Citation Nr: 21021988
Decision Date: 04/14/21	Archive Date: 04/14/21

DOCKET NO. 14-43 656
DATE: April 14, 2021

REMANDED

Entitlement to service connection for a respiratory disorder, including pulmonary interstitial fibrosis and chronic obstructive pulmonary disease (COPD), is remanded.

REASONS FOR REMAND

The appellant is a Veteran who served on active duty from July 1959 to July 1963 and from September 1963 to September 1969.  

This matter comes before the Board of Veterans' Appeals (Board) by order of the United States Court of Appeals for Veterans Claims (hereinafter “the Court”) in October 2019, which granted a joint motion for remand (JMR) vacating an April 2017 Board decision and remanding the issue on appeal for additional development.  The matter initially arose from an October 2012 rating decision by the Milwaukee, Wisconsin, Regional Office (RO) of the Department of Veterans Affairs (VA).  The appeal was most recently remanded for additional development in November 2020.

1. Entitlement to service connection for a respiratory disorder, including pulmonary interstitial fibrosis and COPD, is remanded.

Although this matter has been previously remanded, the Board finds additional development is required for an adequate determination.  The issue on appeal is medically complex and prior medical opinions have addressed the Veteran’s claims as to a respiratory disorder as a result of asbestos or herbicide agent exposure during active service.  It is also noted that a June 2019 Board remand included instructions that the examiner should, if possible, determine the nature and etiology of any present pulmonary granulomas.  

A January 2021 VA medical opinion noted a review of pertinent medical literature and included a finding that the Veteran’s lung/pulmonary granulomas were likely caused by an infection of the lungs from mycobacteria or fungi.  The examiner indicated the granulomas were unlikely due to herbicide agent or asbestos exposure. However, no etiology opinion was provided as to whether an infection of the lungs from mycobacteria or fungi was manifest during or as a result of active service.  An additional clarifying medical opinion is required.

The matters are REMANDED for the following action:

Obtain an addendum opinion from an appropriate clinician clarifying whether it is at least as likely as not (a 50 percent probability or greater) that the Veteran has a chronic respiratory disorder that is related to an in-service lung infection from mycobacteria or fungi.

 

 

MICHAEL A. HERMAN

Veterans Law Judge

Board of Veterans’ Appeals

Attorney for the Board	T. Douglas

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.