Citation Nr: 21010537 Decision Date: 02/25/21 Archive Date: 02/25/21 DOCKET NO. 10-36 540A DATE: February 25, 2021 REMANDED Entitlement to a rating higher than 30 percent for service-connected bronchial asthma (reactive airway disease) is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Marine Corps from September 1982 to September 2002. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a July 2011 rating decision of the Department of Veterans’ Affairs (VA) Regional Office (RO) in Huntington, West Virginia. In October 2016, the Veteran testified at a Travel Board hearing before the undersigned Veterans Law Judge. A transcript of the hearing has been associated with the claims file. In a July 2018 decision, the Board denied the Veteran’s claim for an increased rating for his service-connected asthma. The Veteran appealed the Board decision to the Court of Appeals for Veterans’ Claims (the Court). In August 2019, the parties to the appeal filed a Joint Motion for Remand of the Board’s decision (JMR). In a September 2019 Memorandum, the Court agreed with the parties to set aside the July 2018 Board decision and ordered further consideration and development of the claim, as appropriate. In a February 2020 remand, the Board instructed the RO to obtain an opinion regarding whether the Veteran has had intermittent use of systemic corticosteroids to treat his asthma. At the May 2020 VA examination, the examiner noted that the Veteran was treated with various medications during the appeal period but found that the Veteran had not used any oral or parenteral corticosteroids or immunosuppressive medications in the last 12 to 24 months. However, the Veteran has submitted evidence that during the appeal period, which began 2011, he has used Prednisone to treat his asthma, which the December 2017 VA examiner has defined as a systemic steroid. While further delay is regrettable, the Board finds that in order to accurately evaluate the Veteran’s service-connected asthma, remand is required to obtain an adequate opinion regarding the medications the Veteran has used during the appeal period. In order to warrant a higher rating, the Veteran must demonstrate the intermittent use of systemic corticosteroids (defined as at least three course per year). Here, the Veteran’s lay statements, to include charts outlining his treatment, and medical records indicate the use of Prednisone, Methylprednisolone, and other drugs to treat his respiratory disabilities. However, as the Veteran sought treatment for asthma along with other disabilities, such as allergies, it is unclear whether the steroids were used specifically to treat his asthma or his other unrelated disabilities. As such, remand is required to obtain an addendum opinion regarding the Veteran’s medications. The matters are REMANDED for the following action: 1. Obtain any outstanding relevant treatment records for the disability on appeal. 2. Upon completion of records development, forward the claims folder to a qualified examiner for an addendum opinion. Following a review of the claims file, the examiner should offer an opinion on whether the Veteran has had intermittent use of systemic steroids (defined as at least three courses per year) or daily use of systemic steroids or immunosuppressive medications to treat his bronchial asthma during the appeal period beginning March 2010. In rendering the above opinion, the examiner should note that the Veteran often receives treatment for his asthma in addition to other unrelated disabilities, to include allergies and GERD. In addition, the examiner should address the Veteran’s contentions that he was prescribed systemic steroids, such as Prednisone and Methylprednisolone to treat his asthma. If the examiner finds that the Veteran’s asthma required intermittent or daily use of systemic high dose corticosteroids or immunosuppressive medications as any point during the appeal period, the examiner should identify the duration of this treatment, to include the start and end dates of the specific periods of treatment for such. The need for further in-person examination is left to the discretion of the examiner. (continued on the next page) If the examiner feels that the requested opinion cannot be rendered without resorting to speculation, he or she should state whether the need to speculate is caused by a deficiency in the state of general medical knowledge (i.e., no one could respond given medical science and the known facts), by a deficiency in the record (i.e., additional facts are required), or by the examiner himself or herself (because he or she does not have the needed knowledge or training). T. MAINELLI 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.