Citation Nr: 21012924 Decision Date: 03/08/21 Archive Date: 03/08/21 DOCKET NO. 18-38 645 DATE: March 8, 2021 REMANDED Entitlement to service connection for a respiratory disorder, to include asthma, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from February 1962 to July 1965. This matter comes before the Board of Veterans’ Appeals (Board) from a September 2017 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). In February 2021, the Veteran testified before the undersigned Veterans Law Judge at a virtual Board hearing. In February 2021, the Veteran submitted two articles and waived initial RO consideration of this evidence. 1. Entitlement to service connection for a respiratory disorder, to include asthma, is remanded. The Veteran relates his asthma to exposure to jet fuel and asbestos on the flight line while serving as a lineman aboard the USS Forrestal. See Hearing transcript (Tr.) at 2-3; November 2017 Notice of Disagreement (NOD); July 2017 VA Form 21-4138, Statement in Support of Claim. The Veteran asserts that his respiratory problems developed within months of leaving service. See Tr. at 4; November 2017 NOD. The August 2019 VA opinion addressing the etiology of the Veteran’s respiratory condition is inadequate for rating purposes. The examiner based his negative opinion on the lack of documented treatment for a respiratory condition in service and post-service until September 2013. The examiner reasoned that because the Veteran did not seek care for a respiratory condition until 2013, it could not be related to service. The examiner, however, failed to consider the Veteran’s competent and credible assertions that he experienced hyperventilation on the flight line when was exposed to jet fuel, exhaust, and asbestos; that he developed respiratory problems during service that worsened shortly after separating; and that he has seen doctors for his respiratory problems since 1966. See Tr. at 3-4; November 2017 NOD. The examiner also did not discuss the effect asbestos exposure could have on his respiratory disability. Thus, remand is warranted to obtain an addendum opinion, which also considers the articles recently submitted by the Veteran. Updated VA and private treatment records should also be secured. The matters are REMANDED for the following action: 1. Obtain any outstanding VA treatment records. 2. With any necessary assistance from the Veteran, secure outstanding relevant private treatment records. 3. Then refer the claims file to the examiner who completed the August 2019 medical opinion for preparation of an addendum opinion as to the etiology of the Veteran’s respiratory disability, to include asthma. No additional examination is necessary unless the examiner deems otherwise. After reviewing the claims file, the examiner should address the following: (a). Please identify all respiratory disorders present since May 2017, even if resolved. If diagnoses of chronic obstructive pulmonary disease (COPD), asthma or bronchitis are not warranted, please explain this conclusion in light of the diagnoses of the same in the Veteran’s VA treatment records and the September 2019 VA examination. (b). For each disability so identified, please opine as to whether it is at least as likely as not (50 percent probability or greater) that such disability had its onset in service or is otherwise related to service, to include (but not limited to) as a result of the Veteran’s conceded exposure to jet fuel, jet engine exhaust fumes, and asbestos therein. In addressing this question, please consider, accept as true, and discuss the following: (1). The Veteran’s February 2021 hearing testimony about his work on the flight line. Specifically, the Veteran testified that he was not issued personal protective equipment; that he was close to planes taking off and landing all day long; that he worked so closely with the fuel lines that they burned the hair off his legs; that breathing in the fumes on the ship caused him to hyperventilate; that he began experiencing respiratory problems within months of leaving service; and that he was diagnosed with adult-onset asthma in the late 1960s. See Hearing transcript at 1-10. (2). The Veteran’s statements that his respiratory disorder began during service, worsened shortly after separation, and has required treatment by doctors since 1966. See November 2017 NOD. (3). The Veteran’s conceded exposure to asbestos and jet fuel aboard the USS Forrestal. See November 2017 NOD; July 2017 Statement in Support of Claim. As the Board has deemed the Veteran a credible historian of his respiratory condition, the examiner must assume the above statements in paragraphs (a), (b), and (c) as true, even despite the absence of objective documentation, and determine whether a nexus between the Veteran’s respiratory diagnosis and service is “medically plausible” based on the same. Failure to accept these statements as true will render the opinion inadequate. (4). Articles submitted by the Veteran, to include OSHA Fact Sheet, Do You Have Work-Related Asthma?; Toxicologic Assessment of Jet-Propulsion Fuel 8 (2003) (please specifically discuss the study noted on page 45 regarding “[r]ecent case reports suggest that prolonged exposure to kerosene vapors may result in development of asthma and other respiratory tract symptoms”); and Occupational Asthma. (5) The October 1963 service treatment record (STR) indicating a two-week sore throat and November/December 1964 STR indicating a chest cold, sore throat, swollen and inflamed throat, and productive cough. The examiner should opine whether these in-service symptoms could in any way be related to the development of the Veteran’s respiratory condition, to include asthma, and the diagnosis of adult-onset asthma the Veteran received in the late 1960s that he is competent and credible to report, and that the examiner must accept as true. A complete rationale must be provided for all opinions expressed. Failure to do so will render the opinion inadequate. If the requested opinion cannot be provided without resort to speculation, the examiner should so state and explain why an opinion would be speculative. S. BUSH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. deBruyn, 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.