Citation Nr: 21032293 Decision Date: 05/26/21 Archive Date: 05/26/21 DOCKET NO. 15-02 105A DATE: May 26, 2021 REMANDED Entitlement to service connection for a respiratory condition is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1965 to January 1969. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 2013 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before a Decision Review Officer (DRO) at a hearing in April 2018. A transcript of that hearing is of record. This matter was remanded in December 2018 and August 2020. 1. Entitlement to service connection for a respiratory condition is remanded. Although further delay is regrettable, the Board finds that additional development is necessary prior to appellate review. The Veteran asserts that his respiratory condition is related to service. Specifically, the Veteran has indicated that his respiratory condition is due to his asbestos exposure and/or herbicide exposure. In a February 2019 statement in support of claim, the Veteran also expressed that his respiratory condition may be due to exposure to chemical fumes and paint vapers in the automobile/body paint. In a December 2018 Board decision/remand, the Board conceded the Veteran's exposure to herbicide agents during his service in Thailand. In its August 2020 Board remand, the Board noted that the Veteran's military performance reviews indicate that the Veteran's duties as an automotive paint and body repairman included removing, replacing, and repairing damaged automotive panels, repairing and replacing door locks, window regulators, etc., and doing touch-up and complete paint jobs. The Board stated that these duties overlap with those of a painter and, although brake linings and clutch facing are not specifically identified, the Veteran's duties are generally consistent with repairing or replacing parts of a vehicle such as brake linings and clutch facings. The Board noted that the Veteran has also submitted a February 2019 statement in which he expressed his belief that brake dust was among the material in and around vehicles that he would blow free before repainting and refinishing vehicles. Therefore, the Board found that the evidence is at least in equipoise whether the Veteran was exposed to asbestos during service. Thus, the Board requested a supplemental medical opinion that considered whether the Veteran's respiratory condition is at least as likely as not related to asbestos exposure. The Board notes that the Veteran was initially afforded a VA examination in April 2019. The examiner diagnosed the Veteran with emphysema. The examiner opined that the Veteran's respiratory condition was less likely as not incurred in or caused by the Veteran's military service. The examiner stated that during service, the Veteran's condition was acute only and that there was no evidence of chronicity of care. Thus, the examiner stated that a nexus has not been established. The examiner expressed that while exposure to herbicides during military service was documented, the Veteran has a history of being a cigarette smoker which is more likely the cause of his current diagnosis of emphysema. The Veteran was afforded another VA examination in October 2020. The examiner indicated that the Veteran has a diagnosis of chronic obstructive pulmonary disease (COPD). The examiner opined that it is less likely that the Veteran's current claimed respiratory condition is incurred by the respiratory issues while in the service given that there is no evidence in the Veteran's file supporting that any issues addressed while in service are secondary to COPD. The examiner opined that it is less likely that the Veteran's current claimed respiratory condition is incurred by the asbestos exposure given that the Veteran has a diagnosis of COPD/emphysema with a known tobacco abuse history, which is the primary risk factor associated with development of COPD. The Board finds the October 2020 medical opinion to be inadequate as the examiner did not provide sufficient supporting rationale in his finding that the Veteran's respiratory condition is not related to in-service exposure to asbestos. Here, the examiner failed to consider the Veteran's contentions and failed to discuss why the history of exposure to asbestos would be considered insignificant or less significant than the Veteran's history of smoking. Ultimately, a medical opinion that is based on incomplete facts or on only partial information has no probative value and thus is inadequate. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). Among other considerations, the Board must meaningfully understand whether or not, from a medical perspective, a pathophysiological mechanism from asbestos exposure to subsequently developed COPD/emphysema exists and, if so, why or why not. As such, having not found a meaningful explanation, the Board finds that the October 2020 medical opinion is inadequate for the Board to decide the claim. Thus, on remand, an addendum opinion is needed addressing this deficiency. In addition, it appears that the Veteran may be in receipt of Social Security Administration (SSA) disability benefits. Copies of the administrative decision and any underlying medical records have not been associated with the record. A remand is also required to allow VA to obtain them. The matters are REMANDED for the following action: 1. Contact the SSA and request the Veteran's SSA records, including any administrative decision(s) on his application for disability benefits and all underlying medical records which are in the SSA's possession. A copy of all request(s) sent to the SSA, and all replies, to include any records obtained from the SSA, must be included in the claims file. 2. Thereafter, obtain an etiological opinion from a pulmonologist as to the etiology of the Veteran's respiratory condition, to include COPD/emphysema. Examination of the Veteran is left to the discretion of that examiner, as deemed appropriate. The entire claims folder, including a copy of this Remand, should be made available to and reviewed by the examiner. After review of the claims file, the examiner is specifically instructed to provide the following opinions: Is it at least as likely as not (a 50 percent probability or greater) that the Veteran's respiratory condition had its onset in service or is otherwise related to service to include as due to conceded exposure to herbicides? Is it at least as likely as not (a 50 percent probability or greater) that the Veteran's respiratory condition is due to or related to asbestos exposure? Is it at least as likely as not (a 50 percent probability or greater) that the Veteran's respiratory condition is due to or related to exposure to paint vapers in the automobile/body paint? The examiner is advised that the absence of evidence in the service treatment records is an insufficient basis, by itself, for a negative opinion. The examiner should address the Veteran's contentions and lay statements of record. A clear rationale for all opinions is requested and a discussion of the facts and medical principles involved would be of considerable assistance to the Board, to include the basis for one etiological finding over another (see discussion above). LESLEY A. REIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M.D. 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.