Citation Nr: 1017232 Decision Date: 05/10/10 Archive Date: 05/26/10 DOCKET NO. 05-17 238 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in St. Petersburg, Florida THE ISSUE Entitlement to service connection for a chronic heart disorder to include coronary artery disease with coronary artery bypass graft residuals. REPRESENTATION Appellant represented by: The American Legion ATTORNEY FOR THE BOARD J. T. Hutcheson, Counsel INTRODUCTION The Veteran had active service from April 1972 to February 1980. This matter came before the Board of Veterans' Appeals (Board) on appeal from an August 2003 rating decision of the St. Petersburg, Florida, Regional Office (RO) which denied service connection for coronary artery disease with coronary artery bypass graft residuals. In June 2008, the Board remanded the Veteran's claim to the RO for additional action. This appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. The Department of Veterans Affairs (VA) will notify the Veteran if further action is required on his part. REMAND The Veteran asserts that service connection is warranted for a chronic heart disorder as the claimed disability was manifested during active service or, in the alternative, as the result of his exposure to Agent Orange and other herbicides while stationed in Thailand during the Vietnam War. In April 2005, the Veteran submitted an informal claim of entitlement to service connection for diabetes mellitus, hypertension, migraine, asthma, a bilateral leg disorder, a bilateral foot disorder, and a sleep disorder. An October 2007 VA memorandum in the claims files indicates that: [The Veteran] also reopened a VA compensation claim on February 21, 2007, involving the following issues for service connection due to Agent Orange exposure: stomach disorder; headaches; rectal bleeding; rashes; diabetes; prostate problems; asthma; bone disease; neuropathy; and circulation problems. Because [the Veteran's] file is currently at the BVA, we are unable to proceed as contents contained in his records may be necessary in order for us to reach a favorable decision. The report of a September 2008 VA examination for compensation purposes and the November 2008 addendum thereto notes that the Veteran was diagnosed with coronary artery disease and coronary artery bypass graft residuals. The examining physician's assistant opined that it was "more likely that the Veteran's uncontrolled diabetes, hypertension, combined with his morbid obesity has unfortunately caused his cardiac disease." The record does not reflect that the RO has not acted upon the Veteran's claims of entitlement to service connection for diabetes mellitus, hypertension, a circulatory disorder, migraine, asthma, a bilateral leg disorder, a bilateral foot disorder, a sleep disorder, a stomach disorder, a rectal disorder to include bleeding, a skin disorder to include rashes, a prostate disorder, a bone disorder, and neuropathy claimed as secondary to herbicide exposure. In light of the November 2008 VA examiner's opinion above, the Board finds that the issues of service connection for diabetes mellitus, hypertension, a circulatory disorder and other conditions are inextricably intertwined with the certified issue of service connection for a chronic heart disorder. Harris v. Derwinski, 1 Vet. App. 180 (1991). The fact that an issue is inextricably intertwined does not establish that the Board has jurisdiction of the issue, only that the Board cannot fairly proceed while there are outstanding matters that must be addressed by the RO in the first instance. Accordingly, the case is REMANDED for the following action: 1. Adjudicate the issues of service connection for diabetes mellitus, hypertension, a circulatory disorder, migraine, asthma, a bilateral leg disorder, a bilateral foot disorder, a sleep disorder, a stomach disorder, a rectal disorder to include bleeding, a skin disorder to include rashes, a prostate disorder, a bone disorder, and neuropathy claimed as secondary to herbicide exposure. The Veteran should be informed in writing of the resulting decision and his associated appellate rights. The issues are not on appeal unless there is a notice of disagreement and a substantive appeal as to the issues. 2. Then readjudicate the issue of the Veteran's entitlement to service connection for a chronic heart disorder to include coronary artery disease with coronary artery bypass graft residuals. If the benefit sought on appeal remains denied, the Veteran and his accredited representative should be issued a supplemental statement of the case (SSOC) which addresses all relevant actions taken on the claim, to include a summary of the evidence and applicable law and regulations considered, since the issuance of the last SSOC. The Veteran should be given the opportunity to respond to the SSOC. The Veteran is free to submit additional evidence and argument while the case is in remand status. See Kutscherousky v. West, 12 Vet. App. 369 (1999). The Veteran's appeal must be afforded expeditious treatment by the RO. The law requires that all claims that are remanded by the Board or by the United States Court of Appeals for Veterans Claims (Court) for additional development or other appropriate action must be handled in an expeditious manner. See The Veterans' Benefits Improvements Act of 1994, Pub. L. No. 103-446, § 302, 108 Stat. 4645, 4658 (1994), 38 U.S.C.A. § 5101 (West 2002) (Historical and Statutory Notes). In addition, VBA's Adjudication Procedure Manual, M21-1, Part IV, directs the ROs (CONTINUED ON NEXT PAGE) to provide expeditious handling of all cases that have been remanded by the Board and the Court. See M21-1, Part IV, paras. 8.44-8.45 and 38.02-38.03. _________________________________________________ S. S. TOTH Veterans Law Judge, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board is appealable to the Court. 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) (2009).