Citation Nr: 21032382 Decision Date: 05/26/21 Archive Date: 05/26/21 DOCKET NO. 12-33 931A DATE: May 26, 2021 REMANDED Entitlement to service connection for bone loss, claimed as secondary to service-connected chronic bronchitis with asthma is remanded. Entitlement to service connection for allergy shot residuals, including food allergies and thyroid disorder, is remanded. Entitlement to service connection for chronic obstructive pulmonary disease (COPD) is remanded. Entitlement to an increased rating higher than 0 percent for allergic conjunctivitis is remanded. REASONS FOR REMAND The Veteran had active duty service from October 1992 to September 1994. These matters are before the Board of Veterans' Appeals (Board) on appeal from Department of Veterans Affairs (VA) Agency of Original Jurisdiction (AOJ) rating decisions dated in November 2011 and February 2015. In March 2021, the Veteran testified at a virtual Board hearing before the undersigned Veterans Law Judge. Review of the hearing testimony shows that the Veteran's attorney was not present at the hearing. The Veteran noted during the hearing that she wanted to proceed with the hearing without representation. See March 2012 Board hearing transcript, p. 2. 1. Entitlement to service connection for bone loss, claimed as secondary to service-connected chronic bronchitis with asthma, is remanded. The Veteran testified at the Board hearing that she has bone loss from being on prednisone for many years, both oral and inhaled, due to her service connected chronic bronchitis and asthma. She testified that she had a recent DEXA scan in 2020 as part of her VA back examination. She also noted after the last supplemental statement of the case in a March 2021 VA treatment record that she had recently had an outside DEXA with bone lone loss noted although the treatment provider also noted that there were no records to review. Previous examinations of record do not show any bone loss (see, e.g., August 2020 femur bone scan showing normal results; and August 2020 VA examination showing no osteoporosis) although service connection has been granted by the AOJ for degenerative arthritis of the spine likely exacerabated by steroid use. See February 2021 AOJ rating decision. The Veteran should be given the opportunity to submit any additional treatment records showing additional bone loss in other areas of the body, if available. 2. Entitlement to service connection for allergy shot residuals, including food allergies and thyroid disorder, is remanded. The Veteran essentially argues that her allergy shots caused her to have food allergies and a thyroid disorder. See March 2021 Board hearing transcript, pp. 6, 11. She noted at the Board hearing that she was told by her doctor that it was highly likely that her allergy shots caused her to have food allergies. Id. at 6. The Veteran should be provided with a VA examination to determine whether she has any allergy shot residuals, including food allergies. The Board cannot make a fully-informed decision on the issue of service connection for allergy shot residuals, including food allergies because no VA examiner has opined whether she has any allergy shot residuals, including food allergies, as a result of her taking prednisone for her service-connected chronic bronchitis with asthma. 3. Entitlement to service connection for chronic obstructive pulmonary disease (COPD) is remanded. The Veteran is service-connected for chronic bronchitis with asthma. VA treatment records note COPD in passing but there is no confirmed diagnosed of COPD in the treatment records. For example, an August 2012 VA treatment record notes the Veteran stated that she was recently told by a doctor that she had COPD. An April 2016 VA treatment record notes that the Veteran has COPD. A June 2019 VA treatment record also notes that the Veteran's chief complaint was pulmonary COPD. The Board cannot make a fully-informed decision on the issue of service connection for COPD because no VA examiner has opined whether the Veteran has COPD that was caused or aggravated by her service-connected chronic bronchitis with asthma. 4. Entitlement to an increased rating higher than 0 percent for allergic conjunctivitis is remanded. The Veteran was last evaluated for her allergic conjunctivitis in February 2015. She testified at the Board hearing in March 2021 that she had constant conjunctivitis and had to take drops every day. See March 2021 Board hearing transcript, p. 26. As it appears that the Veteran's allergic conjunctivitis has worsened since she was last evaluated for compensation purposes, additional examination is warranted to determine the present severity of the disability. The matters are REMANDED for the following action: 1. Obtain the Veteran's VA treatment records for the period from March 2021 to present. 2. Ask the Veteran to submit any treatment records or authorize VA to obtain any private treatment records showing bone loss and/ or osteoporosis. 3. If bone loss is shown by the evidence of record, schedule the Veteran for a VA examination for her claimed bone loss. The examiner must review the claims file. The examiner is asked to provide a response to the following: (a) Does the Veteran have bone loss that is at least as likely as not proximately due to prednisone taken to treat her service-connected chronic bronchitis with asthma? (b) Does the Veteran have bone loss that is at least as likely as not aggravated, i.e., worsened beyond its natural progression, by prednisone use to treat her service-connected chronic bronchitis with asthma? 4. Schedule the Veteran for a VA examination for her claimed residuals of allergy shots, including food allergies and thyroid disorder. The examiner must review the claims file. The examiner is asked to provide a response to the following: (a) Does the Veteran have food allergies and/ or a thyroid disorder that is at least as likely as not proximately due to prednisone taken to treat her service-connected chronic bronchitis with asthma? (b) Does the Veteran have food allergies and/ or a thyroid disorder that is at least as likely as not aggravated, i.e., worsened beyond its natural progression, by prednisone use to treat her service-connected chronic bronchitis with asthma? 5. Schedule the Veteran for a VA examination for her claimed COPD. The examiner must review the claims file. The examiner is asked to provide a response to the following: (a) Does the Veteran have COPD that is at least as likely as not proximately due to her service-connected chronic bronchitis with asthma? (b) Does the Veteran have COPD that is at least as likely as not aggravated, i.e., worsened beyond its natural progression, by her service-connected chronic bronchitis with asthma? 6. Schedule the Veteran for an examination by an appropriate clinician to determine the current severity of her service-connected allergic conjunctivitis. The examiner should provide a full description of the disability and report all signs and symptoms necessary for evaluating the Veteran's disability under the rating criteria. S. L. Kennedy Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Sarah B. Richmond, 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.