Citation Nr: 21026391 Decision Date: 05/03/21 Archive Date: 05/03/21 DOCKET NO. 16-32 269 DATE: May 3, 2021 REMANDED Entitlement to service connection for chronic obstructive pulmonary disease (COPD), to include due to asbestos exposure and/or as secondary to service-connected pleural plaques is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1965 to September 1968. This matter comes before the Board of Veterans' Appeals (Board) from a November 2013 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The matter was previously remanded by the Board for additional development in September 2018 and January 2020. It has now returned for further appellate review. Entitlement to service connection for chronic obstructive pulmonary disease (COPD), to include due or asbestos exposure and/or as secondary to service-connected pleural plaques is remanded. While further delay is unfortunate, the Board finds that remand is once again necessary before a final determination can be made in this matter. The Veteran is seeking service connection for COPD, which he asserts is etiologically related to asbestos exposure in service or alternatively service-connected pleural plagues. The Board notes that the Veteran received VA examinations in January 2020, August 2019, August 2016, October 2013, and February 2013 regarding the nature and etiology of the Veteran's claimed COPD. Of specific note, however, in an addendum opinion from the August 2016 examiner, it was stated that as the Veteran had not been evaluated by a pulmonologist regarding whether or not the claimed COPD was due to asbestos exposure or the Veteran's history of smoking an opinion regarding etiology could not be provided without mere speculation. This statement was not addressed by the subsequent VA examiners, nor was the opinion of a pulmonologist sought as indicated by the August 2016 examiner. As the record indicates that a specialist's opinion is necessary to determine the etiology of the Veteran's claimed condition, the Board finds that remand is warranted to obtain an opinion from a pulmonologist regarding the nature and etiology of the Veteran's claimed COPD. Additionally, the Board observes that pursuant to the September 2018 remand decision, the RO was directed to obtain the Veteran's private treatment records from Dr. J.S. The RO requested a release of information from the Veteran in a May 2019 correspondence, however the records request was subsequently rejected in June 2019. As these records may be pertinent to the matter at hand, the Board finds that upon remand the RO should undertake action to obtain these records. The matter is REMANDED for the following action: 1. Ask the Veteran to complete a VA Form 21-4142 for any relevant outstanding private treatment records, to include those from Dr. J. S. Make two requests for the authorized records from any facility so identified, unless it is clear after the first request that a second request would be futile. 2. Afford the Veteran a VA examination with a pulmonologist to address the etiology of the Veteran's claimed COPD. Any and all studies, tests, and evaluations deemed necessary by the examiner should be performed. The claims file should be made available and reviewed by the examiner in conjunction with conducting the examination, and the examiner should specifically note that such review was performed. The examiner should provide an opinion regarding the following: (1) Whether it is at least as likely as not (50 percent or greater probability) that the claimed COPD was caused by the Veteran's in-service exposure to asbestos; or (2) Whether it is at least as likely as not that the Veteran's COPD is related to, caused by, or aggravated by his service-connected pleural plaques or service-connected asbestosis. NOTE: The term "aggravated" refers to any incremental increase in disability beyond the natural progression of the disease, regardless of permanence. Objective measurement, or numerical quantification, is not required to ascertain an increase in disability. (Continued on next page) The examiner must include in the medical report the rationale for any opinion expressed. However, if the examiner cannot respond to an inquiry without resort to speculation, he or she should so state, and further explain why it is not feasible to provide a medical opinion, indicating whether the need to speculate is caused by a deficiency in the state of general medical knowledge (i.e. no one could respond given medical science and the known facts) or by a deficiency in the record or in the examiner (i.e. additional facts are required, or the examiner does not have the needed knowledge or training). T. REYNOLDS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Gorum, 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.