Citation Nr: 21026784 Decision Date: 05/04/21 Archive Date: 05/04/21 DOCKET NO. 18-00 322 DATE: May 4, 2021 REMANDED Entitlement to service connection for a respiratory disorder, to include as due to an undiagnosed illness, is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1992 to July 2014. This matter comes before the Board of Veterans' Appeals (Board) on appeal of a September 2015 rating decision. In January 2021, the Veteran testified at a virtual hearing before the undersigned Veterans Law Judge. A transcript of the hearing has been associated with the record. The Veteran contends that he has a respiratory disorder that developed as a result of exposure to burn pits during service. During the January 2021 Board hearing, the Veteran reported that he experiences chronic shortness of breath, and that he started to notice symptoms of a respiratory disorder when he returned from deployments that took place in 2005 and 2008. The Veteran's service treatment records reflect that he was deployed to Iraq in 2005, Southwest Asia in 2007, and Iraq and Kuwait in 2008. His deployment assessments note that he was exposed to smoke from burning trash, vehicle and exhaust fumes, and sand or dust. June 2005 Emergency Nursing Records from Camp Bucca, Iraq, document that the Veteran sought treatment for shortness of breath, and that he was unable to take deep breaths, however the examiner did not note any respiratory diagnosis related to these symptoms. The Veteran also denied having any difficulty breathing during his service post-deployment assessments, however, service treatment records show that he was diagnosed with upper respiratory infections in July 2011, December 2013, and May 2014. In a June 2015 VA examination, the Veteran was noted to have a diagnosis of chronic obstructive pulmonary disease (COPD) which was diagnosed in April 2005; however, the record does not contain any evidence of this diagnosis. During the examination, the Veteran reported that his respiratory condition onset in 2005. A May 2015 chest x-ray taken of the Veteran was normal. In a September 2015 VA medical opinion, the examiner concluded that it was less likely than not that the Veteran's respiratory disability, diagnosed as COPD, was related to a specific exposure event experienced during service. The examiner explained that the post-deployment assessments were silent for evidence of a respiratory condition and that the records showing respiratory infections during service did not show residuals. The examiner also noted that based on the VA examination, the Veteran's condition began in 2005 prior to deployment, and that there was no evidence of any aggravation in service. The Board finds this opinion is inadequate as it is unclear from the record whether the Veteran was diagnosed with any respiratory condition, including COPD, in 2005. Moreover, the opinion incorrectly noted that the Veteran's condition onset prior to his deployment, however, a January 2006 post-deployment assessment shows that the Veteran's deployment to Iraq began in June 2005. As noted above, in June 2005, the Veteran sought treatment for shortness of breath during his deployment. Accordingly, a remand is necessary to obtain a new examination and medical opinion that addresses the nature and etiology of any respiratory condition the Veteran may have. The Board also notes that the Veteran testified that he sought treatment through TRICARE. On remand, the AOJ should attempt to obtain these outstanding medical records. The matter is REMANDED for the following action: 1. The Agency of Original Jurisdiction (AOJ) should request that the Veteran provide the names and addresses of any and all health care providers who have provided treatment for a respiratory disorder. After acquiring this information and obtaining any necessary authorization, the AOJ should obtain and associate these records with the claims file. The AOJ should also secure any outstanding VA medical records or any relevant TRICARE treatment records. 2. After the above development has been completed, the Veteran should be afforded a VA examination to determine the nature and etiology of any respiratory disorder that may be present. Any and all studies, tests, and evaluations deemed necessary by the examiner should be performed. The examiner is requested to review all pertinent records associated with the claims file, including the Veteran's service treatment records, post-service medical records, and assertions. The examiner should note that the Veteran is competent to attest to factual matters of which he has first-hand knowledge. If there is a medical basis to support or doubt the history provided by the Veteran, the examiner should state this with a fully reasoned explanation. The examiner should provide an opinion as to whether it is at least as likely as not (i.e. 50 percent or greater probability) that the Veteran has a respiratory disorder that is causally or etiologically related to his military service, to include any environmental exposures therein. If the Veteran has any symptomatology that is not attributable to a known clinical diagnosis, the examiner should indicate whether the Veteran has objective indications of a chronic disability resulting from an undiagnosed illness or medically unexplained chronic multisymptom illness, as established by history, physical examination, and laboratory tests. If so, the examiner should also comment on the severity of the symptomatology and report all signs and symptoms necessary for evaluating the illness under the rating criteria. In rendering this opinion, the examiner should address the Veteran's contentions that his exposures during service contributed to the onset of his current respiratory symptoms. The examiner should also consider and address the June 2005 treatment records from Camp Bucca that document shortness of breath and difficulty breathing, as well as the July 2011, December 2013, and May 2014 service treatment records that document upper respiratory infections. The examiner must provide a complete rationale for any opinions provided. Any opinion offered must take into account the Veteran's history and contentions. The medical reasons for accepting or rejecting the Veteran's statements should be set forth in detail. 3. The AOJ should conduct any other development that may be indicated as a consequence of the actions taken in the preceding paragraphs. T. MAINELLI Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Saikh, 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.