Citation Nr: 21074579 Decision Date: 12/15/21 Archive Date: 12/15/21 DOCKET NO. 16-58 492A DATE: December 15, 2021 REMANDED Entitlement to service connection for chronic obstructive pulmonary disease (COPD) is remanded. Entitlement to service connection for a low back disability is remanded. Entitlement to service connection for a left knee disability is remanded. Entitlement to service connection for a right knee disability is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1978 to November 1982. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a September 2015 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). This case was most recently before the Board in June 2021 when it was remanded for additional development. 1. Entitlement to service connection for chronic obstructive pulmonary disease (COPD) is remanded. The Veteran asserts that he has chronic obstructive pulmonary disease (COPD) related to his period of active service. Specifically, he stated that the onset of the disability was in service and, alternatively, that such is related to his exposure to "toxic water" at Camp Lejeune during his active service. The Veteran's post-service treatment records indicate that he has a current diagnosis of COPD. Notably, the Veteran's service treatment records are unavailable for review and some of his personnel records are illegible. Under such circumstances, VA has a heightened duty to assist the Veteran in the development of the case, and a heightened duty to consider carefully the benefit of the doubt rule. See Washington v. Nicholson, 19 Vet. App. 362, 369-70 (2005). In light of the above, further development is required to determine whether the Veteran actually served at Camp Lejeune and the nature and etiology of his currently diagnosed COPD. See McClendon v. Nicholson, 20 Vet. App. 79, 81 (2006). 2. Entitlement to service connection for a low back disability is remanded. 3. Entitlement to service connection for a left knee disability is remanded. 4. Entitlement to service connection for a right knee disability is remanded. The Veteran asserts that he has low back and bilateral knee disabilities resulting from his period of active service. He noted that he has had pain since service related to his duties as a heavy equipment operator. The medical evidence of record demonstrates that the Veteran has current diagnoses of degenerative disc disease and arthritic changes of the lumbar spine and arthritis in the bilateral knees. Additionally, the Veteran's DD Form 214, Certificate of Release or Discharge from Active Duty, indicates that his military occupational specialty was engineer equipment operator. The Board finds that the Veteran is both competent and credible to report back and knee pain since his period of active service. To date, the Veteran has not been afforded a VA examination in connection with these claims. Given his current diagnoses and the Veteran's lay statements regarding his back and knee pain since service, a remand is warranted for a VA examination to fulfill the duty to assist under McClendon, 20 Vet. App. at 81. The matters are REMANDED for the following action: 1. Ask the Veteran to provide the approximate date(s) of his service at Camp Lejeune. Make efforts to verify his service at Camp Lejeune with the service department or other appropriate source(s). The evidence procured, if any, should be associated with the record. 2. Thereafter, obtain a VA opinion regarding the nature and etiology of the Veteran's diagnosed COPD. The claims file should be available to and reviewed by the VA examiner. If an examination is deemed warranted, one should be arranged. All indicated tests and studies should be completed. The examiner should opine whether it is at least as likely as not (a 50 percent probability or greater) that the Veteran's COPD had its onset in or is otherwise etiologically related to the Veteran's period of active service. The examiner should specifically address the Veteran's competent reports of breathing problems in service and, if service at Camp Lejeune is verified, any exposure to contaminated water. A complete rationale should be provided. 3. Obtain a VA opinion regarding the nature and etiology of the Veteran's diagnosed back and knee disabilities. The claims file should be available to and reviewed by the VA examiner. If an examination is deemed warranted, one should be arranged. All indicated tests and studies should be completed. The examiner should respond to the following: (a.) Identify all low back, left knee, and/or right knee disabilities diagnosed during the appeal period (from July 2013). (b.) For each low back disability diagnosed, opine whether it is at least as likely as not (a 50 percent probability or greater) that the disability had its onset in or is otherwise etiologically related to the Veteran's period of active service. The examiner should specifically address the Veteran's competent reports of back trouble related to his duties as an engineer equipment operator in service and his continuous symptoms of back pain since that time. A complete rationale should be provided. (c.) For each left knee disability diagnosed, opine whether it is at least as likely as not (a 50 percent probability or greater) that the disability had its onset in or is otherwise etiologically related to the Veteran's period of active service. The examiner should specifically address the Veteran's competent reports of knee pain related to his duties as an engineer equipment operator in service and his continuous symptoms of left knee pain since that time. A complete rationale should be provided. (d.) For each right knee disability diagnosed, opine whether it is at least as likely as not (a 50 percent probability or greater) that the disability had its onset in or is otherwise etiologically related to the Veteran's period of active service. The examiner should specifically address the Veteran's competent reports of knee pain related to his duties as an engineer equipment operator in service and his continuous symptoms of right knee pain since that time. A complete rationale should be provided. CAROLINE B. FLEMING Veterans Law Judge Board of Veterans' Appeals Attorney for the Board L. Connor, 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.