Citation Nr: 21072451 Decision Date: 12/03/21 Archive Date: 12/03/21 DOCKET NO. 17-33 428 DATE: December 3, 2021 REMANDED Entitlement to service connection for a respiratory condition, to include asthma and bronchitis, is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1989 to February 1993, with additional Reserve service. This matter is on appeal from an April 2015 decision of a Department of Veterans Affairs (VA) Regional Office (RO). In February 2020, a hearing was held before the undersigned. A transcript of the hearing is in the record. The case was previously before the Board in July 2020 when it was remanded for further development. In a January 2021 rating decision, the RO granted entitlement to service connection for degenerative arthritis of the spine with lumbosacral strain and chronic sinusitis. Thus, those matters are no longer on appeal. Entitlement to service connection for a respiratory condition, to include asthma and bronchitis, is remanded. The Veteran contends that she is entitled to service connection for a respiratory condition, to include asthma and bronchitis. However, upon review of the record, the Board finds that further development is necessary to obtain an opinion that adequately addresses the etiology of the Veteran's condition. In November 2020, VA obtained a medical opinion in which the clinician opined that the condition is less likely than not incurred in or related to service. She stated that during service, the Veteran's bronchitis was "acute only" and that "acute bronchitis is an acute condition and is [a separate] entity from asthma." However, June 1997 reserve treatment records note that the Veteran reported having been under a physician's care for an upper respiratory infection and cough during the past 12 months and a possible diagnosis of sinobronchial syndrome. This evidence is favorable to the Veteran's claim because it notes that this symptomatology also occurred years after the initial December 1991 in-service diagnosis of bronchitis, which indicates that the Veteran's symptoms may have lasted longer than the in-service notation of acute bronchitis. Additionally, the examiner did not appear to consider the Veteran's statements at the February 2020 hearing that she sought treatment at a community center for respiratory symptoms after service until 2000. A medical examiner is not required to comment on every piece of favorable evidence in the record; however, the opinion must reflect consideration of the Veteran's medical history so that the Board's evaluation of the claimed disability is fully informed. Monzingo v. Shinseki, 26 Vet. App. 97, 105-07 (2012); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). As this opinion does not reflect consideration of the Veteran's full medical history, an additional opinion must be obtained. The record also reflects the Veteran receives VA treatment; thus, updated VA treatment records should be associated with the claims file. The matters are REMANDED for the following action: 1. Obtain the Veteran's VA treatment records for the period from July 2014 to the present. 2. After completing the development requested in item 1, return the claims file to the November 2020 VA examiner, or another appropriate clinician if that examiner is not available, for review and an addendum medical opinion. An in-person (or telehealth) examination is only necessary if deemed so by the clinician. The reviewing clinician should be requested to provide an opinion (based on a review of the record) to answer the following: Is it at least as likely as not (a 50 percent or greater probability) that the Veteran's respiratory condition was incurred in service or is otherwise related to an in-service event, injury, or disease? The examiner is asked to specifically address the Veteran's competent and credible statements of receiving treatment for respiratory symptoms at a community center after service until 2000, June 1997 reserve service records which note treatment for upper respiratory infections and coughs during the past twelve months and a possible diagnosis of sinobronchial syndrome, in addition to the in-service diagnoses of bronchitis in December 1991. A complete rationale for all opinions must be provided. If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why an opinion would require speculation. The clinician must indicate whether there was any further need for information or testing necessary to make a determination. Additionally, the clinician must indicate whether any opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. M. SORISIO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. H. White, 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.