are at least as likely as not related to service, to include a fall sustained during service. Schedule an in-person examination only if needed to render the appropriate opinion. The examiner must review the claims file. If a diagnosis cannot be provided but the Veteran's condition manifests in symptoms that cause functional impairment, then the examiner should consider them a "disability" for the purpose of providing the requested opinion(s) below. Provide a rationale to support the opinion(s). D. JOHNSON Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Prem, 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.