Citation Nr: 21030638 Decision Date: 05/19/21 Archive Date: 05/19/21 DOCKET NO. 15-00 764 DATE: May 19, 2021 REMANDED Entitlement to service connection for coronary artery disease is remanded. Entitlement to service connection for acquired psychiatric condition, to include posttraumatic stress disorder (PTSD) is remanded. Entitlement to service connection for lung condition due to asbestos exposure is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from May 1975 to June 1976. In May 2018, the Board remanded the case for further development, which is not completed. Stegall v. West, 11 Vet. App. 268, 271 (1998). In March 2018, the Veteran testified at a Board hearing. The transcript is of record. 1. Entitlement to service connection for acquired psychiatric condition, to include PTSD The Board finds that VA has been provided factual notice of potentially relevant SSA records as the Veteran reported receiving Social Security Administration (SSA) disability at his September 2019 VA examination for mental disorders. VA has the duty to acquire a copy of the SSA records, including the decision granting SSA benefits and the supporting medical documentation, if they are relevant. SSA records are relevant if either (1) there is an SSA decision pertaining to a medical condition related to the one for which the Veteran is seeking service connection or (2) there are specific allegations "giv[ing] rise to a reasonable belief" that the SSA records may pertain to the claimed disability. Golz v. Shinseki, 590 F.3d 1317, 1323 (Fed. Cir. 2010); Baker v. West, 11 Vet. App. 163 (1998). As such, any records from Social Security should be obtained as they may contain evidence necessary for the Veteran to substantiate his claim. Murincsak v. Derwinski, 2 Vet. App. 363 (1992). 2. Entitlement to service connection for coronary artery disease Once VA undertakes the effort to provide an examination, it must provide an adequate one. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). The September 2019 VA examiner opined that the Veteran's coronary artery disease is less likely than not caused by active service. The rationale reports that while literature states firefighters are at increased risk for heart problems due to exposure to heat, stress and smoke these studies are based on firefighting as a career and the Veteran was only a firefighter for around seven months. A medical opinion must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. See Nieves- Rodriguez v. Peake, 22 Vet. App. 295 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). The medical opinion provided is conclusory and lacks an appropriate rationale as it merely references literature, without citation, to support a negative nexus and fails to discuss the specific facts of the case. See Bailey v. O'Rourke, 30 Vet. App. 54, 60 (2018). 3. Entitlement to service connection for lung condition due to asbestos exposure The May 2018 Board remand directed the Regional Office (RO) to verify the existence of the claimed stressor related to fires at the Regional Training Center in Great Lakes, Illinois between May 1975 and September 1975 and to verify any fires aboard the USS Chicago between October 1975 to May 1976. An inquiry was made to the National Archives and Records Administration and a response dated March 18, 2019 stated that the deck logs and command history for the USS Chicago were located. The correspondence stated that a review of the deck logs could be performed if a two to three-month date range is provided. The RO requested the Veteran provide a more specific timeline via correspondence dated May 20, 2019. No response was received and on August 14, 2019 a formal finding was issued declaring there is insufficient evidence and any further attempts to obtain information are futile. The VA has a duty to search for records that would assist a Veteran in the development of his claim and for which the Veteran has provided the Secretary information sufficient to locate such records, which includes making as many requests as necessary and ends only when such a search would become "futile." See Gagne v. McDonald, 27 Vet. App. 397, 402-403 (2015). As such, the need to submit multiple 60 to 90-day inquiries alone does not make further attempts futile. Id. In this case, the Veteran reported a timeframe of being onboard the USS Chicago between October 1975 to May 1976. Review of the military personnel records establish that the Veteran was stationed on the USS Chicago during that timeframe with the exception of from February 29, 1976 to March 29, 1976 due to unauthorized absence. As such, further attempts to verify the fires are not futile as multiple separate inquiries in compliance with the 60 to 90-day requirement may be made that cover the time periods of October to February 28, 1976 and March 29, 1976 to May 1976. The matters are REMANDED for the following action: 1. In remanding this case, the Board makes no credibility determination, expressed or implied, at this juncture. 2. Acquire updated VA and/or private treatment records. If such records are unavailable, the Veteran's claim file must be clearly documented to that effect and the Veteran notified in accordance with 38 C.F.R. § 3.159(e). 3. Obtain from SSA all records pertaining to the Veteran's claim for disability benefits, if any, including copies of all medical records considered in deciding any claim. 4. Request that JSRRC, National Archives and Records Administration, or other appropriate repository, investigate and attempt to verify the Veteran's reports of fires, to include while aboard the USS Chicago from October to February 29, 1976 and March 29, 1976 to May 1976. The requests should include deck logs and command history for the relevant time frame and be submitted in multiple inquiries that are compliant with the 60 to 90-day timeframe requirement. If the search for corroborating information leads to negative results, notify the Veteran of this fact; explain the efforts taken to obtain this information, and describe any further action to be taken. If the record lacks sufficient information for verification purposes, such should be noted in a formal finding. 5. After the above development is completed, obtain an addendum medical opinion from a medical professional with appropriate expertise. The examiner should review the Veteran's claims file. If the examiner determines that an opinion cannot be provided without an examination, the Veteran should be scheduled for one. Based on a review of the record, and a new examination if necessary, the examiner must address the following: (a.) Whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran's CAD is related to his active service, or is caused by or aggravated by military service, to include due to his military occupational specialty of firefighter. The term "at least as likely as not" does not mean within the realm of medical possibility, but rather that the medical evidence both for and against a certain conclusion is so evenly divided that it is as medically sound to find in favor of such a conclusion as it is to find against it. In all opinions rendered, the examiner is advised that the Veteran is competent to report his symptoms and treatment history. The examiner must specifically consider and discuss the lay statements of record and the opinion and rationale should reflect such consideration. The opinion and rationale must go beyond a generalized statement that a review of literature does not support the Veteran's claim. The rationale should reflect the specific facts and medical principles specific to the Veteran's claim. A complete rationale containing clear conclusions with supporting data and a reasoned medical explanation connecting the two is required for all medical opinions. The examiner should also identify and explain the relevance or significance, as appropriate, of any history, clinical findings, medical knowledge, or literature, etc., relied upon in reaching the conclusion(s). If the medical professional cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation for why an opinion cannot be rendered. In so doing, the medical professional shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question(s). 6. Obtain an addendum medical opinion from a medical professional with appropriate expertise. The examiner should review the Veteran's claims file. If the examiner determines that an opinion cannot be provided without an examination, the Veteran should be scheduled for one. Based on a review of the record, and a new examination if necessary, the examiner must address the following: (a.) Whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran's lung condition is related to his active service, or is caused by or aggravated by military service, to include due to asbestos exposure. The term "at least as likely as not" does not mean within the realm of medical possibility, but rather that the medical evidence both for and against a certain conclusion is so evenly divided that it is as medically sound to find in favor of such a conclusion as it is to find against it. In all opinions rendered, the examiner is advised that the Veteran is competent to report his symptoms and treatment history. The examiner must specifically consider and discuss the lay statements of record and the opinion and rationale should reflect such consideration. A complete rationale containing clear conclusions with supporting data and a reasoned medical explanation connecting the two is required for all medical opinions. The examiner should also identify and explain the relevance or significance, as appropriate, of any history, clinical findings, medical knowledge, or literature, etc., relied upon in reaching the conclusion(s). If the medical professional cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation for why an opinion cannot be rendered. In so doing, the medical professional shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question(s). G. A. WASIK Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. A. Prinsen 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.