Citation Nr: 21007292 Decision Date: 02/09/21 Archive Date: 02/09/21 DOCKET NO. 13-09 668 DATE: February 9, 2021 REMANDED Entitlement to service connection for a respiratory condition, to include chronic obstructive pulmonary disease (COPD) is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from May 1968 to August 1981 and again from October 1987 to February 1996. This claim is before the Board of Veterans’ Appeals (Board) on appeal from a March 2009 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). This appeal was previously before the Board in July 2019, at which time it was remanded for further evidentiary development. The Veteran is seeking service connection for a respiratory disability, which he attributes to various fumes and chemical exposures during service, to include herbicide exposure. The Veteran’s service treatment records contain several entries noting treatment for respiratory complaints, including coughs, upper respiratory infections, bronchitis, and possible pneumonia. The Veteran’s post-service private and VA treatment records reflect that the Veteran has been treated for various respiratory complaints, diagnosed as bronchitis, asthma, and COPD. At the October 2020 VA examination, found that the Veteran’s current tests results and previous medical history, to include his symptomatology, were indicative of asthma. Upon review of the evidence and examination of the Veteran, the examiner opined that the Veteran’s asthma was less likely than not related to service. Rather, the examiner opined that the most likely cause of the Veteran’s asthma was his long history of smoking. Upon review of the above, the Board finds that a new VA examination and opinion are needed. Indeed, as noted, the record shows diagnoses of COPD and bronchitis during the appeal period. However, the examiner only provided an opinion as to asthma. An opinion must be obtained as to all of the respiratory disabilities diagnosed during the appeal period. Accordingly, this claim is REMANDED for the following action: 1. Obtain a new VA medical opinion regarding the nature and etiology of any current respiratory disability, including COPD and bronchitis. An examination should be scheduled only if deemed needed by the examiner. If an examination is needed, a telehealth appointment should be considered as needed. The examiner must review the relevant evidence in the file for the history of this claimed disability. The examiner must set forth all examination findings with clear rationale for the conclusions reached, including discussing any pertinent medical literature reviewed or other authoritative writing. The examiner is asked to specifically respond to the following: a) Identify (by diagnosis) all respiratory disorders diagnosed during the appeal period. The examiner is advised that the record shows diagnoses of bronchitis, COPD and asthma during the appeal period. If the examiner believes a diagnosis of record was erroneous, an explanation for so finding should be provided. Otherwise, the opinion must address all the diagnoses of record during the appeal period. b) For each current respiratory disorder found to exist during the appeal period, indicate whether it is as likely as not (i.e., a probability of 50 percent or greater) that it was incurred in, caused by, or is otherwise etiologically related to the Veteran’s military service, including especially the result of exposure to hazardous materials purportedly in connection with his military occupational specialty, or from exposure to asbestos, dust and other environmental elements also claimed to have occurred while in service, or to his presumed exposure to herbicides during service. The examiner must discuss the symptomatology reported in service, to include, treatment for respiratory complaints, including coughs, upper respiratory infections, bronchitis, and possible pneumonia. c) If it instead is determined there is another more likely etiology for any respiratory disabilities diagnosed during the appeal period, including COPD, bronchitis and asthma, such as chronic smoking or whatever, this must be identified. A full rationale for all opinions rendered must be provided. (Continued on next page)   2. If upon completion of the above the appeal remains denied, the case should be returned to the Board after compliance with appellate procedure. E. I. VELEZ Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Orie, 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.