Citation Nr: 21067912 Decision Date: 11/08/21 Archive Date: 11/08/21 DOCKET NO. 18-33 251 DATE: November 8, 2021 REMANDED Entitlement to service connection for chronic obstructive pulmonary disease (COPD), claimed as secondary to service-connected ischemic heart disease, is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1969 to February 1971. A virtual hearing was held before the undersigned Veterans Law Judge in November 2021. Entitlement to service connection for COPD, claimed as secondary to service-connected ischemic heart disease, is remanded. At the November 2021 Board hearing, the Veteran clarified he was seeking service connection for COPD on a secondary basis, only, and did not contend his COPD was directly related to his military service. Specifically, the Veteran contended service connection for COPD was warranted because it was caused or aggravated by his service-connected ischemic heart disease. As part of his testimony, the Veteran noted that after he experienced a heart attack in 2011, he started having breathing problems, for which he has been given a CPAP machine and oxygen. In October 2017, the Veteran was provided a VA examination wherein COPD was diagnosed with an unknown date of diagnosis. The Veteran reported experiencing shortness of breath since his heart attack in 2011. After examining the Veteran and reviewing the claims file, the examiner opined the Veteran's coronary artery disease was less likely to cause obstructive lung disease. The examiner explained that a person could have shortness of breath from either a heart or lung condition, but it did not mean that the heart condition had caused the Veteran's COPD. The examiner noted the Veteran had a history of smoking for over 15 years, quitting in 2011 when he had the heart attack. Therefore, the examiner concluded the COPD was likely secondary to the Veteran's history of smoking. See October 2017 VA examination. While the VA examiner addressed the causation aspect of the Veteran's secondary service connection claim, the examiner failed to address whether the Veteran's ischemic heart disease aggravated his diagnosed COPD. Therefore, a remand is required to obtain an adequate medical opinion to address the Veteran's secondary service connection claim. See El-Amin v. Shinseki, 26 Vet. App. 136, 140 (2013). Lastly, the Veteran is reminded that although VA has an obligation to provide an adequate examination and opinion, he can also submit a medical opinion in support of his claim. In this regard, it is noted that at the hearing and in his VA Form 9, substantive appeal, the Veteran reported that his former treating physician, Dr. J.F., had opined that his COPD was related to his ischemic heart disease. Although the Veteran states Dr. J.F. is now retired and unable to provide a medical statement, the Veteran indicated he would discuss the matter with his current treating physician. See November 2021 Hearing transcript. (Continued on the next page) The matter is REMANDED for the following action: Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's COPD is aggravated beyond its natural progression by his service-connected ischemic heart disease (coronary artery disesase). A. ISHIZAWAR Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. Churchwell, 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.