Citation Nr: 21068031 Decision Date: 11/08/21 Archive Date: 11/08/21 DOCKET NO. 18-03 064 DATE: November 8, 2021 REMANDED Entitlement to service connection for a lung disability, to include as due to asbestos exposure, is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1971 to November 1972. This matter came before the Board of Veterans Appeals (Board) on appeal from a February 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). November 2018, September 2020 and March 2021 Board decisions remanded the issue on appeal for further development. Entitlement to service connection for a lung disability, to include as due to asbestos exposure The March 2021 Board remand asked for a new VA pulmonary examination. A VA pulmonary examination was conducted in August 2021 and the examiner concluded that the claimed condition was less likely than not incurred in or caused by the claimed in-service injury, event or illness because there was no diagnosis of asbestosis or any other lung condition. In reaching his conclusion, the examiner stated that "throughout all medical records other than Dr. Gaziano's statement, there was no diagnosis of asbestosis or any other lung condition." This statement is inaccurate, however, as the evidence of record shows that the Veteran was diagnosed with chronic obstructive pulmonary disease (COPD). See VA examination dated September 2019. A medical examination, as this one, that is based on an inaccurate factual premise is inadequate. See Reonal v. Brown, 5 Vet. App. 458, 461 (1993). A new examination and opinionbased on full review of the record and supported by stated rationaleis needed to fairly resolve the issue on appeal. See 38 U.S.C. § 5103A (2012); 38 C.F.R. § 3.159 (2018). Moreover, the August 2021 VA examiner stated that the Veteran did not have, and was never diagnosed with, a respiratory condition but noted that the Veteran's respiratory condition required the use of an inhaler. This implies that the Veteran does indeed have some form of a respiratory disability and thus makes the findings of no disability, inconsistent with the evidence. Therefore, the August 2021 VA examination is inadequate. Finally, the March 2021 Board remand asked for a medical opinion that reconciles the opinions of both Dr. Gaziano and Dr. Alexander. The August 2021 VA examiner did not address Dr. Alexander's opinion, as requested. Accordingly, the Board finds that the August 2021 VA examination is inadequate and remand for a new VA pulmonary examination is required. The matters are REMANDED for the following action: 1. Obtain a VA medical opinion as to the etiology of any diagnosed respiratory disability at any point during the appeal period. An examination should be scheduled only if deemed necessary by the examiner. The examiner should review the file and provide a complete rationale for all opinions expressed. Upon review of the claim file, the examiner must identify any respiratory disability diagnosed during the appeal period. In so doing the examiner must consider the following: the September 2019 VA examination which notes a diagnosis of chronic obstructive pulmonary disease from 8/21/19 and the January 2021 VA medical opinion which notes said diagnosis is corroborated by pulmonary function testing; the January 2021 VA medical opinion which notes that the medical record indicates a diagnosis of asbestosis, yet there is no definitive clinical evidence to support this. For any current lung disability found to be diagnosed at any point during the appeal period, 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 any asbestos exposure therein. In providing the opinion, the examiner should discuss the September 2019 VA examination finding that the Veteran has been diagnosed with COPD. The examiner should also consider and discuss any lay statements of record. All opinions advanced should be reconciled with the other opinions of record, including those of Drs. Gaziano and Alexander. 2. 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 Y. Akkad 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.