Citation Nr: 22017599 Decision Date: 03/25/22 Archive Date: 03/25/22 DOCKET NO. 16-40 708A DATE: March 25, 2022 REMANDED Entitlement to service connection for a respiratory disorder, to include pulmonary embolism, deep vein thrombosis (DVT), and chronic obstructive pulmonary disease (COPD), as secondary to service-connected carcinoma of the lung is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from November 1967 to September 1969, including service in the Republic of Vietnam. This matter was most recently before the Board in December 2021, where it was remanded for additional development. Specifically, the Board determined that the Veteran should be afforded an addendum opinion and a pulmonary function test for his respiratory claim. For the reasons discussed below, the matter is again remanded for further development. Entitlement to service connection for a respiratory disorder, to include pulmonary embolism, deep vein thrombosis, and COPD, as secondary to service-connected carcinoma of the lung is remanded. While the Board regrets delay, the Board finds that further medical clarification is required prior to adjudicating the Veteran's claim. Additionally, there has not been substantial compliance with the Board's prior remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998) (holding veterans are entitled to compliance with Board remand instructions). According to the Veteran's July 2022 VA opinion, the examiner provided a negative nexus opinion, reasoning that the Veteran did not have a current diagnosis based on the "current available records and/or today's exam." However, the Board notes that a "current disability" for VA purposes is any diagnosis made during the claim period on appeal. Therefore, any diagnosis rendered during the appeal period, i.e., since the Veteran filed his claim, is considered a current diagnosis. McClain v. Nicholson, 21 Vet. App. 319, 321 (2007). Additionally, the examiner was asked to address the December 2020 private medical examiner's opinion that the Veteran's lung clots are directly related to Agent Orange exposure. The examiner did not do so. Lastly, private medical treatment records submitted by the Veteran in January 2022 reflect a diagnosis of mild emphysema and acute bronchitis. These records were submitted after the January 2022 examiner's addendum opinion. Therefore, an addendum opinion is warranted. The matters are REMANDED for the following action: 1. Obtain any outstanding VA and private treatment records and associate them with the claims file. 2. Obtain an addendum opinion regarding the Veteran's respiratory claim. The entire claims file and a copy of this Remand must be made available to the reviewing examiner. The examiner should opine whether it is at least as likely as not (50 percent or greater possibility) that the Veteran's respiratory disorder, to include pulmonary embolism, deep vein thrombosis, and COPD is (1) caused by the service-connected carcinoma of the lung cancer, or (2) the Veteran's service-connected carcinoma of the lung cancer has caused additional functional impairment of the pulmonary embolism, deep vein thrombosis, and COPD (e.g., a worsening of the respiratory symptoms beyond those expected by the baseline level of disability, even if temporary). For purposes of this opinion, the examiner note recently received private medical records reflect treatment for acute bronchitis and a diagnosis of mild emphysema with mild scarring in the left lung base status post left lower lobectomy and prior treatment records reflect treatment for pulmonary embolus. In providing an opinion, the examiner should consider the private treatment records, submitted January 8, 2022, listing a diagnosis of mild emphysema and acute bronchitis. The examiner should also opine as to whether there is any medical reason to accept or reject the Veteran's December 2020 private medical examiner's opinion that the Veteran's lung clots are directly related to agent orange exposure. The examiner must provide all findings, along with a complete rationale for his or her opinion(s) in the examination report. If the medical professional cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation for why an opinion cannot be rendered. In doing so, the medical professional shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question. T. MAINELLI Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Adeleke, T. 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.