Citation Nr: 21028462 Decision Date: 05/11/21 Archive Date: 05/11/21 DOCKET NO. 09-29 500 DATE: May 11, 2021 ORDER Service connection for a lung disorder, diagnosed as dyspnea, is granted. FINDING OF FACT The Veteran's lung disorder, diagnosed as dyspnea, began during active service. CONCLUSION OF LAW Resolving reasonable doubt in the Veteran's favor, the criteria for service connection for a lung disorder, diagnosed as dyspnea, are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January 1974 to January 1983. This appeal was most recently before the Board in December 2020, at which time the Board directed the Agency of Original Jurisdiction (AOJ) to associate with the claims file VA treatment records from February 10, 2020 to the present. The requested VA treatment records have been associated with the claims file. Therefore, there has been substantial compliance with the December 2020 Board remand directives. Stegall v. West, 11 Vet. App. 268, 271 (1998). Service connection for a lung disorder, diagnosed as dyspnea, is granted. The Veteran claims entitlement to service connection for a lung disorder as a result of his military service, to include his service in the Persian Gulf. In a statement received by VA in March 2008, the Veteran noted that he served in Kuwait and Egypt and was exposed to environmental hazards which led to his breathing problems, including shortness of breath. During his March 2013 Board hearing, the Veteran testified that he experienced trouble breathing when he was stationed in the desert, and that he was given inhalers during service to treat his symptoms. See March 2013 Hearing Transcript, pp. 6-7. He stated that his problems continued thereafter. The Board concludes that the Veteran has a current disability that began during active service. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). The evidence in favor of the claim includes an October 2017 VA respiratory conditions examination showing that the Veteran was diagnosed with dyspnea and noted that the date of diagnosis was in 1982 (during active service). The Veteran's service treatment records indicate that on February 6, 1974, he was seen for upper respiratory infection for three days with wheezing on inspiration. The assessment was common cold, possible pneumonia. On January 23, 1978, the Veteran presented with complaints of chest pain and "hyper" after a road march. The Veteran reported previous episodes of chest pain after physical exertion. The chest pain was described as knife-like mid sternal pain followed by rapid breathing and weakness. On physical examination, the Veteran was pale, and his respiration was shallow and rapid with mild carpal spasm. After brown bag breathing, the Veteran noted improvement. On November 14, 1995, while deployed to Egypt, the Veteran was seen for non-resolving chest discomfort. The Veteran complained that it was still hard to breathe, that he was awakened during the night by shortness of breath but not pain. The Veteran was seen later that day with complaints of chest pain for two days; he reported shortness of breath and chest tightness and noted that it hurt to breathe in, but exhalation did not worsen the pain. The provider noted that the Veteran gave extremely vague symptoms of his breathing being "hard" and could not describe it any better. There was no history of asthma. The assessment was shortness of breath. The evidence against the claim includes multiple VA examinations noting that the Veteran did not have a respiratory disability. However, those VA examination reports were previously found inadequate by the Board. Pursuant to the April 2020 Board remand, the Veteran underwent a VA examination in July 2020. The examiner opined that the Veteran's complaints of shortness of breath were less likely than not related to service, to include as a result of an undiagnosed illness resulting from his Persian Gulf service. The examiner noted that based on a review of the service treatment records and a phone interview, there was no objective evidence of pulmonary functional impairment related to the Veteran's shortness of breath because prior pulmonary function tests were normal. The July 2020 VA examiner also opined that the Veteran's shortness of breath does not represent an undiagnosed illness or medically unexplained chronic multi-symptom illness related to his service in Southwest Asia. The examiner explained that possible etiologies include diagnosed sleep apnea, extreme obesity and related deconditioning, and coronary artery disease. The examiner noted that a diagnostic work up of the Veteran's shortness of breath was encouraged, then stated that it was beyond the scope of the VA examination to complete such a workup. The examiner recommended that the Veteran follow up with his primary care physician. The Board finds that the July 2020 medical opinion is inadequate for adjudication purposes. In the April 2020 remand, the Board explained that prior VA examination opinions were inadequate because they failed to include any discussion of the November 1995 service treatment records noting the Veteran's report of shortness of breath, chest tightness, and diagnosis of mild reactive airway disease. The remand instructed that the VA examiner consider the full record, to include any lay statements from the Veteran concerning the onset and continuity of his symptoms; his January 1978 and November 1982 in-service complaints of chest pain on exertion; the November 1995 service treatment records that note his report of shortness of breath and chest tightness that worsened as well as the diagnosis of mild reactive airway disease; and the September 2002 and October 2004 VA treatment records that note his report of shortness of breath after returning from Egypt. The July 2020 VA examiner did not discuss in-service complaints, findings, or diagnoses; lay statements regarding continuity; or post-service treatment records. Based on the foregoing, and upon review of the record, the Board finds the evidence to at least be in equipoise as to whether the Veteran's current lung disorder, diagnosed as dyspnea, arose in service. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for a lung disorder, diagnosed as dyspnea, is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. The appeal is granted. J. Ragheb Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board E.O., 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.