Citation Nr: A21019965 Decision Date: 12/15/21 Archive Date: 12/15/21 DOCKET NO. 200819-105468 DATE: December 15, 2021 ORDER New and relevant evidence having been received, the claim of entitlement to service connection for pulmonary fibrosis is reopened. REMANDED Entitlement to service connection for pulmonary fibrosis, to include as due to asbestos exposure is remanded. FINDING OF FACT Evidence received since a final June 2018 rating decision relates to information that tends to prove a matter at issue in the pulmonary fibrosis disability claim. CONCLUSION OF LAW Evidence received since a final June 2018 rating decision is new and relevant; therefore, the Veteran's claim of entitlement to service connection for a pulmonary fibrosis disability is readjudicated. 38 U.S.C. §§ 5108, 7105(c) (2012); 38 C.F.R. §§ 3.2501, 20.1103 (2020). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January 1975 to January 1977. In April 2020, the Veteran submitted a VA Form 20-0995, Decision Review Request: Supplemental Claim, and requested readjudication of pulmonary fibrosis most recently addressed in an August 2019 rating decision. In August 2020, the agency of original jurisdiction (AOJ) issued the supplemental claim decision on appeal, which found that new and relevant evidence had not been received. Therefore, the Board must determine whether new and relevant evidence has been received based only on the evidence of record at the time of the decision on appeal. In the August 2020 VA Form 10182, Decision Review Request: Board Appeal, the Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the agency of original jurisdiction (AOJ) decision on appeal. 38 C.F.R. § 20.301. Therefore, the Board may only consider the evidence of record at the time of the RAMP supplemental claim decision on appeal. 38 C.F.R. § 20.301. Whether new and relevant evidence has been received to reopen the claim of entitlement to service connection for pulmonary fibrosis VA will readjudicate a claim if new and relevant evidence is presented or secured. AMA, Pub. L. No. 115-55, § 5108, 131 Stat. 1105, 1109. The evidence necessary for VA to readjudicate the Veteran's claim must be merely "new" and "relevant." In this regard, the AMA defines "new evidence" as "evidence not previously part of the actual record before agency adjudicators." Additionally, "relevant evidence" is defined as "information that tends to prove or disprove a matter at issue in a claim." 38 C.F.R. § 3.2501 (a)(1). The relevant evidence standard is a lower standard than the "material evidence" standard because the statutory definition of relevant does not require that the new evidence relate to an unestablished fact or raise a reasonable possibility of substantiating the claim. The Board will consider this lower standard in deciding the Veteran's appeal. In a June 2018 rating decision, VA denied service connection for pulmonary fibrosis. At the time of that decision, VA found that it was not established that pulmonary fibrosis resulted from asbestos exposure, and more specifically, the Veteran's interstitial pneumonia was unrelated to asbestos exposure. Further, it was noted that the Veteran did not have a diagnosis of asbestosis. An August 2019 rating decision confirmed the previous denial of service connection. The Veteran filed a supplemental claim in April 2020. The AOJ issued a rating decision declining to readjudicate the claim. The AOJ acknowledged the Veteran's conceded in-service asbestos exposure based on his MOS, and this was noted as a favorable finding. The Veteran was in fact afforded a VA examination in August 2019 to assess the nature and etiology of his claimed lung disease. The examiner opined that the Veteran's lung disease was less likely than not related to service, reasoning that he had no diagnosis of asbestosis. The examiner also cited a medical treatise regarding pulmonary fibrosis, indicating that it is noted to be idiopathic when the cause can't be found. Review of the claims file reflects that the Veteran submitted a statement in April 2020 which was not considered by a VA examiner. Specifically, the Veteran indicated that after separation from service, he was not exposed to any hazardous materials, and it was only during service that he had exposures. Given the favorable findings of asbestos exposure in service, and the Veteran's new statement regarding absence of exposure to hazardous materials in post-service civilian life, the Board finds that the evidence submitted since the previous rating decision contains information that tends to prove a matter at issue in this claim. Therefore, the petition to readjudicate the previously denied claim is granted. REASONS FOR REMAND 1. Entitlement to service connection for pulmonary fibrosis, to include as due to asbestos exposure, is remanded. When VA undertakes to obtain an examination/opinion, it must ensure that the examination/opinion is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). A medical opinion/examination is considered adequate "where it is based on consideration of the veteran's prior medical history and examinations and also describes the disability, if any, in sufficient detail so that the Board's evaluation of the claimed disability will be a fully informed one." Stefl v. Nicholson, 21 Vet. App. 120, 123 (2007). The Veteran was afforded a VA examination in August 2019 to assess the nature and etiology of his pulmonary fibrosis. The examiner opined that it is less likely than not related to service. It was reasoned that the Veteran has no diagnosis of asbestosis, and per medical treatise research, idiopathic pulmonary fibrosis may originate from a multitude of factors. The Board finds this opinion to be inadequate for adjudication purposes. Specifically, the examiner relied on the absence of an alternate diagnosis to justify an absence of etiological relation to the current pulmonary fibrosis without further explaining why the absence of an asbestosis diagnosis was significant. Furthermore, while the Veteran cited medical treatise evidence indicative that there are multiple causal factors possible, the examiner did not address specifically why asbestos exposure is more or less likely to have caused the current pulmonary fibrosis. Therefore, an addendum opinion must be obtained for proper adjudication of this claim. The matters are REMANDED for the following action: The issue of entitlement to service connection for a lung disability is remanded to correct a duty to assist error that occurred prior to the August 2020 rating decision on appeal. The Agency of Original Jurisdiction (AOJ) obtained an August 2019 medical opinion prior to the rating decision on appeal. However, this medical opinion does not provide an adequate rationale regarding whether the Veteran's lung disability had its onset in service or is otherwise related to service. Obtain an addendum opinion from the August 2020 VA examiner regarding the etiology of the Veteran's claimed pulmonary fibrosis. The Veteran's electronic claims folder, including a copy of this remand, must be provided to the examiner. The examiner is requested to address the following: Whether it is at least as likely as not (50 percent probability or greater) that the Veteran's claimed pulmonary fibrosis was incurred in or otherwise related to service, to include due to asbestos or chemical exposure. The examiner is requested to address the Veteran's April 2020 VA Form 21-4138 where he stated that he worked in close proximity to chemicals during service and did not have such exposure, post service. All opinions offered must be accompanied by a clear rationale consistent with the evidence of record. If the examiner finds it impossible to provide any part of the requested opinions without resort to pure speculation, he or she should so indicate and provide a rationale as to why such a finding is made. L. Baskerville Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Comninos, Georgio 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.