Citation Nr: 21040658 Decision Date: 07/06/21 Archive Date: 07/06/21 DOCKET NO. 17-63 078 DATE: July 6, 2021 ORDER Service connection for chronic obstructive pulmonary disease (COPD) is granted. REMANDED The issue of service connection for sleep apnea, to include as secondary to service-connected restrictive lung disease is remanded. FINDING OF FACT Resolving reasonable doubt in the Veteran's favor, his COPD related to asbestos exposure during service. CONCLUSION OF LAW The criteria for service connection for COPD are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Navy from December 1962 to December 1966. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an April 2016 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). The appeal was last before the Board in March 2021 where it was remanded for additional development. Service connection for COPD. The Veteran contends his COPD is related to asbestos exposure during service. The Board finds that the Veteran has a current disability that is related to asbestos exposure and will grant the appeal. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). The May 2000 VA respiratory examination shows the Veteran has a current diagnosis of COPD. During service, the Veteran was seen for complaints of shortness of breath and was diagnosed with bronchopneumonia after being treated for a respiratory infection. The RO found that the Veteran was exposed to asbestos during service. Thus, the question becomes whether the current disability is related to service. The evidence in favor of the claim includes the May 2000 VA examination which noted the Veteran's COPD was related to post-service exposure to asbestos. The March 2020 VA medical opinion noted the Veteran's COPD and asbestosis can be related as causation and/or aggravation. The March 2021 VA medical opinion also notes exposure to asbestos can cause restrictive lung disease and COPD may then develop as a complication. VA medical treatment records reflect numerous instances of the Veteran's diagnosis of COPD with a history of asbestos exposure. Viewing the evidence in a light most favorable to the Veteran, no further medical inquiry would assist the Board. There is a relationship between the Veteran's asbestos exposure in service and his current COPD. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for COPD is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. REASONS FOR REMAND The issue of service connection for sleep apnea, to include as secondary to service-connected restrictive lung disease is remanded. The matter is REMANDED for the following action: 1. BACKGROUND FOR THE RO ADJUDICATOR: There has not been substantial compliance with the Board's remand directives regarding the issue. Another remand is required. Stegall v. West, 11 Vet. App. 268, 271 (1998). In March 2021, the RO was instructed to obtain a medical opinion that was to address the Veteran's sleep apnea on a direct and secondary basis with adequate rationale. Review of the March 2021 VA medical opinion indicates this has not been accomplished. The March 2021 examiner opined that the Veteran sleep apnea was not caused or aggravated by asbestosis and/or a service-connected restrictive lung disease and only stated the Veteran's sleep apnea was not caused by asbestos exposure with no accompanying rationale. A Remand is required to obtain an adequate opinion. The remand directives follow. 2. Obtain a medical opinion by a suitable clinician to determine the etiology of his sleep apnea. The electronic file, including a copy of the Remand, must be reviewed by, the VA examiner. All appropriate tests, studies, and consultations must be done, and all clinical findings must be reported in detail. Based upon a review of the relevant evidence of record, history provided by the Veteran, and sound medical principles, the VA examiner should provide the following opinions: (a.) Whether the Veteran's sleep apnea was caused by or aggravated by any in-service event, injury, or disease, to include conceded asbestos exposure? (b.) Whether the Veteran's sleep apnea was caused by or aggravated by any service-connected disability? The examiner is advised: He/she must fully explain the opinions. A summary conclusion is not sufficient under the law and the opinion will be returned for further clarification. THE EXAMINER MUST ALSO EXPRESS AN OPINION OF WHETHER THE VETERAN'S ACCOUNT OF THE DEVELOPMENT OF THE DISABILITIES IS CONSISTENT WITH THE MEDICAL EVIDENCE AND THE EXAMINER'S KNOWLEDGE AND PRACTICE EXPERIENCE. The examiner must review the entire record in conjunction with making the requested opinions. IN ADDITION TO ANY RECORDS THAT ARE GENERATED BECAUSE OF THIS REMAND, the VA examiner's attention is drawn to the following: *THE VETERAN HAS CONCEDED EXPOSURE TO ASBESTOS DURING SERVICE. *Service treatment records are silent as to any complaints, treatments, or diagnosis of a sleep disorder. *Service connection is in effect for restrictive lung disease, coronary artery disease, diabetes mellitus, type 2, and per this decision, COPD. 3. After the above development, readjudicate the issue on appeal. If the benefits sought on appeal are denied, the Veteran and his representative should be supplied a supplemental statement of the case (SSOC). An appropriate period should be allowed for response before the case is returned to the Board. Vito A. Clementi Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. McDuffie, Counsel The Board's action is binding only with respect to this matter. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.