Citation Nr: 22002003 Decision Date: 01/13/22 Archive Date: 01/13/22 DOCKET NO. 17-67 660 DATE: January 13, 2022 REMANDED Entitlement to service connection for Parkinson's disease, to include as due to in-service chemical exposure, is remanded. Entitlement to service connection for a respiratory disorder, to include as due to in-service chemical exposure, is remanded. Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) is remanded. REASONS FOR REMAND 1. Entitlement to service connection for Parkinson's disease, to include as due to in-service chemical exposure, is remanded. Regarding the claim for Parkinson's disease, in the June 2020 remand, the Board directed the RO to obtain an additional VA medical opinion as to the etiology of the Veteran's Parkinson's disease. In particular, the examiner was asked to opine whether the Veteran's Parkinson's disease was related to his active duty service, to include his in-service exposure to tear gas during basic training. While a subsequent VA examination was conducted in August 2021, the examiner opined that Parkinson's disease was not related to service based on the absence of documented treatment in the service treatment records and that there was no objective evidence that the Veteran was intoxicated with tear gas or sustained a chronic exposure to tear gas during his active duty service. The opinion did not take into consideration the Veteran's competent report of in-service exposure to tear gas during basic training. As such, remand is required to obtain another opinion to assess the nature and etiology of any currently present Parkinson's disease. 2. Entitlement to service connection for a respiratory disorder, to include as due to in-service chemical exposure, is remanded. Regarding the claim for a respiratory disorder, in the June 2020 remand, the Board directed the RO to obtain an additional opinion as to the etiology of the Veteran's respiratory disorder. In particular, the examiner was asked to opine whether the Veteran's respiratory disorder, to include bronchial asthma, chronic bronchitis, and chronic pulmonary disease (COPD), was related to his active duty service, to include his in-service exposure to tear gas during basic training. In a September 2020 VA medical opinion, the examiner diagnosed the Veteran with asthma and opined that the Veteran's respiratory disorder was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. As rationale for the opinion, the examiner indicated that the Veteran's claims folder was silent for a diagnosis of a respiratory condition (asthma, COPD, bronchitis) during active service. The examiner further reported that the Veteran's respiratory condition started between 2006 and 2009. However, while the examiner stated that the current asthma was less likely than not incurred in or caused by the claimed in-service injury, event, or illness, he failed to address the post-service medical records, which reflect a diagnosis of chronic bronchitis and COPD. In addition, the VA examiner did not address the Veteran's contentions that his respiratory disorder was related to his active duty service, to include his competent statements regarding in-service exposure to tear gas during basic training. A subsequent VA medical opinion was obtained in October 2020. The examiner opined that the Veteran's respiratory disorder was less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The examiner found that the Veteran's current respiratory disorders were asthma, COPD, and obstructive sleep apnea. The examiner further reported that there was no evidence of chronic bronchitis. However, the October 2020 VA examiner failed to reconcile the finding of no evidence of chronic bronchitis with the post-service medical records, which reflect a diagnosis of chronic bronchitis. As such, remand is required to obtain another opinion regarding the Veteran's respiratory disorder claim. 3. Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) is remanded. Finally, the claim for a TDIU is inextricably intertwined with the above remanded appeals and must be likewise remanded until the remand directives are accomplished. The matters are REMANDED for the following action: 1. Obtain any and all outstanding treatment records for the Veteran's Parkinson's disease and respiratory disorder that are not currently of record. 2. Obtain an addendum opinion from an appropriate clinician to determine the etiology of the Veteran's currently diagnosed Parkinson's disease. The clinician should opine as to whether it is at least as likely as not that the Veteran's Parkinson's disease is related to his active duty service, to include his in-service chemical exposure. In providing the above opinion, the clinician should assume that the Veteran was exposed to tear gas during basic training, as he is competent to report such exposure. If the clinician determines that an examination is necessary to provide the requested opinions, then one should be scheduled. 3. Obtain an opinion from an appropriate clinician to determine the etiology of the Veteran's current respiratory disorders. The clinician should opine as to whether any of the Veteran's respiratory disorders, to include bronchial asthma, chronic bronchitis, and COPD, is at least as likely as not related to his active duty service, to include his in-service chemical exposure. In providing the above opinion, the clinician should assume that the Veteran was exposed to tear gas during basic training, as he is competent to report such exposure. If the clinician determines that an examination is necessary to provide the requested opinions, then one should be scheduled. T. SHERRARD Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Grzeczkowicz 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.