Citation Nr: 21022582 Decision Date: 04/16/21 Archive Date: 04/16/21 DOCKET NO. 16-40 438 DATE: April 16, 2021 REMANDED Entitlement to service connection for respiratory condition, to include asthma, as due to exposure to asbestos, lead paint, and harmful fumes is remanded. REASONS FOR REMAND The Veteran served in the United States Navy on active duty from July 1964 to July 1966. The issues come before the Board of Veterans’ Appeals (Board) on appeal from a June 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a hearing before the undersigned Veterans Law Judge in September 2019. A transcript of the hearing has been included with the record. These matters were previously before the Board in January 2020. The Board remanded to afford the Veteran a VA examination. The Board again remanded in October 2020 to provide an addendum opinion regarding the Veteran’s in-service asbestos exposure. Although the Board regrets further delay, another remand is necessary to provide the Veteran with every possible consideration. Further development is necessary prior to appellate review to provide the Veteran with an adequate VA medical addressing all raised contentions. Entitlement to service connection for respiratory condition, to include asthma, as due to exposure to asbestos, lead paint, and harmful fumes is remanded. In January 2021, the Veteran submitted a statement in support of his claim, raising the contention that his respiratory condition is related to his active duty service aboard the U.S.S. Randolph. Specifically, the Veteran noted that he was exposed to asbestos, lead based paint, and harmful fumes from aircraft and other machinery. The Board must consider all theories of entitlement either expressly raised by the claimant or which are reasonably raised by the record. See Robinson v. Shinseki, 557 F.3d 1355, 1362 (Fed. Cir. 2009). VA’s duty to assist includes obtaining a medical opinion when such an examination or opinion is necessary to make a decision on the claim. 38 U.S.C. § 5103A. Without a medical opinion that clearly addresses the relevant facts and medical science, the Board is left to rely on its own lay opinion, which it is forbidden from doing. Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). The record contains medical opinions addressing the Veteran’s asbestos exposure, but is absent of a medical opinion addressing the Veteran’s new raised contentions regarding lead paint and harmful fumes exposure. Here, an addendum opinion is required to address the Veteran’s contentions that his in-service exposures to lead based paint and harmful fumes are related to his present respiratory condition, to include asthma. Additionally, the February 2020 and February 2021 VA examiners address the Veteran’s pulmonary records from 2017, to include the Veteran’s February 2017 chest computer tomography (CT) scan. These imaging reports are not associated with the Veteran’s file and will need to be obtained for the record. The matters are REMANDED for the following action: 1. Obtain and associate with the Veteran’s electronic claims file any outstanding VA treatment records, to include the Veteran’s February 2017 chest CT scan. 2. After all outstanding records have been associated with the claims file, obtain an addendum opinion addressing the etiology of the Veteran’s respiratory condition related to his claimed in-service exposure to lead paint and harmful fumes. If the examiner deems it necessary, afford the Veteran a VA examination. The examination may be conducted via telehealth or similar service during the social distancing restrictions of the COVID-19 pandemic. Provide the claims file, including a copy of this REMAND, to the examiner for review. Following a review of the evidence of record, the examiner must opine as to whether it is at least as likely as not (50 percent probability or more) that the Veteran’s respiratory condition, to include asthma, is otherwise etiologically related to in-service exposure to lead paint or harmful fumes. The examiner must provide a comprehensive report including a clearly stated rationale for any opinions offered and conclusions reached, citing the objective medical findings leading to the conclusions, and must not be based solely on the lack of records. In this regard, the Board emphasizes that the Veteran is competent to report his symptoms and history, and such statements by the Veteran regarding symptomatology and medical history must be specifically acknowledged and considered in formulating any opinions concerning the onset and severity of his disability. If such reports are rejected by the examiner, a reason for doing so must be provided. JENNIFER HWA Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A.V. Bona, 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.