Citation Nr: 0604428 Decision Date: 02/15/06 Archive Date: 02/28/06 DOCKET NO. 00-11 799 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUES 1. Entitlement to service connection for a kidney disorder. 2. Entitlement to service connection for chronic obstructive pulmonary disease (COPD). 3. Entitlement to service connection for a heart disorder with inoperable atrial fibrillation. REPRESENTATION Appellant represented by: The American Legion WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Nathan Paul Kirschner, Associate Counsel INTRODUCTION The veteran served on active duty from October 1950 to October 1952. This matter comes before the Board of Veterans' Appeals (Board) on appeal from rating decisions by the Regional Office (RO) of the Department of Veterans' Affairs (VA) in St. Petersburg, Florida. In November 1999 the RO, in pertinent part, denied the veteran's claim as to whether new and material evidence had been opened sufficient to reopen the veteran's claim for service connection for a kidney disability. In August 2001 the RO, again in pertinent part, denied the appellant's claims of entitlement to service connection for a heart condition with inoperative atrial fibrillation and chronic obstructive pulmonary disease. In October 2004 the Board reopened the veteran's claim for service connection for a kidney disability and REMANDED that claim, along with the veteran's claims for service connection for a heart condition with inoperative atrial fibrillation and chronic obstructive pulmonary disease to the RO for further development. After the requested development was completed the RO again denied service connection for kidney disease, a heart condition with inoperative atrial fibrillation, and chronic obstructive pulmonary disease. REMAND The evidence in this case includes a statement from Craig N. Bash M.D. wherein he addresses each of the disabilities now on appeal before the Board. He has advanced his opinion that each of the disabilities was initially manifested during service and he indicated that in arriving at his opinions, he had considered service medical records and post-service medical records. Under such circumstances, VA examination with opinion would is required. See 38 U.S.C.A. § 5103A (West 2002); Green v. Derwinski, 1 Vet. App. 121 (1991). The appellant is hereby notified that it is the appellant's responsibility to report for the examination and to cooperate in the development of the case, and that the consequences of failure to report for a VA examination without good cause may include denial of the claim. 38 C.F.R. §§ 3.158 and 3.655 (2005). The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC for the following actions: 1. Arrangements should be made with the appropriate VA medical facility for the veteran to be afforded a VA renal examination in order to ascertain the etiology and severity of any renal disability that may be present. Such tests as the examining physician deems necessary should be performed. The examiner should express an opinion as to whether it is at least as likely as not (i.e., a likelihood of 50 percent or greater) that any current kidney disability was initially manifested during service or is otherwise related to military service to include any medical treatment therein. The examiner should provide a complete rationale for the opinion expressed. The claims folder must be made available to the examiner in conjunction with the examination, and the examiner should acknowledge such review in the examination report to specifically include consideration of the opinion advanced by Dr. Bash. 2. The RO should also schedule the veteran for a pulmonary examination. All indicated evaluations, studies, and tests deemed necessary by the examiner should be accomplished, to include pulmonary function testing. The examiner should provide an opinion as to the veteran's current diagnosis, and as to whether it is at least as likely as not (i.e., a likelihood of 50 percent or greater) that any diagnosed respiratory disorder was manifested in service or is otherwise related to his service. The claims folder must be made available to and reviewed by the examiner in conjunction with the scheduled examination, and the examiner should acknowledge such review in the examination report to specifically include consideration of the aforementioned opinion from Dr. Bash. 3. The RO should also schedule the veteran for a heart examination. All indicated evaluations, studies, and tests deemed necessary by the examiner should be accomplished. The examiner should provide an opinion as to the veteran's current diagnosis, and as to whether it is at least as likely as not (i.e., a likelihood of 50 percent or greater) that any diagnosed cardiac disorder is related to his service, to include any medical treatment therein. The examiner should also address the question of whether the veteran manifested essential hypertension during his period of service. The claims folder must be made available to and reviewed by the examiner in conjunction with the scheduled examination, and the examiner should acknowledge such review in the examination report to specifically include consideration of the aforementioned opinion from Dr. Bash. 4. Thereafter, the RO should readjudicate the issues on appeal. If the determination remains unfavorable to the appellant, he should be provided with a supplemental statement of the case (SSOC) that addresses all relevant actions taken on the claims for benefits, to include a summary of the evidence and applicable law and regulations considered. The appellant should be given an opportunity to respond to the SSOC. The appellant has the right to submit additional evidence and argument on the matter or matters the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board of Veterans' Appeals or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2005). _________________________________________________ C. W. SYMANSKI Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Appeals for Veterans Claims. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (2005).