Citation Nr: 21042318 Decision Date: 07/12/21 Archive Date: 07/12/21 DOCKET NO. 20-25 635 DATE: July 12, 2021 REMANDED Entitlement to service connection for respiratory disability due to asbestos exposure is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from July 1965 to April 1971. He died in April 2021. The Appellant is the surviving spouse who has been substituted following the Veteran's death. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a July 2018 rating decision of the Agency of Original Jurisdiction (AOJ). In May 2021, the Appellant testified at a Virtual Hearing before the undersigned Veterans Law Judge of the Board. A transcript of the hearing is associated with the record. Entitlement to service connection for respiratory disability due to asbestos exposure is remanded. Although the Board sincerely regrets the additional delay, based on the contentions raised at the hearing and upon review of the July 2018 VA medical opinion, the Board finds that remand is necessary for an addendum medical opinion. By way of background, the Veteran filed his original claim in February 2018 seeking service connection for respiratory issues due to asbestos exposure in service. In a July 2018 rating decision, the claim was denied based on no evidence of asbestosis, and finding that diagnosed respiratory disorders of asthma, chronic obstructive pulmonary disease (COPD), and obstructive sleep apnea (OSA) were not due to asbestos exposure. The record shows a VA respiratory examination of July 2018 where the examiner acknowledged the Veteran's "extensive exposure to Asbestos aboard the USS Enterprise" from 1967 to 1971. The examiner noted that the Veteran was a machinist/mechanic in service, "involved with handling pumps, valves and pipes lined with asbestos material" and was not issued protective equipment at that time. As for the medical history, the examiner added that in 2010, the Veteran developed respiratory conditions of asthma, COPD, OSA. However, the examiner found no evidence of Asbestosis, stating that the "veteran's PFT's results are not typically compatible with Asbestosis." The examiner indicated that the Veteran's non-service-connected pulmonary conditions of Asthma and COPD were not due to asbestos exposure, and that obstructive sleep apnea contributes to the Veteran's respiratory symptoms but is not due to asbestos exposure. See Respiratory Conditions Disability Benefits Questionnaire (DBQ) dated July 2018. At the Board hearing, the Appellant testified about her recollection that the Veteran was first diagnosed with a respiratory issue "back in 1969" which was after they first married. See Hearing Transcript at 3. Further, the Appellant disagreed with the July 2018 examination because at the time, the VA examiner failed to consider medical evidence of "pulmonary nodule that was in the Veteran's lung back from 2013." Id. at 5. The Appellant added that private treatment record also showed "there was a pulmonary granuloma" which was also not considered by the VA examiner. See East Tennessee Pulmonary Associates dated August 21, 2017; Hearing Transcript at 3. Taking into consideration the lay testimony and medical records, the Board finds that an addendum opinion should be obtained regarding etiology and current disability associated with the pulmonary nodule or pulmonary granuloma as due to asbestos exposure. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from a qualified medical professional (preferably a clinician in pulmonary disorders) regarding the etiology of the Veteran's pulmonary granuloma and pulmonary nodule. Based on the review of the record, the examiner should provide an addendum opinion on the following: a) Discuss any current symptoms associated with pulmonary nodule and pulmonary granuloma; determine whether there is a current respiratory disability associated with the pulmonary nodule or pulmonary granuloma. b) Whether the Veteran's pulmonary nodule or pulmonary granuloma is at least as likely as not (a 50 percent or greater probability) related to asbestos exposure during the Veteran's service onboard USS Enterprise. In rendering the opinion, the examiner is asked to consider the Appellant's May 2021 hearing testimony that pulmonary nodule was in the Veteran's lung from 2013, and private treatment records from East Tennessee Pulmonary Associates dated August 21, 2017 showing evidence of pulmonary granuloma. The examiner must explain why or why not for all conclusions reached. 2. Upon completion of the requested development and any additional development deemed appropriate, adjudicate the claim on appeal. If the determination remains unfavorable, the Appellant and her representative should be furnished a supplemental statement of the case which addresses all relevant evidence. The Appellant and her representative should be afforded the applicable time period in which to respond. Then, return the case to the Board. KELLI A. KORDICH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. A., 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.