Citation Nr: 21015524 Decision Date: 03/17/21 Archive Date: 03/17/21 DOCKET NO. 15-26 754 DATE: March 17, 2021 REMANDED Entitlement to service connection for a respiratory disability is remanded. INTRODUCTION The Veteran served on active duty from June 1970 to June 1974. When this case was most recently before the Board in August 2020 the above-noted issue was remanded for further development. The case has since been returned for additional appellate review. REASONS FOR REMAND Although most unfortunate and frustrating, the Board finds additional development remains necessary prior to final adjudication of the issue on appeal. When VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). Further, a remand by the Board confers upon the claimant, as a matter of law, the right to compliance with the remand instructions, and imposes upon VA a concomitant duty to ensure compliance with the terms of the remand. See Stegall v. West, 11 Vet. App. 268, 271 (1998). In this case, the Veteran has asserted he was exposed to a number of harmful substances, to include trichloroethylene, herbicides, asbestos, polychlorinated biphenyls (PCBs), metals, and petroleum/other fuel related chemicals. To date, the RO has not substantially complied with the Board’s prior instructions. In the course of the August 2020 remand, the Board concluded that based on the evidence of record to include the Veteran’s military personnel records, credible statements, and treatment records, there is a sufficient basis to support that the Veteran was exposed to asbestos and other chemicals, given his duties and circumstances as an electrician in the U.S. Coast Guard during active duty service. The Board then instructed the RO to obtain a comprehensive VA medical opinion from a respiratory specialist addressing each of the Veteran’s theories of entitlement. Thereafter, the RO obtained a cursory medical opinion from an Internal Medicine Physician, rather than a Pulmonologist, as directed. In addition, the examiner merely restated the opinion provided by the December 2019 VA examiner, as well as some other notes. The examiner then concluded the Veteran’s sleep apnea and asthma were less likely than not proximately due to his exposure to asbestos in service. The examiner wholly ignored the Veteran’s other reported chemical exposures. Based on the foregoing, the Board finds this opinion to be quite insufficient. As such, a remand is again required. Accordingly, this case is REMANDED for the following actions: Obtain an addendum medical opinion from a VA Pulmonologist with sufficient experience and expertise to provide an opinion as to the etiology of the Veteran’s claimed respiratory disorders, to include asthma, emphysema, obstructive sleep apnea, or any other respiratory disorder diagnosed in the course of this appeal period. Another examination of the Veteran must be performed only if deemed necessary by the examiner providing the opinion. In this regard, the physician must state whether the Veteran’s respiratory disorders at least as likely as not (a 50 percent probability or greater) originated during his period of active service or are otherwise etiologically related to his active service, to specifically include his conceded exposure to asbestos and other chemicals in service. The examiner must specifically address the Veteran’s lay reports relative to the nature and etiology of his claimed disability. The examiner must also provide a complete rationale for all proffered opinions. If the physician is unable to provide any required opinion, he or she should explain why. If the physician cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation as to why this is so. If the inability to provide a more definitive opinion is the result of a need for additional information, the physician should identify the additional information that is needed. T. REYNOLDS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board G. Fraser, 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.