Citation Nr: 21029500 Decision Date: 05/13/21 Archive Date: 05/13/21 DOCKET NO. 16-17 857 DATE: May 13, 2021 REMANDED Entitlement to service connection for asthma is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from June 1967 to June 1970 with combat in Vietnam. In October 2019 the Veteran testified before the undersigned Veterans Law Judge (VLJ) in a Videoconference Hearing. A transcript of that proceeding has been prepared and has been associated with the file. This issue was last before the Board in October 2019 when it was remanded for a medical opinion. The Board finds that its remand directives were not fully complied with and another remand is necessary for the adjudication of the appeal. Stegall v. West, 11 Vet. App. 268 (1998). Entitlement to service connection for asthma is remanded. As noted above, the Board sought a nexus opinion regarding the Veteran's service connection claim for asthma. The Board directed the examiner to address the lay evidence of record, specifically, the Veteran's brother's and sister's lay statements, as well as review the claims file. In neither the December 2019 negative nexus opinion nor the August 2020 negative nexus addendum opinion, was the lay evidence addressed. A remand by the Board imposes upon the Secretary of VA a concomitant duty to ensure compliance with the terms of the remand. Where remand orders of the Board are not complied with, the Board errs in failing to ensure compliance. Stegall v. West, 11 Vet. App. 268 (1998). Moreover, the examiner determined that the earliest diagnosis of asthma was in 2006 when the previous VA examiner noted it was in 2004 and the medical evidence of record shows complaints of asthma and wheezing as early as 1980. For an opinion to be adequate, it must include consideration of the Veteran's statements, be based on accurate factual premises, and contain a rationale sufficient to support its conclusions. See Barr v. Nicholson, 21 Vet. App. 303, 311 (2007) (When VA undertakes to provide a VA examination or obtain a VA opinion, it must ensure that the examination or opinion is adequate); see also Kowalski v. Nicholson, 19 Vet. App. 171, 179 (2005) (a VA examination must be based on an accurate factual premise). The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination for his diagnosed asthma. The examiner must review the claims file, to include the Veteran's testimony before the undersigned Veterans Law Judge. The examiner is asked to provide a response to the following: Is the Veteran's asthma at least as likely as not related to service, including his testimony that he had an asthma attack after inoculations and after going through the gas chamber in basic training and that it has continued since then, requiring treatment? The Board draws the examiner's attention to the medical evidence of record showing that the Veteran had asthma in a March 1987 treatment note and gets attacks every once in a while, with the last attack "6 7 years ago." The Board draws the examiner's attention to the lay evidence of record. The Veteran's brother wrote that the Veteran told him he "suffered a severe breathing reaction" after he received his inoculations at Fort Leonard Wood, Missouri. The Veteran's sister wrote that his asthma symptoms started after his military service and have continued ever since then. The examiner should elicit a full history from the Veteran and consider the lay statements of record. The Veteran is competent to attest to factual matters of which he has first-hand knowledge, and if there is a medical basis to support or doubt the history provided by the Veteran, and the other lay evidence of record, the examiner should provide a fully reasoned explanation. A rationale for all opinions expressed is requested as adjudicators are precluded from making any medical findings. T. REYNOLDS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board L. Nelson 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.