Citation Nr: 21069277 Decision Date: 11/18/21 Archive Date: 11/18/21 DOCKET NO. 18-22 083 DATE: November 18, 2021 ORDER The claim for entitlement to service connection for hypertension has been withdrawn and is dismissed. REMANDED Entitlement to service connection for asbestosis is remanded. FINDING OF FACT In March 2021, prior to the promulgation of a decision on this appeal, the Board received notification from the Veteran that he would like to withdraw his appeal relating to entitlement to service connection for hypertension. CONCLUSION OF LAW The criteria for withdrawal of the issue of entitlement to service connection for hypertension are met. 38 U.S.C. § 7105; 38 C.F.R. § 19.55. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from February 1966 to February 1970. These matters come before the Board of Veterans' Appeals (Board) on appeal from an October 2017 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO), the Agency of Original Jurisdiction (AOJ). In March 2021, the Veteran testified at a hearing before the undersigned Veterans Law Judge (VLJ). A copy of the transcript has been associated with the file. 1. Entitlement to service connection for hypertension Pursuant to 38 U.S.C. § 7105, the Board may dismiss any appeal which fails to allege specific error of fact or law in the determination being appealed. A substantive appeal may be withdrawn in writing at any time before the Board promulgates a decision. Except for appeals withdrawn on the record at a hearing, appeal withdrawals must be in writing. 38 C.F.R. §§ 20.202, 20.204. Withdrawal may be made by the Veteran or by his or her authorized representative. 38 C.F.R. § 20.204. In March 2021, the Veteran sent a signed statement indicating his desire to withdraw his appeal for service connection for hypertension. As the Veteran has properly withdrawn his appeal in writing, the Board no longer has appellate jurisdiction and can take no further action on this matter. 38 U.S.C. § 7105; 38 C.F.R. §§ 20.204. Accordingly, the appeal of the issue of service connection for hypertension is dismissed. REASONS FOR REMAND 1. Entitlement to service connection for asbestosis is remanded. The Veteran filed a claim on April 27, 2017, asserting that he has a diagnosis of asbestosis that was caused by his active military service. The Veteran was afforded a VA examination in August 2017. The Veteran reported that his asbestos condition began while he was working as a ship fitter in the Navy. He claimed that he was exposed to asbestos during service. The examiner noted that in February 2001, a private toxicology consult found that x-ray results satisfied the criteria for possible asbestosis which is considered when there is no radiographic evidence in the presence of other risk factors. The examiner noted that the diagnosis of possible asbestosis was made but has never been documented by x-ray or biopsy. The condition has persisted with complaints of dyspnea. X-rays in August 2017 were noted as normal. Pulmonary function testing results dated August 2017 indicated FVC: 85% predicted; FEV-1: 93% predicted; and FEV-1/FVC: 110%. The examiner remarked that there is no diagnosis of asbestosis because there is no pathology to render a diagnosis. The examiner found that the claimed condition was less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service injury, event, or illness. The rationale was that the Veteran has no evidence of asbestosis related lung disease, and a normal CXR and pulmonary function tests. In April 2018 the Veteran submitted a statement indicating that he served as a ship fitter on two ships, the USS Cimarron and the USS Kawishiwi, and made three Vietnam tours. Before the decommissioning of the ships, he was assigned to remove the insulation from pipes. He testified that every day there was "dust flying all over the place" and that he wore no protection. He also stated that he worked with insulated pipes because of being a welder, and that he slept on the top bunk, directly below pipes over his head. At the outset of the March 2021 hearing, it was noted that the Veteran was withdrawing his claim for entitlement to service connection for hypertension and that issue was not addressed. The Veteran's representative then stated the Veteran's contention that the August 2017 examiner did not have the proper testing done to make a decision to confirm or rule out a diagnosis of asbestosis. The representative noted that a private review was submitted that addressed additional testing that took place in 2011, including chest x-rays, to determine whether the Veteran had suffered damage to his lungs due to asbestos exposure and there was a finding of left lung changes consistent with asbestos related pneumoconiosis. The Veteran was told that he was diagnosed with asbestosis. He currently experiences respiratory problems that have limited his ability to walk for more than a short distance or use stairs. The Veteran has also testified that he was provided a regular chest x-ray in conjunction with his claim. He stated that asbestosis does not appear on a regular chest x-ray. The Veteran indicated that previously, asbestosis was found via the interpretation of a "B-reader" who interpreted the Veteran's imaging studies. The National Institute for Occupational Safety and Health (NIOSH) B Reader Program provides the opportunity for physicians to demonstrate proficiency in the International Labour Office (ILO) system for classifying radiographs of pneumoconioses. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7189962/ Unfortunately, the 2011 private study referenced by the August 2017 examiner and by the Veteran's hearing testimony is not in the record and is unavailable for review by the Board. The Board finds that a remand is necessary to provide the Veteran a new examination to include appropriate imaging that is interpreted by a certified "B-reader." Should a diagnosis of asbestosis be confirmed, a medical opinion shall be obtained as to whether it is at least as likely as not that such diagnosis is related to the Veteran's active service, including exposure to asbestos while serving as a ship fitter. The matters are REMANDED for the following action: Schedule the Veteran for an examination by a qualified examiner who carries B-reader certification. The examiner should confirm or rule out a diagnosis of asbestosis. Should a diagnosis of asbestosis be confirmed, the examiner should provide the following opinion: Whether it is at least as likely as not (50 percent probability or greater) that the Veteran's asbestosis is caused by exposure to asbestos during active service. Michael J. Skaltsounis Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Debra B. McLoughlin, 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.