Citation Nr: 21014548 Decision Date: 03/15/21 Archive Date: 03/15/21 DOCKET NO. 15-37 460 DATE: March 15, 2021 REMANDED Entitlement to a compensable rating from August 15, 2012, a rating in excess of 30 percent from July 10, 2014, and a rating in excess of 60 percent from October 9, 2020 for chronic bronchitis with asthma is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Army from August 1997 to September 2000. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a July 2013 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Waco, Texas. The RO, in pertinent part, granted service connection and a 0 (zero) percent (noncompensable) rating for chronic bronchitis, effective August 15, 2012. The issue on appeal was previously before the Board in August 2018 and September 2020, when it was remanded to the agency of original jurisdiction (AOJ) for additional development. In April 2020, after taking further action, the AOJ granted service connection for asthma and evaluated that condition together with bronchitis as 30 percent disabling, effective July 10, 2014. In October 2020, the AOJ further increased the rating to 60 percent, effective October 9, 2020. Although the Board regrets the additional delay, another remand is necessary to ensure that there is a complete record on which to decide the Veteran’s claim. Entitlement to a compensable rating from August 15, 2012, a rating in excess of 30 percent from July 10, 2014, and a rating in excess of 60 percent from October 9, 2020 for chronic bronchitis with asthma is remanded. Under 38 C.F.R. § 4.97, Diagnostic Code 6602, a 100 percent rating is warranted if Forced Expiratory Volume in one second (FEV-1) is less than 40 percent predicted, or; the ratio of Forced Expiratory Volume in one second to Forced Vital Capacity (FEV-1/FVC) is less than 40 percent, or; if there is more than one attack per week with episodes of respiratory failure, or; the condition requires daily use of systemic (oral or parenteral) high dose corticosteroids or immunosuppressive medications. Private treatment records from a Dr. P. indicate that the Veteran was prescribed Dulera Aerosol, 100-5 MCG/ACT, 2 puffs, inhaled twice daily, beginning as early as July 10, 2014. On June 9, 2015, the dosage was changed to 200-5 MCG/ACT at the same frequency. It is unclear from the record whether this medication constitutes a “high dose corticosteroid or immunosuppressive medication” as that term is used in the regulation and, if so, how long the Veteran’s use of the medication continued. Clarification of that matter is required. This matter is REMANDED for the following action: 1. Ask the Veteran to indicate when he began to use Dulera Aerosol, and to indicate how long he used it and whether he uses it presently. The response received should be associated with the claims file. 2. Ask the Veteran to provide a release for any medical records that might demonstrate his continued use of Dulera Aerosol beyond June 9, 2015. If he provides the necessary release(s), assist him in obtaining the records identified, following the procedures set forth in 38 C.F.R. § 3.159. Any new or additional (i.e., non-duplicative) evidence received should be associated with the record. If any of the records sought are not available, the record should be annotated to reflect that fact, and the Veteran and his representative should be notified. 3. Obtain copies of records pertaining to any VA treatment the Veteran has received since the time that such records were last procured, following the procedures set forth in 38 C.F.R. § 3.159. The evidence obtained, if any, should be associated with the record. 4. Make arrangements to provide the record on appeal to a qualified clinician for purposes of obtaining an opinion as to whether Dulera Aerosol, 100-5 MCG/ACT and/or 200-5 MCG/ACT constitutes a “high dose corticosteroid or immunosuppressive medication.” A complete rationale should be provided. 5. After completing the above, and any other development as may be indicated by any response received as a consequence of the actions taken in the preceding paragraphs, the issue on appeal should be readjudicated based on the entirety of the evidence. If any benefit sought remains denied, the Veteran and his representative should be issued a supplemental statement of the case. An appropriate period of time should be allowed for response. DAVID A. BRENNINGMEYER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Joseph T. Leonard, Law Clerk 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.