Citation Nr: 21072475 Decision Date: 12/03/21 Archive Date: 12/03/21 DOCKET NO. 16-38 118 DATE: December 3, 2021 REMANDED Entitlement to service connection for a pulmonary disability, claimed as the result of asbestos exposure is remanded. Entitlement to a total disability rating based on individual unemployability (TDIU) due to service-connected disabilities, prior to March 1, 2016, is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1962 to July 1965. In July 2021, the Board remanded this case for additional development. The Board finds that there has not been substantial compliance with the remand requests. Stegall v. West, 11 Vet. App. 268 (1998). Entitlement to service connection for a pulmonary disability, claimed as the result of asbestos exposure is remanded. The Veteran asserts that a pulmonary disability is the result of service, to include asbestos and paint fume exposure while in service. In July 2021, the Board remanded the claim for a VA examination to determine the nature and etiology of any pulmonary disability diagnosed during the pendency of the appeal, to include COPD, emphysema, and pulmonary nodules. The examiner was asked to reconcile any diagnoses which conflicted with prior diagnoses and opine whether any diagnosed pulmonary disability was at least as likely as not related to service, to include in-service exposure to asbestos. An August 2021 VA examination diagnosed COPD and pulmonary nodules. The examiner stated that emphysema was a component of COPD and that it was unclear if emphysema was a clinical diagnosis separable from diagnosed COPD. The examiner opined that diagnosed pulmonary disabilities including COPD and pulmonary nodules, were the result of the Veteran's history of smoking. In the rationale, the examiner explained that medical imaging did not show "characteristic changes of interstitial lung disease (ILD), of which asbestosis [wa]s a component under the rubric of pneumoconiosis, or ILD due to inhaled particulates. In the absence of evidence, or at least a strong suggestion, for ILD...any claim of asbestosis c[ould] be no more than speculative...." The Board finds the opinion incomplete. The examiner noted that in-service asbestos exposure was considerable but concluded that the etiology of the diagnosed pulmonary disabilities was smoking. The examiner did not discuss whether the noted asbestos exposure may have contributed to or aggravated the pulmonary disabilities. The examination should also consider any exposure to paint fumes during service. The examiner also did not discuss whether any COPD or pulmonary nodules were related to any other aspect of service. When VA provides an examination or obtains an opinion, the examination or opinion must be adequate. Barr v. Nicholson, 21 Vet. App. 303 (2007). Therefore, remand for a VA examination is necessary. Entitlement to TDIU prior to March 1, 2016 is remanded. The claim for TDIU is inextricably intertwined with the claim for service connection for a pulmonary disability and must also be remanded. Harris v. Derwinski, 1 Vet. App. 180 (1991). The matters are REMANDED for the following action: 1. After obtaining any necessary releases, obtain all relevant VA and private treatment records not already associated with the claims file. All attempts to locate records must be documented in the claims file. 2. Then, schedule the Veteran for a VA examination with a pulmonologist to determine the etiology of any pulmonary disability. The examiner must review the claims file and should note that review in the report. All appropriate tests or studies should be accomplished, and all clinical findings should be reported in detail. The examiner should provide all findings, including findings pertinent to the Veteran's exposure to asbestos and paint fumes, as it relates to symptoms, with a complete rationale for the opinions, in the examination report. The examiner should diagnosed all pulmonary disabilities found and should reconcile that diagnosis with the other evidence of record. The examiner should opine whether it is at least as likely as not (50 percent or greater probability) that any pulmonary disability had its onset in or is otherwise related to service, to include exposure to asbestos and paint fumes. The examiner should opine whether it is at least as likely as not (50 percent or greater probability) that any asbestos or paint fume exposure during service contributed to or aggravated any pulmonary disability. If it is determined that there is another likely etiology for any pulmonary disability, that should be stated and explained. A complete rationale for all opinions expressed should be clearly provided. The examiner must consider the Veteran's statements and all lay statements regarding onset in-service and statements regarding the continuity of symptomatology. Harvey P. Roberts Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E.O., 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.