Citation Nr: 18139932 Decision Date: 10/01/18 Archive Date: 10/01/18 DOCKET NO. 16-58 305 DATE: October 1, 2018 REMANDED Entitlement to service connection for the cause of the Veteran's death is remanded. REASONS FOR REMAND The appellant is the surviving spouse of a Veteran who served on active duty from January 1962 to December 1963. The Veteran died in July 2015. This matter is before the Board of Veterans' Appeals (Board) on appeal from a February 2016 rating decision by the Philadelphia, Pennsylvania Department of Veterans Affairs (VA) Regional Office (RO). In July 2017, a hearing was held before a Decision Review Officer (DRO) at the RO; a transcript is associated with the record. 1. Entitlement to service connection for the cause of the Veteran's death is remanded. The appellant asserts the Veteran died due to a fall caused by his service-connected Meniere’s disease. July 2015 VA and private treatment records show the Veteran sustained multiple injuries after falling from a ladder at home. An August 2015 autopsy report notes the Veteran’s cause of death was body trauma due to an accident. In a February 2016 VA opinion, a VA examiner indicated he reviewed the relevant VA and private treatment records and opined it was less likely than not that the Veteran’s death was caused by his service-connected Meniere’s disease. He reasoned that the death certificate was silent for Meniere’s syndrome as a contributory cause of death, that there was no evidence of recent treatment for Meniere’s syndrome, and that no medical evidence supported the claim. However, the examiner did not address medical evidence submitted by the appellant in November 2015. Specifically, she submitted a Mayo Clinic medical article that suggests Meniere’s disease can make one more prone to falling and an October 2014 private treatment record that shows the Veteran was treated for another fall at that time. As the examiner did not address this evidence and, in fact, noted there was no evidence supporting the claim, the February 2016 opinion is inadequate, and remand to secure an adequate opinion is necessary. In addition, it’s not clear whether there are outstanding records of VA treatment fore the service-connected Meniere’s disease. At the July 2017 DRO hearing, the appellant suggested the Veteran received VA outpatient care for the disbaility, and the earliest records of VA treatment associated with the file date from June 2015. Any VA treatment records are within VA’s constructive possession, and are considered potentially relevant, especially if they show treatment for Meniere’s disease in this case. On remand, it should be determined whether the Veteran received VA treatment prior to June 2015, and, if so, the records of such treatment should be obtained and associated with the record. The matter is REMANDED for the following action: 1. Obtain any VA treatment records from prior to June 2015. 2. After the above-requested development is completed, the AOJ should arrange for the Veteran's record to be forwarded to an appropriate physician for review and an advisory medical opinion. The examiner should also have available for review the 38 C.F.R. § 3.312 (c)(1) definition of contributory cause of death. Upon review of the record, the examiner should respond to the following: Based on the factual evidence of record, is it at least as likely as not (a 50 percent or better probability) that the service-connected Meniere’s disease caused or contributed (contributed substantially or materially; combined to cause death; aided or lent assistance to the production of death) to the Veteran’s death. The examiner must provide rationale for all opinions, to specifically include comment on the evidence already in the record, including the February 2016 VA opinion, the Mayo Clinic Internet article that indicates there is a medical link between Meniere’s disease and falling, and the October 2014 private treatment records that show the Veteran had fallen before. KRISTY L. ZADORA Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD William Skowronski, Associate Counsel