Citation Nr: 21070709 Decision Date: 11/24/21 Archive Date: 11/24/21 DOCKET NO. 09-32 088 DATE: November 24, 2021 REMANDED Entitlement to service connection for respiratory disorder, claimed as bronchitis, asthma, chronic obstructive pulmonary disease (COPD), and allergic rhinitis, is remanded. Entitlement to a total disability benefits based on individual unemployability (TDIU) prior to June 15, 2011, is remanded. Entitlement to special monthly pension (SMP) based on a need for the regular aid and attendance of another is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from July 1968 to May 1972. These matters come before the Board of Veterans' Appeals (Board) on appeal from a January 2005 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In October 2015, June 2018, December 2019, April 2020, and August 2020, the Board remanded the matters to the Agency of Original Jurisdiction (AOJ) for additional development, and they have now returned for final adjudication. The Board acknowledges the extended history of this case. Regretfully, as discussed below, additional development is necessary prior to final adjudication. 1. Service connection for Respiratory Disorder is Remanded. In the most recent August 2020 remand, the Board instructed the AOJ to obtain an addendum VA medical opinion that discusses the Veteran's chronic bronchitis and its relation to his active duty service. In accordance with the remand directives, the AOJ obtained an April 2021 addendum VA medical opinion where an examiner opined that while the Veteran had in service reports for sinusitis, hay fever, and asthma in 1968, and had a consulting visit in 1970 for allergic rhinitis, his record since then was silent for pulmonary condition. Thus, the examiner concluded that chronicity of bronchitis is not demonstrated, and a nexus is not found. The Board finds that there was not substantial compliance with the remand directives as the VA medical opinion obtained is incomplete. See Stegall v. West, 11 Vet. App. 268 (1998). In that regard, the examiner did not discuss all of the relevant in service reports to include the multiple reports of allergic rhinitis in March 1969, May 1970, and March 1971. The Veteran was also assessed as having an upper respiratory infection in October 1971. Moreover, the examiner relied on the absence of medical records after the Veteran's service. A review of the record shows that the Veteran was assessed with bronchitis in September 1977, December 1985, and April 1988. When VA undertakes to provide a medical examination, it must ensure that the examination is adequate. See Barr v. Nicholson, 21 Vet. App. 303 (2007). Accordingly, a remand is required to obtain another addendum VA medical opinion. 2. TDIU prior to June 15, 2011 is Remanded. 3. SMP based on Aid and Attendance is Remanded. As a decision on the remanded issue of entitlement to service connection for a respiratory disorder could significantly impact a decision on the issues of entitlement to a TDIU and SMP, these two issues must also be remanded as they are inextricably intertwined with the respiratory disorder claim. Harris v. Derwinski, 1 Vet. App. 180 (1991). The matters are REMANDED for the following action: 1. The claims file should be sent to an appropriate examiner to offer an opinion as to whether the Veteran's chronic bronchitis is at least as likely as not (50 percent probability or greater) due to his military service; in-service respiratory complaints, symptoms, treatment; and/or his contention of chronic symptoms since service. In offering the opinion, the examiner is asked to consider reports of allergic rhinitis in March 1969, May 1970, and March 1971, and the assessment of having an upper respiratory infection in October 1971. The examiner should also consider the post service record that shows that the Veteran was assessed with bronchitis in September 1977, December 1985, and April 1988. The need for an examination is left to the discretion of the examiner. A rationale for all opinions offered is requested as adjudicators are precluded from making any medical findings. 2. After the above development, readjudicate the appeal, including the inextricably intertwined issues. D. Martz Ames Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Mathew 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.