Citation Nr: 21024192 Decision Date: 04/22/21 Archive Date: 04/22/21 DOCKET NO. 18-35 108 DATE: April 22, 2021 REMANDED Entitlement to service connection for sarcoidosis is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1988 to November 1990. This matter is before the Board of Veterans’ Appeals (Board) on appeal of a February 2016 rating decision of the Philadelphia, Pennsylvania, Regional Office (RO) of the Department of Veterans Affairs (VA). The Veteran appeared at a hearing before the undersigned Veterans Law Judge in November 2020. A transcript of the hearing is in the Veteran’s file. Of note, the Board recognizes that the Veteran filed a separate appeal for service connection for diabetes, stemming from a May 2019 rating decision. The Veteran has opted into the Appeals Modernization Act (AMA) review system for that issue. It will be subject to a separate appellate decision under that system. During the Veteran’s November 2020 Board hearing, he reported that while stationed at Malmstrom Air Force Base in Montana, he started experiencing respiratory problems. He noted that he was exposed to environmental hazards, to include contaminated water located in storage tanks at the Air Force Base. He also stated that his respiratory issues affected his weight. The Veteran stated that he had an appointment with VA the following day. A review of the Veteran’s claims file reveals that no VA treatment records have been associated with the claims file since January 2019. Because the VA records noted at the hearing have not been associated with the Veteran’s claims file are potentially probative and are deemed to be constructively of record, they must be obtained. Further, while on remand, the Veteran should be asked to supplement the record with information specific to the nature of the claimed exposure to contaminated water while in service. Next, the Veteran was afforded a VA examination in December 2016. The VA examiner provided a negative nexus opinion regarding whether the Veteran’s currently diagnosed sarcoidosis was related to service. However, the Board notes that in the VA examiner’s response, he indicated that he had requested medical records from Geisinger (Hospital) and the Emergency Department record in which the Veteran presented with the rib discomfort leading to a diagnosis of sarcoidosis in 2009 be sent to him. It is unclear if the VA examiner was in receipt of the records that he requested at the time of the examination. The Board finds that a remand is necessary to fully and fairly adjudicate this issue. 38 C.F.R. § 3.159(c)(4); Barr v. Nicholson, 21 Vet. App. 303 (2007). On remand, an additional medical opinion is warranted to determine if the currently diagnosed sarcoidosis disability is related to the Veteran’s military service. The matters are REMANDED for the following action: 1. The RO should invite the Veteran to submit any additional evidence in support of his claim, to include exposure to contaminated water during service. 2. Ask the Veteran to provide the names, addresses, and approximate dates of treatment of all health care providers who have treated him for his sarcoidosis disability, to include the medical records from Geisinger Hospital and the Emergency Department record in which the Veteran presented with the rib discomfort leading to a diagnosis of sarcoidosis in 2009. After securing any necessary releases, request any records identified which are not duplicates of those contained in the claims file. If any requested records are unavailable, annotate the file and notify the Veteran. 3. Obtain complete VA treatment records, dated since January 2019, from any VA medical facility at which the Veteran receives treatment. See November 2020 Board Hearing Transcript. 4. After completing any further development deemed necessary based upon the Veteran’s response to the VA inquiries noted above, schedule the Veteran for a VA examination by an appropriate medical professional to determine the nature and etiology of the diagnosed sarcoidosis disability. The entire claims file must be reviewed by the examiner. The examiner is to conduct all necessary tests and studies. (The Board recognizes the practical difficulties of scheduling an examination in view of the COVID-19 epidemic, and requests flexibility and understanding in affording the Veteran an opportunity to report for an examination.) The examiner is to provide an opinion as to whether it is at least as likely as not (a 50 percent or greater probability) that the diagnosed disability had its onset during, or is otherwise related to, the Veteran’s active service. In rendering the opinion, the examiner must consider the Veteran’s assertion of contaminant water exposure during service. The examiner must provide a comprehensive report, including complete rationales for all opinions and conclusions reached. A. C. MACKENZIE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A-L Evans, 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.