Citation Nr: 21077278 Decision Date: 12/29/21 Archive Date: 12/29/21 DOCKET NO. 15-05 521 DATE: December 29, 2021 REMANDED Entitlement to service connection for chronic obstructive pulmonary disease (COPD), to include on a secondary basis, is remanded. Entitlement to an initial compensable evaluation for pleural plaques is remanded REASONS FOR REMAND The Veteran served on active duty in the U.S. Army from December 1970 to September 1972. These matters were before the Board of Veterans' Appeals (Board) in May 2021, at which time they were remanded. They return now to the Board for appellate review. 1. Entitlement to service connection for COPD is remanded. While it regrets the additional delay, the Board finds that a remand is necessary in order to afford the Veteran an adequate VA examination and medical opinion for his COPD claim. The VA examiner who furnished the June 2021 opinion and September 2021 addendum indicated only that "[p]leural plaques are not an established primary etiology of COPD in the medical literature." The opinion is conclusory and fails to address the question of aggravation. The addendum did not improve matters, the examiner failing explicitly to address whether pleural plaques constituted a causative or aggravating factor in the Veteran's COPD. On remand, a new VA examination must be conducted and a thorough medical opinion as to etiology obtained. 2. Entitlement to an initial compensable evaluation for pleural plaques is remanded. As explained in the prior Board remand, the Veteran's claim for increase is inextricably intertwined with the service connection claim, as the claim for service connection for COPD may impact the assigned rating for a respiratory disability. Accordingly, the claim for increase must also be remanded. Tyrues v. Shinseki, 23 Vet. App. 166, 177 (2009); Harris v. Derwinski, 1 Vet. App. 180, 183 (1991). The matters are REMANDED for the following action: 1. After obtaining the necessary authorization, update the claims file with any relevant outstanding VA and/or private treatment records. 2. Then, schedule the Veteran for a VA examination to explore the etiology of his diagnosed COPD, preferably with an examiner who has not yet participated in this matter. All indicated tests and studies should be conducted and all clinical findings reported in detail. The entire claims file should be made available to and be reviewed by the examiner in conjunction with this request. The examiner is requested to state whether, on an at least as likely as not basis, COPD had its onset in active-duty service or is etiologically related to active-duty service. If COPD is not found to be directly related to service, the examiner should state whether, on an at least as likely as not basis, COPD has been caused or aggravated in any degree by any service-connected disability, including pleural plaques. All opinions expressed must be supported by thorough rationale. 3. Then, re-adjudicate the claim. GAYLE STROMMEN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Z. Sahraie, 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.