Citation Nr: 21022619
Decision Date: 04/16/21	Archive Date: 04/16/21

DOCKET NO. 06-09 893
DATE: April 16, 2021

REMANDED

Entitlement to service connection for a pulmonary/respiratory disorder claimed as due to in-service asbestos exposure is remanded.

REASONS FOR REMAND

The Veteran served on active duty from October 1956 to October 1960 in the United States Navy. The Veteran also served on active duty from November 1962 to December 1979 in the United States Coast Guard.

This case originally came before the Board of Veterans’ Appeals (Board) on appeal from a May 2005 rating decision issued by a Regional Office (RO) of the Department of Veterans Affairs (VA).

This case has a lengthy procedural history, and it was most recently remanded by the Board in April 2018. The Board remanded the claim for a VA addendum opinion by a pulmonologist. In October 2020, the Veteran was afforded a VA addendum opinion by a VA physician; however, the evidence of record indicates that this physician specialized in family medicine rather than pulmonology. Accordingly, the Board finds that the RO did not substantially comply with the Board’s April 2018 remand directives, and another remand is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). 

The matters are REMANDED for the following action:

1. Obtain an addendum medical opinion from a pulmonologist regarding the nature and etiology of the claimed lung condition. The claims file and copies of all pertinent records must be reviewed by the examiner in conjunction with the examination.

Following the review of all records, the examiner should provide an opinion clarifying the following:

Is there an appropriate diagnosis for the respiratory/pulmonary pathology claimed by the Veteran?  Please indicate the symptomatology and onset date associated with any diagnosed pulmonary or respiratory disorder. The clinical significance of all in-service and post-service imaging, pulmonary function tests, and other relevant testing should be discussed. The examiner must explain what is meant by granulomatous disease, caseated lesions, a mild restrictive pulmonary deficit, a nodular opacity in the right lung, changes to scarring in both lungs, mild restrictive lung disease, bilateral small nodules and small focal areas of opacity, a right lower lobe parenchymal density, mild obstruction with significant bronchodilator responsiveness (BDR), minimal chronic interstitial finds mid and lower lungs bilaterally, and minimal chronic pleural thickening lung apices vis-à-vis the Veteran’s claimed asbestosis or any other diagnosable pathology.

For any diagnosed respiratory/pulmonary condition, the examiner should opine as to whether the condition at least as likely as not (a 50 percent or greater probability) arose during or as a result of his active service, including any in-service asbestos exposure.

All opinions provided must be thoroughly explained, and an adequate rationale for any conclusions reached must be provided. If any requested opinion cannot be provided without resorting to speculation, the examiner should state and explain why an opinion cannot be provided without resorting to speculation.

An in-person examination is not required unless accurate diagnoses and opinions cannot be provided without an in-person examination.

 

 

K. Anderson

Acting Veterans Law Judge

Board of Veterans’ Appeals

Attorney for the Board	E. Hicks, 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.