Citation Nr: 18140277 Decision Date: 10/02/18 Archive Date: 10/02/18 DOCKET NO. 16-10 876 DATE: October 2, 2018 REMANDED Entitlement to service connection for an abdominal aneurysm. REASONS FOR REMAND The Veteran served honorably in the Army from September 1968 until April 1971. This case comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2012 rating decision of the Department of Veteran Affairs (VA) Regional Office (RO) in Roanoke, Virginia. In his March 2016 substantive appeal the Veteran did not request a Board hearing before a Veterans Law Judge (VLJ). The Veteran initiated an appeal regarding the issue of entitlement to an initial evaluation in excess of 30 percent, for service-connected posttraumatic stress disorder (PTSD) but did not perfect the appeal. In July 2014 the Veteran filed a Notice of Disagreement (NOD). In a January 2016 rating decision, the RO increased the evaluation to 70 percent. The issue was addressed in a January 2016 statement of the case (SOC). In a March 2016 substantive appeal, the Veteran indicated that he read the SOC and that he was only appealing the issues of entitlement to service connection for an abdominal aneurysm and entitlement to service connection for diabetes mellitus. Additionally, in a March 2017 submission the Veteran’s representative noted the increased rating issue was withdrawn. Accordingly, the issue of entitlement to an initial evaluation in excess of 70 percent is not in appellate status, and no further consideration is necessary. In a January 2016 rating decision, service connection for diabetes mellitus was granted. This represents a full grant of the benefits sought, and the issue is no longer in appellate status. See Grantham v. Brown, 114 F. 3d 1156, 1158 (Fed. Cir. 1997). The record contains no indication that the Veteran has disagreed with the initial rating or effective date assigned, thus, those matters are not in appellate status. See Grantham, 114 F. 3d at 1158 (holding that a separate notice of disagreement must be filed to initiate appellate review of “downstream” elements such as the disability rating or effective date assigned). Entitlement to service connection for an abdominal aneurysm. Remand is required to secure an examination. VA has a duty to assist claimants to obtain evidence needed to substantiate a claim. 38 U.S.C. § 5103A (2012); 38 C.F.R. § 3.159 (2018). VA’s duty to assist includes providing a medical examination when is necessary to make a decision on a claim. 38 U.S.C. § 5103A(d); 38 C.F.R. § 3.159(c)(4). The RO did not provide the Veteran with an aneurysm examination. Such development is necessary if the information and evidence of record does not contain sufficient competent medical evidence to decide the claim, but (1) contains competent evidence of diagnosed disability or recurrent symptoms of disability, (2) establishes that the Veteran suffered an event, injury or disease in service, or has a presumptive disease during the pertinent presumptive period, and (3) indicates that the claimed disability may be associated with the in-service event, injury, or disease, or with another service-connected disability. 38 C.F.R. § 3.159(c)(4); McLendon v. Nicholson, 20 Vet. App. 79, 83-86 (2006) (noting that the third element establishes a low threshold and requires only that the evidence “indicates” that there “may” be a nexus between the current disability or symptoms and active service, including equivocal or non-specific medical evidence or credible lay evidence of continuity of symptomatology). Here, VA treatment records show a diagnosis of an abdominal aortic aneurysm. The Veteran’s service treatment records (STRs) show complaints of severe stomach burning, pain in upper gastrointestinal system, and abdominal cramping. Additionally, the Veteran’s VA treatment records include similar abdominal symptoms. Because there is evidence of currently diagnosed disabilities, an in-service event, and an indication that the current disabilities may be associated with the in-service event, remand for a VA examination is required. The matter is REMANDED for the following action: 1. Contact the appropriate VA Medical Center and obtain and associate with the claims file all outstanding records of treatment. If any requested records are not available, or the search for any such records otherwise yields negative results, that fact must clearly be documented in the claims file. Efforts to obtain these records must continue until it is determined that they do not exist or that further attempts to obtain them would be futile. The non-existence or unavailability of such records must be verified and this should be documented for the record. Required notice must be provided to the Veteran and his representative. 2. Contact the Veteran and afford him the opportunity to identify by name, address and dates of treatment or examination any relevant medical records. Subsequently, and after securing the proper authorizations where necessary, make arrangements to obtain all the records of treatment or examination from all the sources listed by the Veteran which are not already on file. All information obtained must be made part of the file. All attempts to secure this evidence must be documented in the claims file, and if, after making reasonable efforts to obtain named records, they are not able to be secured, provide the required notice and opportunity to respond to the Veteran and his representative. 3. After any additional records are associated with the claims file, provide the Veteran with an appropriate examination to determine the etiology of his abdominal aneurysm. The entire claims file must be made available to and be reviewed by the examiner. Any indicated tests and studies must be accomplished and all clinical findings must be reported in detail and correlated to a specific diagnosis. An explanation for all opinions expressed must be provided. The examiner must elicit a full history from the Veteran regarding his post-service symptoms. The examiner must provide an opinion regarding whether it is at least as likely as not (50 percent or greater probability) that the abdominal aneurysm had onset in, or is otherwise related to, active military service. The examiner must specifically address the complaints of cramping, stomach burning, and upper gastrointestinal pain contained in the Veteran’s STRs. K. MILLIKAN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD C. Bruton, Associate Counsel