Citation Nr: 21029047 Decision Date: 05/12/21 Archive Date: 05/12/21 DOCKET NO. 14-43 418 DATE: May 12, 2021 REMANDED Entitlement to service connection for a lung condition, to include breathing problems, as a result of chemicals and/or asbestos exposure is remanded. REASONS FOR REMAND The Veteran had active service from April 1970 to March 1972. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 2014 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO or AOJ). This case was previously before the Board in October 2018 when it was remanded for additional development. While on remand, the Veteran requested a Travel Board Hearing in February 2019 and March 2019 correspondence; however, he subsequently withdrew his request in March 2021 correspondence. This case has now returned to the Board for further appellate action. Here, the Veteran contends that he was exposed to asbestos and chemicals in-service. Specifically, he contends that his duties included working as a F-4 Phantom Jet Engine Mechanic exposed him to asbestos in the engines, hot air ducts, hydraulic fluid lines, clamps, and from insulated blankets that were on the engines and were required to be removed and replaced. The Veteran further contends that after having experienced breathing problems, he was transferred to the Spectro Oil Analysis Program (SOAP), where he tested fuel, oil, and hydraulic oil for engine wear. The Veteran contends that in the course of these duties he was exposed to chemicals to include sulfuric acid, xylene cadmium particles, ketone, toluene, acetylene, and carbon dioxide. Accordingly, the Veteran asserts that the asbestos and chemical exposure, in-service, "ruined his lungs." See Veteran's statements dated March 2013, June 2014, August 2014, October 2014, December 2014, November 2018, and March 2021. On remand, the Veteran was afforded a VA examination in November 2019 for his respiratory condition. The examiner noted a diagnosis of lung asbestos exposure and stated the Veteran's pulmonary condition included benign neoplasms. In a November 2019 opinion, the examiner opined that the Veteran's respiratory condition was less likely than not related to service. In this regard, the examiner pointed to a November 2014 CT scan which showed a pulmonary nodule, with no mention of asbestos, and a June 2017 treatment record indicating there was no diagnosis of asbestos. However, the Board cannot make a fully-informed decision on the issue of service connection for a lung condition because the November 2019 VA examiner did not opine as to whether any of the Veteran's other diagnosed respiratory conditions, to include shortness of breath, chronic obstructive pulmonary disease (COPD), emphysema, and pulmonary nodules are related to service, including as due to chemicals and/or asbestos exposure. In this regard, the record indicates that during the period on appeal, the Veteran was diagnosed with shortness of breath, see June 2015 private treatment record, and COPD, see October 2014 VA treatment record. Moreover, the physician who conducted pulmonary function test (PFT) in November 2019, noted severe decrease in diffusing capacity suggesting emphysema in the presence of an obstructive lung defect. The physician noted that the Veteran was extremely short of breath and coughed before and through test "very badly." Additionally, as indicated by the November 2019 VA examiner, the Veteran has pulmonary nodules. In light of the foregoing, the Board finds that an additional VA medical opinion is needed to determine the etiology of additional diagnosis of a lung disorder noted during the appeal period, as explained above. Additionally, the Board notes that in an October 2020 Appellate Brief, the Veteran's representative indicated that the supplemental statement of the case (SSOC) issued in July 2020, had referenced an "independent examiner" report dated July 13, 2020. However, this report is not associated with the Veteran's claims file. On remand, the AOJ should associate the July 2020 "independent examiner" report with the claims file. The matter is REMANDED for the following actions: 1. Obtain and associate with the claims file, the "independent examiner" report dated July 13, 2020, as referenced in the July 2020 SSOC. 2. Then, return the Veteran's claims file to the examiner who conducted the November 2019 VA examination for respiratory conditions so a supplemental opinion may be provided. If that examiner is no longer available, provide the Veteran's claims file to a similarly qualified clinician. A new examination (physical or telehealth) is only required if deemed necessary by the examiner. After reviewing the claims file, to include a copy of this Remand, and examining the Veteran, the examiner should address the following: (a.) Whether it is at least as likely as not (50 percent or greater probability) that the Veteran's diagnosis of shortness of breath (noted in June 2015 private treatment record, even if since resolved) had its onset in service or otherwise etiologically related to service. (b.) Whether it is at least as likely as not that the Veteran's diagnosis of COPD (noted in October 2014 VA treatment record, even if since resolved) had its onset in service or otherwise etiologically related to service. (c.) Whether it is at least as likely as not that the emphysema (indicated in November 2019 PFT results, even if since resolved) had its onset in service or otherwise etiologically related to service. (d.) Whether it is at least as likely as not that the Veteran's diagnosis of pulmonary nodules (noted by November 2019 VA examiner, even if since resolved) had its onset in service or otherwise etiologically related to service. (e.) Note - the examiner must include consideration of the Veteran's report that he had in-service exposure to asbestos and to chemicals (to include sulfuric acid, xylene cadmium particles, ketone, toluene, acetylene, and carbon dioxide). The examiner must also consider and address the Veteran's report that he had in-service breathing problems which has continued since service and has worsened. A complete rationale for all opinions must be provided. If the examiner cannot provide the requested opinion without resorting to speculation, it must be so stated, and he/she must provide the reasons why an opinion would require speculation. The examiner must indicate whether there is any further need for information or testing necessary to make a determination. Additionally, the examiner must indicate whether any opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner. 3. Then, review all medical opinions and any examination reports provided to ensure that the requested information was provided. If any report or opinion is deficient in any manner, the AOJ must implement corrective procedures. 4. Then, readjudicate the claim. If the decision is adverse to the Veteran, issue a Supplemental Statement of the Case and allow the applicable time for response. Then, return the case to the Board. T. Blake Carter Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Smith, 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.