Citation Nr: 21026560 Decision Date: 05/03/21 Archive Date: 05/03/21 DOCKET NO. 20-04 114 DATE: May 3, 2021 REMANDED Entitlement to an initial compensable rating for restrictive lung disease is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1961 to February 1963. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a May 2018 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO) granting service connection for restrictive lung disease and assigning an initial noncompensable rating. The Veteran testified at a Board hearing before the undersigned Veterans Law Judge in January 2021. The Board finds that remand is necessary to provide a new VA examination and assess the current severity of the Veteran's condition. At the Board hearing the Veteran and his wife testified that his condition has changed since the time of the most recent VA examination, including a "tremendous" decrease in ability in the last couple of years and adding that "if he does anything physical, he can't breathe." The Veteran and his wife are competent to testify to an increase in severity of symptoms associated with the Veteran's observable physical capacities, and therefore the Board finds that there is objective evidence of worsening requiring a new VA examination. 38 C.F.R. § 3.327(a); see Snuffer v. Gober, 10 Vet. App. 400, 403 (1997) (citing Allday v. Brown, 7 Vet. App. 517, 526 (1995)). The Board additionally finds that remand is needed to address whether the Veteran's restrictive lung disease has required outpatient oxygen therapy, a fact that is relevant to the rating for the Veteran's condition. See 38 C.F.R. § 4.97, Diagnostic Code 6833, General Rating Formula for Interstitial Lung Disease. The record reflects that the Veteran has a diagnosis of COPD and also has been prescribed oxygen for home use. Thus, in November 2019 and January 2020, a VA clinician was asked whether the Veteran's service-connected restrictive lung disease would require oxygen therapy at home. The clinician first opined, "The main treatment for restrictive lung disease is supportive oxygen. . . . Thus, the oxygen is issued for the restrictive lung disease," and then subsequently stated, "To opine and choose one pulmonary condition over another for the use of oxygen (when the [treating] pulmonologist stated it is unclear) would be resorting to mere speculation." Given the conflicting opinion from the same clinician, an additional opinion is necessary to address the conflict. See Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). The Board notes that the Veteran's treating pulmonologist wrote letters in February 2021 and March 2021 regarding the nature and cause of his restrictive lung disease. Because it has already been established that the Veteran has restrictive lung disease related to his military service, the current information required for purposes of the present appeal is information regarding the severity of the Veteran's condition. This may include statements discussing whether the Veteran's restrictive lung disease would require oxygen, as there is currently conflicting information regarding this issue. On remand, the Veteran is welcome to submit further statements from a clinician addressing the severity of his condition. The matter is REMANDED for the following action: 1. Schedule the Veteran for an examination regarding the current severity of his service-connected restrictive lung disease. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran's disability under the rating criteria. The examiner must also discuss whether the Veteran's existing prescription for outpatient oxygen therapy would have been required for his restrictive lung disease alone; or, alternatively, whether it cannot be differentiated whether the oxygen was required for restrictive lung disease or for COPD. 2. After the above development and any other development deemed necessary is completed, readjudicate the Veteran's claim. K. Parakkal Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Davis, 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.