Citation Nr: 21029608 Decision Date: 05/14/21 Archive Date: 05/14/21 DOCKET NO. 13-11 752A DATE: May 14, 2021 REMANDED Entitlement to service connection for bronchial asthma is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from September 1955 to May 1959. This matter initially came before the Board of Veterans' Appeals (Board) on appeal from a December 2011 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In April 2017, the Board remanded this case to schedule a hearing. In September 2018, the Veteran testified at a hearing before the undersigned Veterans Law Judge. The Board remanded the case again in March 2019 and July 2020 for further development. Entitlement to service connection for bronchial asthma is remanded. While the Board sincerely regrets further delay, a fully-informed decision on the issue of entitlement to service connection for bronchial asthma can not be made because there has not been substantial compliance with the Board's remand directives. See Stegall v. West, 11 Vet. App. 268 (1998). In July 2020, the Board remanded this case to obtain an addendum opinion by a physician (M.D.) that specializes in respiratory conditions. The Veteran was afforded an addendum opinion in January 2021. Although, the examiner was a physician (M.D.), her specialty was in internal medicine, not respiratory conditions. Thus, a remand is necessary to obtain an addendum opinion by a physician (M.D.) who specializes in respiratory conditions (i.e. a pulmonologist). Additionally, the July 2020 remand found there were outstanding VA treatment records from the 1980s. At the October 2019 VA examination, the Veteran reported that "he started going to the VA in West VA in the 1980s and was diagnosed with chronic bronchitis." The Board remanded this case to have the VA ask the Veteran for information regarding outstanding records and to obtain these records. However, the VA only asked the Veteran to provide information regarding private treatment records. There is no evidence in the record that the VA tried to procure VA treatment records from the 1980's. The matters are REMANDED for the following action: 1. Ask the Veteran to identify the names, addresses, and approximate dates of treatment for all VA and non-VA health care providers who treated him from discharge until the present for the claimed respiratory disability including the VA facility that diagnosed him with chronic bronchitis in the 1980s as reported at the October 2019 VA examination. With any necessary authorization from the Veteran, the RO should attempt to obtain copies of pertinent treatment records identified by the Veteran which have not previously been secured. 2. Obtain an addendum opinion for the Veteran's respiratory condition by a physician (M.D.) who specializes in respiratory conditions (i.e. a pulmonologist). The examiner should opine as to whether it is at least as likely as not (50 percent probability or greater) that the Veteran's bronchial asthma/COPD, allergic rhinosinusitis, and bronchiectasis: A) Had its onset in service, or B) Is otherwise related to an in-service injury, event, or disease, to include environmental exposure to mold and treatment for colds, coughing, and wheezing. In rendering this opinion, the examiner must consider and address the following: i. Explain the difference between bronchial asthma/COPD, allergic rhinosinusitis, and bronchiectasis. ii. The September 2018 hearing testimony wherein the Veteran reports that it rained almost every day in Japan, causing it to be damp, and that he went to sickbay several times for trouble breathing, cough, and a stuffed nose, and was treated with all-purpose capsules and some cough medicine and told to go back to work. iii. May 2012 correspondence wherein the Veteran reports damp conditions, mildew, and mold, and that he sought treatment when he had trouble breathing due to the mold spores that used to pop in the air. iv. May 2012 correspondence containing a statement from R.S. who confirms he served in Japan with the Veteran and that he remembers it being damp and moldy. v. Service treatment records relating to the Veteran's treatments for upper respiratory problems including, cough, wheezing, and stuffy nose. vi. Dr. D.T.'s September 2018 opinion. The examiner is requested to provide a clear rationale and explain in detail the underlying reasoning for any opinions expressed. A discussion of the facts and medical principles involved would be of considerable assistance to the Board. If the examiner cannot provide the requested opinion without resorting to speculation, he or she should expressly indicate this and provide a supporting rationale as to why an opinion cannot be made without resorting to speculation. TANYA SMITH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Papacalos, 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.