Citation Nr: 21070361
Decision Date: 11/23/21	Archive Date: 11/23/21

DOCKET NO. 16-13 688
DATE: November 23, 2021

REMANDED

Entitlement to service connection for the cause of the Veteran's death is remanded. 

REASONS FOR REMAND

The Veteran had active duty service in the United States Navy from July 1955 to May 1959.  He died in August 2013.  The appellant is his surviving spouse.  

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a February 2015 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO).  

In December 2019, the appellant testified before the undersigned Veterans Law Judge.  The Board remanded the claim for further development in February 2020 and July 2020.

Unfortunately, another remand is required, as the September 2021 VA examiner did not address the appellant's reported observed respiratory symptomatology since service, as specifically requested by the Board in the July 2020 remand directives. Additionally, given the Board's concession of in-service chemical exposures, including lead-based paint, and to afford the appellant every possible consideration, an opinion as to the etiology of diabetes and hypertension will also be secured.

The matter is REMANDED for the following action:

Refer the claims file to an examiner other than the September 2021 VA examiner, preferably a physician, for preparation of an addendum opinion as to the cause of the Veteran's death. Following a thorough review of the claims file, the examiner should address the following:

(a) Is it at least as likely as not (50 percent probability or greater) that the Veteran's diabetes had its onset in or is otherwise related to the Veteran's service, to include as a result of conceded exposure to chemicals from working on aircraft carriers and lead-based paint therein?

(b) Is it at least as likely as not (50 percent probability or greater) that the Veteran's hypertension had its onset in or is otherwise related to the Veteran's service, to include as a result of conceded exposure to chemicals from working on aircraft carriers and lead-based paint therein? 

(c) If and only if the answer to (a) and (b) is no, is it at least as likely as not (50 percent probability or greater) that any diagnosed respiratory disorder, including acute respiratory failure (see August 2013 private treatment record) had its onset in or is otherwise related to the Veteran's service, to include as a result of conceded exposure to chemicals from working on aircraft carriers and lead-based paint therein.

In addressing this question, please discuss the appellant's competent and credible reports of observation of the Veteran's continuous respiratory symptoms since 1968 (continuous chronic cough and runny nose). See Board Hearing Transcript at 4-6. The examiner must assume the appellant's statements as true, even despite "objective documentation."  Failure to discuss this lay evidence will result in an inadequate opinion and another remand.

(d) Please state whether a nexus between the Veteran's acute respiratory failure and service is "medically consistent" with the symptomatology reported by the appellant as noted above (continuous chronic cough and runny nose since 1968).

(e) For any respiratory disorder attributed to service in inquiry (c), please also opine as to whether it is at least likely as not (50 percent or greater probability) that such disorder:

(1) contributed substantially or materially to cause death;

(2) combined to cause death;

(3) aided or lent assistance to the production of death;

(4) resulted in debilitating effects and general impairment of health that would render the Veteran materially less capable of resisting the effects of other disease or injury primarily causing death; or

(5) was of a progressive or debilitating nature, such that it had a material influence in accelerating the Veteran's death.

A complete rationale should be given for all opinions and conclusions expressed. If the examiner is unable to opine without resorting to speculation, he or she should provide a rationale for this conclusion.

 

S. BUSH

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	S.S. Mahoney

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.