Citation Nr: 21011483 Decision Date: 03/01/21 Archive Date: 03/01/21 DOCKET NO. 14-19 333 DATE: March 1, 2021 REMANDED Entitlement to service connection for a lung disability, other than lung cancer, to include as due to exposure to herbicides or aviation fuel, or as secondary to his service-connected degenerative arthritis of the lumbosacral spine with degenerative disc disease is remanded. REASONS FOR REMAND The Veteran had active duty military service from November 1965 to November 1972. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a January 2012 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). The claim was previously before the Board in November 2019. The November 2019 Board decision reopened the claim of entitlement to service connection for a lung condition, other than lung cancer, and remanded the issue for an addendum VA medical opinion on the etiology of his diagnosed centrilobular emphysema. The Board finds that the remand directives were not substantially complied with and an additional remand is required. Once VA undertakes the effort to provide an examination when developing a service connection claim, it must provide one that is adequate for purposes of the determination being made. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). The Board specified that the examiner must provide an opinion that included the Veteran’s theory of causation by exposure to aviation fuel. No opinion was provided that addressed the Veteran’s theory regarding aviation fuel exposure. Additionally, the remand directives specified that the examiner must provide an opinion that included the Veteran’s theory of causation by exposure to herbicides. The examiner opined that the Veteran’s centrilobular emphysema was less likely than not caused by Agent Orange exposure. The rationale provided was that Agent Orange exposure has not been associated with the development of centrilobular emphysema and a review of the Veteran’s medical records does not provide any documentation that he complained of, or was treated for, centrilobular emphysema during service. Other than a lack of records, no other rationale was provided. Therefore, the Board finds the opinion insufficient for VA adjudication purposes and a remand for an additional opinion is necessary. See Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). Although the Board regrets the additional delay, because there was not substantial compliance with the remand directives, another remand is necessary to obtain adequate medical opinions that address the Veteran’s contentions. Stegall v. West, 11 Vet. App. 268, 271 (1998). The matter is REMANDED for the following actions: 1. Obtain an addendum opinion from an appropriate clinician addressing the etiology of the Veteran’s centrilobular emphysema. It is left to the examiner’s discretion whether to perform an in-person examination of the Veteran. The examiner is requested to review all pertinent records associated with the claims file, including the Veteran’s service treatment records, post-service medical records, and assertions. Specifically, the examiner is asked to address: (a.) Whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s centrilobular emphysema had its onset during service or is causally or etiologically due to service, to include specifically addressing the Veteran’s contentions regarding exposure to aviation fuel. (b.) Whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s centrilobular emphysema had its onset during service or is causally or etiologically due to service, to include specifically addressing the Veteran’s contentions regarding exposure to herbicides, including Agent Orange. The examiner is asked to provide a complete rationale for any opinion offered. H.M. WALKER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Krista Johnson, 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.