Citation Nr: 18140536 Decision Date: 10/04/18 Archive Date: 10/03/18 DOCKET NO. 14-13 686 DATE: October 4, 2018 REMANDS Entitlement to service connection for the cause of death is remanded. REASON FOR REMAND The Veteran had a period of active duty service February 1967 to January 1970. 1. Entitlement to service connection for the cause of death is remanded. The appellant is claiming service connection for cause of death. At the time of the Veteran’s death, service connection had been granted for coronary artery disease (CAD), anxiety disorder, and residuals of lacerations to the second, third, and fourth fingers of his left hand. The Veteran’s death certificate states that the Veteran’s death was caused by cardiac arrest contributed to by pulmonary arrest, chronic obstructive pulmonary disease, and renal failure. To establish service connection for the cause of the Veteran's death, the evidence must show that a disability incurred in or aggravated by active service caused, or contributed substantially or materially to cause, that death. 38 U.S.C. § 1310 (2012); 38 C.F.R. § 3.312 (2018). The service-connected disability will be considered as the principal (primary) cause of death when such disability, singly or jointly with some other condition, was the immediate or underlying cause of death or was etiologically related thereto. 38 C.F.R. § 3.312 (b) (2018). A contributory cause of death is inherently one that is not related to the principal cause. For a service-connected disability to be determined as a contributory cause of a veteran's death for compensation purposes, it must be shown that it contributed substantially or materially; that it combined to cause death; that it aided or lent assistance to the production of death. It is not sufficient to show that it casually shared in producing death, but rather it must be shown that there was a causal connection. 38 C.F.R. § 3.312 (c)(1) (2018). In a March 2014 VA cause of death C&P addendum opinion, the examiner opined that the Veteran’s immediate cause of death was cardiac arrest, contributed by pulmonary arrest, chronic obstructive pulmonary disease and renal failure. The examiner noted that the etiology of the Veteran’s cardiac arrest was not associated with his CAD, but rather conditions of the respiratory system. The examiner noted that the Veteran’s service connected CAD did not cause his cardiac arrest which resulted in his death. The Board finds the March 2014 cause of death VA C&P addendum opinion to be inadequate because it only addresses whether the Veteran’s CAD caused his cardiac arrest. The examiner did not address in detail whether the Veteran’s CAD which contributed substantially or materially to his cardiac arrest resulting in his death. 38 C.F.R. § 3.312 (c)(1) (2018). VA has a duty to assist. The VA’s duty to assist requires it to provide a medical examination or obtain a medical opinion if the information and evidence of record does not contain sufficient medical evidence to decide the claim, but contains competent lay or medical evidence of a current diagnosed disability. See 38 C.F.R. § 3.159 (2018). The current claims record contains competent and credible evidence of a CAD disability. The Appellant asserts that the etiology of the Veteran’s cause of death is his CAD disability or that the Veteran’s CAD contributed substantially or materially contributed to the Veteran’s death. After a thorough review of the Veteran’s claims file, a VA addendum opinion is necessary to make a determination on the Veteran’s cause of death claim. 1. Obtain an opinion from a VA medical professional. The examiner should review the claims folder and documents contained in the electronic claims folder. The examiner is requested to provide the following opinion: a) The examiner is asked to provide an opion as to whether it is at least as likely as not (50 percent probability or more) that the Veteran’s service-connected coronary artery disease contributed substantially or materially to his cardiac arrest resulting in his death If the above opinion is negative, then the examiner is asked to provide an opinion as to whether it is at least as likely as not (50 percent probability or more) that a disability of service origin caused ot contributed substantially or materially to the Veteran’s death/ (Continued on the next page)   A complete rationale for any opinions expressed must be provided. ROBERT C. SCHARNBERGER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Elliot Harris, Associate Counsel