Citation Nr: 22012201
Decision Date: 03/02/22	Archive Date: 03/02/22

DOCKET NO. 18-45 176
DATE: March 2, 2022

REMANDED

Entitlement to service connection for the Veteran's cause of death is remanded.

REASONS FOR REMAND

Having reviewed the record, the Board finds remand is warranted for an addendum opinion on whether the Veteran's sarcoidosis, noted as a contributory cause of death on the death certificate, is at least as likely as not related to conceded exposure to particulate matter and/or burning oil well fires.  

Though opinions were obtained in November 2021 and December 2021, the examiner did not provide a rationale for his opinion that the medical record showed no evidence of symptoms suggestive of sarcoidosis while in service or within 1 year of separation of service.  

Of particular note, the appellant has asserted that the Veteran's in-service respiratory symptoms and vision changes may have been early symptoms of sarcoidosis, and submitted an article in support of her assertions from the Mayo Clinic.  See April 2017 Statement and Article.  However, the November 2021 and December 2021 examiner did not reconcile his opinion with the in-service evidence of upper respiratory symptoms and change in vision during deployment.  Specifically, he did not address the January, February, and March 1991 upper respiratory infections.  Additionally, the examiner did not address the Veteran's vision change from 20/20 bilaterally in January 1991 to 20/25 in the left eye and 20/30 in the right eye in May 1991 during a period of deployment.  

As the examiner did not address this evidence or offer a rationale, the Board cannot make a fully informed opinion on this issue.  Accordingly, remand is warranted so the examiner, or an appropriate clinician, can provide an opinion and supporting rationale on whether the Veteran's sarcoidosis, noted as a contributory cause of death on the death certificate, is at least as likely as not related to conceded exposure to particulate matter and/or burning oil well fire.  The examiner is advised that merely listing evidence without offering a supporting rationale is insufficient.  

The matters are REMANDED for the following actions:

Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's sarcoidosis was at least as likely as not related to conceded exposure to particulate matter and/or burning oil well fires.

The examiner must address (i) the January, February, and March 1991 upper respiratory infections and congestion and (ii) the Veteran's vision change from 20/20 bilaterally in January 1991 to 20/25 in the left eye and 20/30 in the right eye in May 1991, which occurred during a period of deployment.  

Additionally, attention is invited to the following: the April 2017 submitted Mayo Clinic article regarding symptoms of sarcoidosis; a September 1993 VA treatment record noting a complaint of sinus problems since Desert Storm; a July 1994 VA treatment record noting a history of rhinitis for years and shortness of breath and wheezing with exertion and at night; a December 1994 VA treatment record noting a complaint of continuous paroxysmal nocturnal dyspnea since Desert Storm; and a November 1996 dermatology consultation to evaluate a rash in view of questionable chest X-ray findings and ruling out a diagnosis of sarcoidosis.  

Any opinions offered should be accompanied by the underlying reasons for the conclusions.  The examiner is advised that merely listing evidence without offering a supporting rationale is insufficient.  

 

 

TANYA SMITH

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	S. Vang, 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.