Citation Nr: 1328455 Decision Date: 09/06/13 Archive Date: 09/16/13 DOCKET NO. 08-15 678 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in San Diego, California THE ISSUES 1. Entitlement to service connection for stroke, to include as secondary to service-connected hypertension. 2. Entitlement to service connection for visual problems, to include as secondary to service-connected hypertension. 3. Entitlement to service connection for tachycardia, to include as secondary to service-connected hypertension. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD A. Michel, Associate Counsel INTRODUCTION The Veteran had active service from April 1992 to April 1998. This case comes before the Board of Veterans' Appeals (Board) on appeal from an August 2006 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Los Angeles, California. Jurisdiction was subsequently transferred to the RO in San Diego, California. In September 2012 the Veteran withdrew his claim for an increased rating for his right shoulder disability. Moreover, the RO granted entitlement to service connection for hypertensive heart disease in a January 2013 rating decision. As such, these claims are not before the Board. The Board notes that in September 2012 the Veteran also cancelled his request for a hearing before a Decision Review Officer. In May 2013 the Veteran testified at a videoconference hearing before the undersigned. A copy of the transcript is associated with the claims file. The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC. VA will notify the appellant if further action is required. REMAND At the outset, the Board notes that in September 2012, the RO requested disability records from the Social Security Administration (SSA). Although the RO requested such records, there is no indication that a response was received. The United States Court of Appeals for Veterans Claims has consistently held that where VA has notice that the veteran is receiving benefits from the SSA and that records from that Administration may be relevant, VA has a duty to acquire a copy of the decision granting SSA benefits and the medical documents relied upon by the SSA. See Baker v. West, 11 Vet. App. 163 (1998). Therefore, on remand, the RO should obtain a response to the request for SSA records. The Veteran contends that service connection is warranted for the disabilities on appeal as they are related to his service-connected hypertension. The Veteran was afforded VA examinations in December 2012 in which review of the claims file was not noted. The VA examiner noted that the Veteran had been diagnosed with supraventricular arrhythmia in 2006, and he reported rapid heartbeat in 2005 to 2007. The examiner also answered in the affirmative to the question "has the Veteran had a cardiac arrhythmia?" The examiner also noted intermittent supraventricular tachycardia but then stated that it had never been documented. The examiner stated that the Veteran was very anxious throughout the examination; the Veteran had ventricular tachycardia with exercise on 23-hour Holter monitor in June 2005, but no arrhythmia. The VA examiner appeared to base the opinion that the Veteran did not currently have tachycardia, in part, on absence of treatment. Therefore, the rationale is inadequate because it is symptoms, not treatment, which are the essence of any evidence of continuity of symptomatology. Savage v. Gober, 10 Vet App. 488, 496 (1997) (citing Wilson v. Derwinski, 2 Vet. App. 16, 19 (1991)). The December 2012 VA examiner also noted a diagnosis of Bell's palsy in 2005 with sudden onset of right facial paralysis; resolution was slow; no facial weakness now; no other neuropathy at same time. The Board finds that review of the claims file is imperative for a thorough VA examination and opinion as the record contains varying medical records and opinions as to whether the Veteran had a stroke or his incident was Bell's palsy. Specifically, the Board notes that Dr. S.T.F., M.D., provided an opinion in February 2007 that the Veteran had hypertensive eye changes and facial numbness related to Bell's palsy or small stroke related to poor blood pressure control. The Board finds that review of and comment on such medical records is required on remand. Accordingly, the case is REMANDED for the following action: 1. The RO or the AMC should undertake appropriate development to obtain any outstanding medical records pertaining to treatment or examination of the claimed disabilities on appeal, to specifically include SSA records. 2. Then, the Veteran should be afforded an examination by a physician with appropriate expertise to determine the nature and etiology of his claimed blurred vision, stroke, and tachycardia. The claims folder must be made available to and reviewed by the examiner. Any indicated studies should be performed. Based on the examination results and the review of the claims folder, to specifically include Dr. S.T.F.'s opinion, the examiner should provide an opinion as to whether there is a 50 percent or better probability that the Veteran has (or has had at any time since he filed his claim in December 2006) a disability or disabilities manifested by blurred vision, stroke, and/or tachycardia, and if so, whether there is a 50 percent or better probability that the claimed blurred vision, stroke, and/or tachycardia, if present, are etiologically related to (caused by or permanently worsened by) his service-connected hypertension or any other disease or injury of service origin. A complete rationale for each opinion expressed must also be provided. 3. The RO or the AMC should also undertake any other development it determines to be warranted. 4. Then, the RO or the AMC should adjudicate the issues on appeal in light of all pertinent evidence and legal authority. If the benefits sought on appeal are not granted to the Veteran's satisfaction, a Supplemental Statement of the Case should be furnished to him and his representative and they should be afforded the requisite opportunity to respond. Thereafter, if indicated, the case should be returned to the Board for further appellate action. By this remand the Board intimates no opinion as to any final outcome warranted. The appellant need take no action until he is otherwise notified, but he may furnish additional evidence and/or argument during the appropriate time frame. See Kutscherousky v. West, 12 Vet. App. 369 (1999). This REMAND must be afforded expeditious treatment. The law requires that all claims that are remanded by the Board or the Court for additional development or other appropriate action must be handled in an expeditious manner. See 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2012). _________________________________________________ MICHAEL A. PAPPAS 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) (2012).