Citation Nr: 21012191 Decision Date: 03/03/21 Archive Date: 03/03/21 DOCKET NO. 14-41 058A DATE: March 3, 2021 REMANDED Entitlement to service connection for the Veteran’s respiratory disability, to include asthma, is remanded. REASONS FOR REMAND The Veteran served honorably in the U.S. Air Force on Active Duty for Training (ACDUTRA) from May 2006 to July 2006. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from rating decisions issued in April 2012 and May 2013 by a Department of Veterans Affairs (VA) Agency of Original Jurisdiction (AOJ). The Veteran testified before the undersigned at a hearing held in September 2019; a transcript of that hearing is of record. In November 2019, the Board remanded this appeal for further development, including scheduling the Veteran for a VA examination to evaluate his respiratory condition. However, for the reasons set forth below, to the extent that the January 2020 VA examination report failed to include the directed discussions, substantial compliance with the Board’s November 2019 Remand directives has not occurred; accordingly, the Veteran’s service connection claim for a respiratory disability must once again be remanded for further development. See Stegall v. West, 11 Vet. App. 268, 271 (1998); see also Dyment v. West, 13 Vet. App. 141, 146-47 (1999). Entitlement to service connection for the Veteran’s respiratory disability, to include asthma, is remanded. Unfortunately, the Veteran’s service connection claim for a respiratory disability must be remanded for further development. Although the Board sincerely regrets the additional delay, it is necessary to ensure that there is a complete record upon which to decide the Veteran’s claim so that he is afforded every possible consideration. The Veteran contends that his current respiratory disability is causally related to his military service, and that his pre-existing respiratory condition was permanently worsened and aggravated during his 2006 basic military training which involved strenuous physical exercise. As noted above, the Board previously remanded the Veteran’s claim in December 2019 for further development, to include obtaining a VA medical opinion. In offering these opinions, the examiner was asked to comment on the following evidence: (a) The July 2006 memorandum relating to the Veteran’s military discharge due to his asthma; (b) The private treatment records from LSU Health Sciences Center submitted in March 2012; (c) The June 2012 private medical opinion provided by the Veteran’s primary care physician (Dr. B), along with Dr. B’s February 2013 addendum opinion; (d) The November 2012 VA examination and opinion; and (e) The Veteran’s testimony as to the nature of his asthma as a child, directly before service and during service. Although the directed VA examination report was obtained in January 2020, the Board notes that the report fails to address the following evidence of record as directed: (1) the Veteran’s private treatment records from LSU Health Sciences Center submitted in March 2012; (2) Dr. B’s June 2012 private medical opinion; (3) Dr. B’s February 2013 private addendum opinion; (4) the November 2012 VA examination report; and (5) the Veteran’s testimony as to the nature of his asthma as a child, directly before service and during service. Accordingly, the Veteran’s service connection claim for his respiratory disability must be remanded for an additional medical opinion in compliance with the Board’s November 2019 Remand directives. See Stegall, 11 Vet. App. at 271; see also Barr v. Nicholson, 21 Vet. App. 303, 310-11 (2007). Accordingly, this matter is REMANDED for the following action: 1. Obtain any outstanding private or VA treatment records and associate all such records with the electronic claims file. The AOJ should undertake the appropriate efforts to obtain and associate with the claims file any outstanding service treatment records, as well as any relevant and outstanding VA or private treatment records. If any records sought are not obtained, a written statement to that effect should be incorporated into the record. 2. After the above development and any additionally indicated development has been completed, forward the claims file to an appropriate examiner to determine the nature and etiology of the Veteran’s current respiratory disability. 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. a) The examiner is asked to determine whether it is at least as likely as not (50 percent probability or greater) that the Veteran’s asthma was aggravated by the Veteran’s period of active service. Aggravation indicates a permanent worsening of the underlying condition as compared to an increase in symptoms. b) If aggravation is found, the examiner should attempt to quantify the extent of additional disability resulting from the aggravation and opine whether it is clear and unmistakable that any permanent worsening was due to the natural progress of the disease. The examiner must comment on the following evidence of record: (1) The July 2006 memorandum relating to the Veteran’s military discharge due to his asthma; (2) The private treatment records from LSU Health Sciences Center submitted in March 2012; (3) The June 2012 private medical opinion provided by Dr. B, along with Dr. B’s February 2013 addendum opinion; (4) The November 2012 VA examination and opinion; and (5) The Veteran’s testimony as to the nature of his asthma as a child, directly before service and during service. (Continued on the next page)   The examiner must include a rationale with all opinions, citing to supporting clinical data/medical literature as appropriate. H. SEESEL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board H. Marsdale 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.