Citation Nr: 21072388 Decision Date: 12/03/21 Archive Date: 12/03/21 DOCKET NO. 14-43 418 DATE: December 3, 2021 REMANDED Entitlement to service connection for the Veteran's respiratory disabilities is remanded. REASONS FOR REMAND The Veteran served in the United States Air Force from April 1970 to March 1972. In October 2018, the Board remanded the case to the Agency of Original Jurisdiction (AOJ) for the Veteran to receive a VA examination that considered whether there was a nexus between the Veteran's lung condition and his in service jobs. In November 2019, the Veteran received a new VA examination. In a May 2021 remand the Board determined that the November 2019 VA examiner failed to consider whether the Veteran's other respiratory issues where possibly linked to service. The examiner only addressed the Veteran's pulmonary condition; thus, the case was remanded for another VA examination. A medical opinion was provided in May 2021. The examiner reviewed the claims file and first noted that the Veteran's separation examination was silent for any treatment or complaints of COPD, emphysema, or pulmonary nodules. The examiner considered the Veteran's statements about exposure to chemicals and asbestos exposure but noted that his CT scan showed no evidence of asbestos-related conditions. While the Veteran's in service breathing problems were noted, the examiner stated that there were no records from 1972 through 2011 that showed complains of shortness of breath. The examiner also specifically attributed his respiratory conditions to his history of smoking. Therefore, the examiner determined that the Veteran's respiratory conditions were not related to service. Unfortunately, another addendum opinion is needed. The examiner relied on an absence of treatment records from 1972 to 2011 to support a negative finding without considering the Veteran's lay assertions. Additionally, this portion of the opinion is based on an inaccurate premise because a private treatment record from April 2009 notes that the Veteran had "some occasional SOB with activities and subsides with rest." The Board emphasizes that it is not determining whether or not the Veteran's statements about continuity of symptoms are credible at this time, as the additional development set forth in the directives below could impact that determination. The matter is remanded for the following actions: 1. Provide the Veteran's claims file to a qualified clinician to determine the etiology of the Veteran's respiratory conditions. A new examination of the Veteran is only necessary if deemed so by the clinician. After reviewing the claims file and a copy of this remand, the clinician should address the following: Whether it is a least as likely as not that the Veteran's shortness of breath, COPD, emphysema, and pulmonary nodules are related to service, to include exposure to chemicals and asbestos. The clinician must address the Veteran's lay statements that he has had breathing problems that began in service and continued since then. It is not sufficient to base a negative opinion entirely on the absence of medical records. The clinician must provide a complete rationale for his or her opinion(s) in the examination report. If any of the above requested opinions cannot be made without resort to speculation, the clinician must state this and provide a rationale for such conclusion. 2. Then, review all medical opinions and any examination reports provided to ensure that the requested information was provided. If any report or opinion is deficient in any manner, the AOJ must implement corrective procedures 3. Readjudicate the claim. D. Martz Ames Veterans Law Judge Board of Veterans' Appeals Attorney for the Board R. Brunot, 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.