Citation Nr: 21029823 Decision Date: 05/17/21 Archive Date: 05/17/21 DOCKET NO. 15-30 049 DATE: May 17, 2021 REMANDED Entitlement to service connection for a respiratory disability, to include asbestosis and asthma, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Air Force from February 1969 to August 1972. This matter is on appeal from a March 2015 rating decision. In May 2019, this matter was remanded by the Board for additional development. The Veteran contends that has a respiratory disability related to in-service asbestos exposure to fuels, aircraft parts (brake pads), and aircraft hangar equipment containing asbestos. See April 2021 Brief. Pursuant to the Board's remand, on September 2019 VA respiratory conditions Disability examination the examiner indicated diagnoses of asthma since 2014 and RML and LLL nodules since 2015. The Veteran is a non-smoker who indicated a history of asthma since the late 1970s to 1980s. The examiner noted that the Veteran stated that he was exposed to asbestos in service, but had not been diagnosed with asbestosis. The examiner opined that the Veteran's claimed disability was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. Regarding asthma, the rationale, in part, was that several studies have demonstrated that active smoking increases the risk for developing asthma. However, the Veteran is a non-smoker. Regarding pulmonary nodules, the examiner cited medical literature which indicates that pulmonary nodules typically present in middle age and grow slowly over the years, but stated that there was not etiology for the development of a pulmonary nodule as noted based on a review of literature. The examiner further opined that there are no records in the service treatment records which indicate a respiratory disability and asbestos is not an etiology for the development of asthma or a pulmonary nodule per medical literature. Subsequent to the VA examination, the Veteran submitted additional private treatment records which include a June 2018 report which indicates that there was no progression of asbestosis. Nonetheless, these records suggest a diagnosis of asbestosis. In addition, pursuant to the Board's remand in a July 2020 memorandum, the RO Joint Services Records Research Coordinator (JSRRC) issued a formal finding that it is probable that the Veteran was exposed to asbestos during his active service. Since the VA examination and opinion regarding the Veteran's respiratory disability is based on a review of an incomplete record and as it remains unclear whether the Veteran has any currently diagnosed respiratory disability which is related to his service, and to afford a VA examiner an opportunity to consider the complete record, on remand an addendum should be obtained. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). The matter is REMANDED for the following action: Provide the claims file to an appropriate VA examiner, other than the September 2019 VA examiner, who should determine whether a new VA examination is warranted in order to provide the requested opinion. The claims folder should be made available to the examiner for review of pertinent documents. The report should reflect that such a review was conducted. The examiner should provide the following opinion: Is it at least as likely as not (50 percent or more probability) that any respiratory disability, including asthma and asbestosis, diagnosed at any time during the course of the appeal, had its onset in or is etiologically-related to the Veteran's active duty service, to include asbestos exposure? The examiner is asked to consider and discuss as necessary the pertinent evidence of record to include the Veteran's lay statements and complaints concerning the onset of his current respiratory disability and asbestos exposure, including those made to medical providers; July 2020 memorandum; and April 2021 Brief. The Board, by this remand, makes no determination, expressed or implied, concerning the credibility of any statements on file. (Continued on the next page) The report of examination should include the complete rationale for all opinions expressed. The phrase "at least as likely as not" does not mean within the realm of medical possibility, but rather the weight of medical evidence both for and against a conclusion is so evenly divided that it is as medically sound to find in favor of that conclusion as it is to find against it. KELLI A. KORDICH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Adams, 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.