Citation Nr: 21022935 Decision Date: 04/19/21 Archive Date: 04/19/21 DOCKET NO. 20-03 040 DATE: April 19, 2021 REMANDED Entitlement to service-connection for bronchitis, to include as secondary to the Veteran’s service-connected disabilities, is remanded. Entitlement to service-connection for chronic obstructive pulmonary disease (COPD), to include as secondary to the service-connected disabilities, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from September 1965 to July 1967. These matters come before the Board from a March 2018 decision of a Department of Veterans Affairs Regional Office (RO). The Board remanded the matter for further development in September 2020. Unfortunately, after this remand, the Veteran died. The Appellant is the Veteran’s surviving spouse, who have been granted substitution into this appeal. 1. Entitlement to service-connection for bronchitis, to include as secondary to the Veteran’s service-connected disabilities is remanded. 2. Entitlement to service-connection for chronic obstructive pulmonary disease (COPD), to include as secondary to the service-connected disabilities is remanded. The Veteran asserted that he has bronchitis and COPD as a result of exposure to burn pits and various fuels while he was serving on active duty in Vietnam. Service personnel records show that the Veteran served in the Republic of Vietnam from July 1966 to June 1967. The Veteran’s Military Occupational Specialty was Heavy Vehicle Driver. Pursuant to the Board’s September 2020 remand directives, the Veteran was afforded a November 2020 medical opinion DBQ. The examiner opined, “It is less likely than not that any diagnosed pulmonary disability had its onset in service, was aggravated by service, or is otherwise related to any incident of service, to include as a result of exposure to burn pits and fuel fumes. VA record from April 2019 documents Veteran has COPD as a result of smoking and burn pit exposure. Exposure to burn pits is acknowledged as contributor to Veteran’s COPD/bronchitis. It is known smoking is primary cause of COPD/chronic lung conditions. A negative opinion must be given because I am unable to say burn pits exposure primary reason veteran developed COPD/bronchitis.” The Board regrets the further delay but finds that remand is necessary to provide the Veteran the greatest possible consideration, in order to obtain an adequate VA medical opinion. Where VA provides a Veteran with an examination in a service connection claim, the medical opinion must be adequate. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). Here, the examiner’s opinion is inadequate as his rationale relies on the wrong standard of proof. VA law and regulations do not require that service be the primary reason for the claimed disability; it need only be a cause. Accordingly, remand is required to ensure the record contains a VA opinion that adequately addresses both the medical and lay evidence of record, and to clarify the nature and etiology of the bronchitis and COPD. McLendon v. Nicholson, 20 Vet. App. 79 (2006); 38 U.S.C. § 5103A(d)(2), 38 C.F.R. § 3.159(c)(4)(i). The matters are REMANDED for the following action: 1. The examiner must review the claims file and should note that review in the report. All findings should be reported in detail. As to the diagnoses of bronchitis and COPD, the examiner should opine whether these diagnoses had onset in service, was aggravated by service, or is otherwise related to any incident of service, to include as a result of exposure to burn pits and fuel fumes. The examiner should also opine whether it is at least as likely as not (50 percent probability or greater) that bronchitis or COPD was caused by any service-connected disabilities. The examiner should also opine whether it is at least as likely as not (50 percent probability or greater) that bronchitis or COPD had been aggravated by any service-connected disabilities. If there is an alternative etiology for any pulmonary disabilities found, the examiner should so state. The examiner is requested to discuss the treatise on burn pits submitted by the Veteran in June 2018.   The rationale for all opinions should be provided. If a full rationale or explanation cannot be provided, then the examiner should state why this is the case. The examiner should note that service need not be the only cause of these disabilities, but only that it is least as likely as not that service was a cause. Nathaniel J. Doan Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. Ottley III 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.