Citation Nr: 21008491 Decision Date: 02/17/21 Archive Date: 02/17/21 DOCKET NO. 17-26 532 DATE: February 17, 2021 REMANDED The issue of entitlement to service connection for bronchial glomus tumor is remanded. VETERAN CONTENTIONS The Veteran contends that he was exposed to toxic materials while performing his duties in service. He asserts that while his Military Occupational Specialty (MOS) was clerical, he engaged significantly in other activities, including as fire leader in the fire brigade, and as a bosun’s mate, which led to exposure to toxic materials including asbestos, paint chips, and chemical fumes. REASONS FOR REMAND The Veteran served on active duty in the Navy from March 1981 to May 1985. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). There was a January 2020 video hearing before the undersigned Veterans Law Judge and the transcript is of record. The issue of entitlement to service connection for irritable bowel syndrome (IBS) was appealed in an August 2015 notice of disagreement along with the claim currently on appeal. During the pendency of the appeal, the agency of original jurisdiction (AOJ) granted service connection for that disorder in a March 2017 rating decision. Because the Veteran was granted the highest permitted schedular rating for IBS, that decision serves as a complete grant of the benefits sought on appeal, and that issue is no longer before the Board. See Grantham v. Brown, 114 F.3d 1156, 1159 (Fed. Cir. 1997). To date, no VA examination has been conducted for bronchial glomus tumor. However, VA is obligated to provide an examination when there is competent medical evidence of a disability that may be associated with an in-service event, injury, or disease, but there is insufficient information to make a decision on the claim. See 38 U.S.C. § 5103A(d); 38 C.F.R. § 3.159(c)(4); McLendon v. Nicholson, 20 Vet. App. 79 (2006). Here, the Veteran has been diagnosed with a bronchial glomus tumor and there is competent evidence of record that suggests that he may have been exposed to asbestos and other chemical fumes while in service. Additionally, there are two positive nexus opinions of record indicating that it is as likely as not that the Veteran’s tumor is related to asbestos exposure. Both opinions point to inhalational trauma and repetitive airway tissue damage as the reasons for their conclusion, but neither opinion considers nor addresses the Veteran’s long-standing history of smoking as a possible etiological basis of his condition. Because the existing medical opinions are insufficient to make a determination, remand to obtain a VA examination is appropriate. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination with an appropriate clinician to determine the nature and etiology of his bronchial glomus tumor. All clinical findings should be reported in detail. The entire claims file and this Remand should be made available to and be reviewed by the examiner in conjunction with this request. Following review of the claims file and examination of the Veteran, the examiner should provide an opinion regarding whether: It is at least as likely as not (50 percent probability or greater) that the Veteran’s bronchial glomus tumor is causally related to his active service, specifically including as a result of exposure to asbestos, paint chips, and chemical fumes. For the purpose of providing the opinion requested, please accept as valid the Veteran’s statements regarding his history of exposure to asbestos and chemical fumes as a result of “extra” in-service duties a member of the fire brigade and Bosun’s mate. Please also consider and address the Veteran’s long-term smoking habit in providing the opinion requested, specifically explaining whether a history of smoking is associated with the development of bronchial glomus tumors. A complete rationale for the examiner’s opinion should be provided, citing to specific evidence of record, as necessary. If the examiner cannot provide an opinion without resort to speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). If the inability to provide an opinion without resorting to speculation is due to a deficiency in the record (additional facts are required), the AOJ should develop the claim to the extent it is necessary to cure any such deficiency. If the inability to provide an opinion is due to the examiner's lack of requisite knowledge or training, then the AOJ should obtain an opinion from a medical professional who has the knowledge and training needed to render such an opinion. S.C. Krembs Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Z. Sloley, 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.