Citation Nr: 21041920 Decision Date: 07/10/21 Archive Date: 07/10/21 DOCKET NO. 18-25 931 DATE: July 10, 2021 REMANDED Entitlement to service connection for COPD as a result of exposure to asbestos is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from September 1974 to September 1978. This matter originally came before the Board of Veterans' Appeals (Board) on appeal from a May 2017 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In June 2019, the Board denied entitlement to service connection for asbestosis. The Veteran appealed the June 2019 Board decision to the United States Court of Appeals for Veterans Claims (CAVC). In June 2020, the CAVC granted a Joint Motion for Partial Remand (JMPR) submitted by the Veteran and the Secretary of Veterans Affairs (Parties), vacated the June 2019 Board decision in so far as it denied entitlement to service connection for a left knee disability and COPD, and remanded the matters to the Board for compliance with the JMPR instructions. The Parties to the JMPR agreed that the Board erred when it did not find whether the Veteran's diagnosed COPD was related to service and directed the Board to determine whether the Veteran's COPD was due to service, to include asbestos exposure therein. In December 2020, the Board remanded this issue in accordance with the JMPR. 1. Entitlement to service connection for COPD as a result of exposure to asbestos is remanded. While the Board sincerely regrets further delay, a fully-informed decision on the issue of entitlement to service connection for COPD can not be made because there has not been substantial compliance with the Board's remand directives. See Stegall v. West, 11 Vet. App. 268 (1998). In December 2020, the Board remanded this case to obtain an addendum opinion and specifically advised the examiner that exposure to asbestos is conceded as consistent with the circumstances of the Veteran's naval service. The Veteran was afforded an addendum opinion in April 2021. The examiner opined the Veteran's COPD was less likely as not related to service, to include asbestos exposure. However, he reasoned that "there is no evidence of asbestos exposure or of asbestosis." Thus, a remand is necessary to obtain an addendum opinion to properly consider the evidence of record, including the VA's contention that the Veteran was exposed to asbestos in service. The Board also notes the Veteran requested a B-reader. The April 2021 examiner, however, noted that a B-reader was not necessary as this was used when CT scans were not readily available. The Veteran had a test high resolution and CT scans are better both in specificity and sensitivity. Additionally, the Veteran stated in June 2021 correspondence that he wants "an adequate physical examination and explanation for the 'coarse opacities' and 'ground glass haziness' diagnosed as being present in the lower lobes of my lungs." The examiner is instructed to consider whether this is related to his asbestos exposure in service. The matters are REMANDED for the following action: 1. Obtain updated VA treatment records. 2. Obtain an addendum opinion, conducted by a pulmonologist, M.D., as to the nature and etiology of the Veteran's respiratory disability, to include COPD and the "coarse opacities" and 'ground glass haziness' noted at the April 2017 VA examination. The entire file should be made available to the examiner. The examiner is requested to review all pertinent records associated with the claims file, including the Veteran's service treatment records, post-service medical records, and assertions. Following a review of the claims file, the examiner should address the following: A) Diagnose all current respiratory disabilities, to include COPD, and the "coarse opacities" and 'ground glass haziness' noted at the April 2017 VA examination. For the purposes of this question, a current respiratory disability is any respiratory disability present since August 2016, even if it subsequently resolved. B) For each diagnosis in subpart (a), please opine as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran's respiratory disability had its onset in or is otherwise etiologically related to his active military service, to include as a result of conceded asbestos exposure therein. The examiner is advised that exposure to asbestos is conceded as consistent with the circumstances of the Veteran's naval service. The examiner is advised that there is no requirement that any disability manifest during active service, and that service connection is warranted for post-service manifestations of disease that are attributable to asbestos exposure in service. The examiner should also discuss the importance, if any, of the articles submitted by the Veteran in October 2020 as to a possible relationship between COPD and asbestos exposure. The examiner is requested to provide a clear rationale and explain in detail the underlying reasoning for any opinions expressed. A discussion of the facts and medical principles involved would be of considerable assistance to the Board. If an examiner cannot provide the requested opinion without resorting to speculation, he or she should expressly indicate this and provide a supporting rationale as to why an opinion cannot be made without resorting to speculation. TANYA SMITH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Papacalos, Associate 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.