Citation Nr: 22018194 Decision Date: 03/28/22 Archive Date: 03/28/22 DOCKET NO. 17-55 271 DATE: March 28, 2022 REMANDED Entitlement to service connection for a respiratory disorder, to include breathing issues, shortness of breath, difficulty sleeping, and sleep apnea, is remanded. REASONS FOR REMAND The Veteran served honorably on active duty in the United States Navy from September 1989 to December 1993. The Veteran had an additional period of service from December 10, 1993, to March 31, 2004, that has been deemed dishonorable for VA purposes, and therefore benefits cannot be awarded for injuries incurred during that period. See June 2016 VA Administrative Decision. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2017 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Houston, Texas. In April 2019, and most recently in October 2019, the Board remanded the Veteran's claim for additional development. Unfortunately, as explained below, the Board is not satisfied that there was substantial compliance with the remand; therefore, the appeal must once again be remanded. See Stegall v. West, 11 Vet. App. 268, 271 (1998); D'Aries v. Peake, 22 Vet. App. 97, 105 (2008). Entitlement to service connection for a respiratory disorder is remanded. The Veteran seeks entitlement to service connection for a respiratory disorder which he asserts was incurred in or caused by his active service. The Veteran's DD Form 214 show that the Veteran worked as a hull technician. The probability of asbestos exposure is considered high. In October 2019, the Board remanded the claim for the RO to obtain an addendum opinion addressing whether the Veteran's respiratory disorder was related to his claimed in-service asbestos exposure. The RO obtained a VA examination and opinion in December 2019. After reviewing the Veteran's claims file, the examiner concluded that the Veteran's respiratory disorder is less likely not incurred in our caused by claimed asbestos exposure during service. The examiner noted the Veteran's "significant history" of chronic heart failure with an ejection fraction (EF) of approximately 30 percent. Addressing the Veteran's documented post-service complaints of shortness of breath, the examiner explained that the Veterans' EF is very low and would cause shortness of breath at rest. The examiner noted the Veteran's history of smoking and emphysema along with multiple spontaneous pneumothorax that required a chest tube. She also stated that there is no noted diagnosis of asbestosis. She then stated that a nexus has not been established. However, nowhere in this rationale does the examiner address, as requested, whether any of the Veteran's respiratory disorders, were caused by the claimed in-service asbestos exposure. Accordingly, the Board finds this opinion to be inadequate and an additional remand is warranted. Accordingly, the matter is REMANDED for the following actions: Obtain a VA medical opinion from an appropriate VA medical professional, who has not previously provided an opinion, that addresses all respiratory conditions diagnosed during the pendency of the appeal (since June 2017), to include emphysema, and multiple spontaneous pneumothorax. A full VA examination should not be scheduled unless deemed necessary by the examiner or otherwise required by the evidence. The examiner must review the claims file in its entirety, to include a copy of this REMAND, and that review must be noted in the report. The examiner should set forth all currently-diagnosed respiratory conditions, including those diagnosed during the pendency of the appeal, even if currently resolved. Thereafter, the examiner is asked to provide an opinion with respect to the following: (a) Whether any currently-diagnosed respiratory condition to include emphysema, and multiple spontaneous pneumothorax, was incurred in or caused by an in-service injury, illness, or event during the Veteran's active service from September 27, 1989 to December 9, 1993, to include possible exposure to asbestos? The examiner should note that the Veteran's military occupational specialty of hull technician has a high probability of exposure to asbestos In providing the requested opinion, the examiner should specifically consider and address the following evidence: STR note documenting the Veteran's complaints of cough productive of phlegm for the 7 days prior, with the provider rendering a diagnosis of upper respiratory infection. See April 29, 1991 STR STR note documenting the Veteran's past history of asbestos exposure due to work of removing lagging between 1989 and 1999. See July 7, 1997 STR The Veteran's claim for breathing issues, shortness of breath and difficulty sleeping, all related to claimed asbestos exposure in-service beginning in 1989. See June 2017 Claim The examiner must set forth a complete rationale for any conclusion reached, citing to medical literature and/or evidence in the Veteran's claims file as necessary. If an opinion cannot be reached without resorting to speculation, the examiner must fully explain why. 2. Thereafter, review the requested VA medical opinion to ensure responsiveness and compliance with the directives of this remand; implement corrective procedures as needed. Compliance with the Board's remand instructions is neither optional nor discretionary. Stegall v. West, 11 Vet. App. 268 (1998). LESLEY A. REIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Gates 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.