Citation Nr: 21039864 Decision Date: 07/01/21 Archive Date: 07/01/21 DOCKET NO. 19-10 729 DATE: July 1, 2021 REMANDED Entitlement to service connection for sinusitis, to include as due to asbestos and/or herbicide agent exposure, is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1964 to November 1967. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an October 2017 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran requested a Board hearing and was subsequently scheduled for a virtual tele-hearing in April 2021. He did not report for the hearing and did not provide good cause or request to reschedule the hearing. Accordingly, his hearing request is deemed withdrawn. 38 C.F.R. §§ 20.703, 20.7 04. The Veteran contends that he was treated for sinus problems while serving aboard the U.S.S. St. Paul in 1967 and that he has suffered from chronic sinusitis/sinus problems since that time. See July 2017 Statement from Veteran; October 2017 VA Examination Report (Veteran states sinus problems first started in-service and that he was treated by a corpsman and diagnosed with a "tropical cold"); October 2017 NOD (Veteran states he was treated for sinus problems in 1967 aboard the U.S.S. St. Paul); and June 2020 NOD. He further asserts that his currently diagnosed chronic sinusitis is related to in-service exposure to asbestos and herbicide agents. See, e.g., July 2017 Statement from Veteran (states he was exposed to asbestos in the engine rooms of the U.S.S. St. Paul and that asbestos deteriorated into powder in some areas); see also June 2020 Statement from Veteran (states he has suffered from sinus problems since his release from service in 1967 and that he is a Blue Water Veteran who has been exposed to Agent Orange and asbestos). Of note, the Veteran's in-service exposure to asbestos and herbicide agents based on his naval service aboard the U.S.S. St. Paul and military occupational specialty (i.e., electrician) has been conceded by the RO. Service treatment records (STRs) do not reflect complaints, treatment, or diagnoses of sinusitis or sinus problems. VA treatment records show ongoing sinus complaints beginning around 2001; the earliest VA records contained in the claims file are dated in 1999. As explained below, the Veteran has also endorsed post-service treatment from private medical providers for chronic sinus problems. The Veteran was afforded a VA examination in October 2017. The pertinent diagnosis was chronic sinusitis. The Veteran reported that he had served in the Navy from 1964 to 1967 and that he had suffered from chronic sinus infections for years. He stated that they first started in the Navy and that he had been treated therein for his symptoms (diagnosed by a corpsman as a "tropical cold"). Following service, he reported that he was treated for sinus issues on multiple occasions by civilian and VA providers, including a private ENT. The VA examiner opined that the claimed sinus condition was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The examiner reasoned that the STRs were silent for any complaints and that there were no post-military records shortly after discharge to support onset symptoms was during service. The Board does not find the October 2017 VA opinion to be adequate at this juncture. Specifically, the examiner's rationale is based exclusively on the absence of in-service treatment for a sinus condition, as well as the lack of any documented post-service treatment proximate to discharge. As noted above, the Veteran has consistently (and competently) reported that he was treated for sinus problems during service; that he had continuous sinus symptoms after discharge from service; and that he received private treatment for such symptoms following service. The United States Court of Appeals for Veterans Claims has stated that "[t]he examiner must address the Veteran's lay statements to provide the Board with an adequate medical opinion." Miller v. Wilkie, 32 Vet. App. 249, 260 (2020). In this case, the October 2017 VA examiner did not address the Veteran's relevant lay statements, specifically as to in-service onset and post-service treatment and symptoms. The opinion also fails to address the relationship, if any, between his in-service asbestos/herbicide agent exposures and the currently diagnosed sinus condition. As such, the Board finds that remand is required for a new VA opinion, as outlined further in the remand directives below. Lastly, the Veteran should also be afforded the opportunity to submit (or request that VA obtain on his behalf) any private treatment records, to include those records pertaining to post-service sinus treatment from a private ENT. The matter is REMANDED for the following actions: 1. Obtain all outstanding records of VA treatment, to specifically include any records dated prior to October 1999 and after September 2020. 2. With any assistance needed from the Veteran, request and obtain any outstanding private treatment records pertaining to the issue on appeal, to specifically include any post-service medical treatment from an otolaryngologist(s)/ENT. 3. Obtain an opinion from an appropriate clinician to determine the nature and etiology of the Veteran's sinus condition. If the clinician determines that additional examination of the Veteran is necessary to provide an adequate opinion, such examination must be scheduled. The examiner must opine whether it is at least as likely as not (50 percent or greater probability) that the Veteran's sinus condition, diagnosed as chronic sinusitis, is related to an in-service injury, event, or disease, including conceded exposure(s) to asbestos and/or herbicide agents therein. The examiner must discuss the Veteran's reports of being treated for sinus problems while serving aboard the U.S.S. St. Paul in 1967 and suffering from chronic sinusitis/sinus problems since that time. See July 2017 Statement from Veteran; October 2017 VA Examination Report (Veteran states sinus problems first started in-service and that he was treated by a corpsman and diagnosed with a "tropical cold"); October 2017 NOD (Veteran states he was treated for sinus problems in 1967 aboard the U.S.S. St. Paul); October 2017 VA Examination Report (Veteran states sinus problems first started in the Navy); and June 2020 NOD. The examiner is advised that the Veteran is competent to report injuries/symptoms and that his reports must be considered in formulating the requested opinions. All opinions provided must be thoroughly explained and an adequate rationale for any conclusions reached must be provided. The examiner should not rely on the absence of evidence of in-service treatment or injury in the Veteran's service treatment records as a basis for any given opinion. If any requested opinion cannot be provided without resort to speculation, the medical professional should state and explain why an opinion cannot be provided without resort to speculation. 4. After the above development, and any other development deemed necessary, readjudicate the claim. L. Chu Veterans Law Judge Board of Veterans' Appeals Attorney for the Board H. Hoeft 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.