Citation Nr: 21069764 Decision Date: 11/19/21 Archive Date: 11/19/21 DOCKET NO. 19-00 291A DATE: November 19, 2021 REMANDED Entitlement to an initial compensable rating for the service-connected pleural plaque (right side) is remanded. REASONS FOR REMAND The Veteran had active service from November 1965 to February 1969. In April 2021, he testified at a hearing before the undersigned Veterans Law Judge (VLJ). The Veteran seeks an initial compensable rating for his service-connected right side pleural plaque. He was last examined for the severity of this disability in July 2017. After his April 2021 hearing, he submitted two private pulmonary function test (PFT) results dated a couple of months before, and a couple of months after, his July 2017 VA pulmonary examination, which both showed that his condition was worse than was shown on the concurrent VA examination. Unlike the VA examination, however, the private PFT results did not contain an indication from the provider as to which part of the PFT was most indicative of the severity of the Veteran's service-connected lung disability. Thus, they are not conclusively more reliable for rating purposes than the 2017 VA examination which contained a statement from the examiner indicating which of the multiple tests performed would be the most appropriate to use in rating the Veteran's condition. However, given that four years have passed since the Veteran was last examined by VA for this disability, and given the indication in the private PFT records that the 2017 VA examination may not have accurately assessed the severity of the Veteran's lung condition, the Board finds that a new VA examination is needed before it can decide this claim. The Veteran also testified before the Board of Veterans' Appeals that he continues to treat regularly with private providers for his lung disability. However, the claims file does not contain complete and current treatment records from these providers. As such, current records from any related private treatment providers should also be obtained, as they could contain information which could help substantiate the Veteran's claim. Accordingly, the matter is REMANDED for the following actions: 1. Ask the Veteran to complete a VA Form 21-4142 for all private providers who treated him for his service-connected lung disability. Previously unobtained records should be sought from all identified providers dating from the earliest date the Veteran ever treated with them to present. Make two requests for all authorized records unless it is clear after the first request that a second request would be futile. 2. Then, schedule the Veteran for an examination by an appropriate clinician to determine the current severity of his service-connected right side pleural plaque. The Veteran's claims file should be made available to the examiner in conjunction with this examination, and the examiner's review of the folder should be annotated in the examination report. The examiner should complete all necessary tests, provide a full description of the disability, and report all signs and symptoms associated with the disorder. To the extent possible, the examiner should identify any symptoms and functional impairment due to the Veteran's right side pleural plaque alone and discuss the effect of the condition on any occupational functioning and activities of daily living. A rationale for all requested opinions shall be provided. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation stating why this is so. In so doing, the examiner shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question. No action is required of the Veteran until he is notified by VA. However, he is advised of his obligation to cooperate in ensuring the duty to assist is satisfied. Kowalski v. Nicholson, 19 Vet. App. 171 (2005). His failure to report for a VA medical examination may impact the determination made. 38 C.F.R. § 3.655. The Veteran also is advised that he has the right to submit additional evidence and argument with respect to this matter. Kutscherousky v. West, 12 Vet. App. 369 (1999). This appeal must be afforded prompt treatment. THERESA M. CATINO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Davidoski, 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.