Citation Nr: 18141470 Decision Date: 10/10/18 Archive Date: 10/10/18 DOCKET NO. 15-14 592A DATE: October 10, 2018 REMANDED Entitlement to an initial evaluation greater than 10 percent disabling for the period prior to March 23, 2016, and greater than 30 percent for the period thereafter, for service-connected coronary artery disease (CAD) status post myocardial infraction is remanded. REFERRED The issue of entitlement to an evaluation in excess of 50 percent disabling for service-connected post-traumatic stress disorder (PTSD) was raised in a November 2007 statement and is referred to the Agency of Original Jurisdiction (AOJ) for adjudication. REASONS FOR REMAND The Veteran served on active duty from June 1961 to August 1971. In a November 2017 rating decision, the evaluation of the Veteran’s service-connected disability was increased from 10 percent disabling to 30 percent disabling, effective March 23, 2016. In July 2018, the Veteran was sent correspondence by the Board seeking clarification of his representation. The letter informed the Veteran that if he did not respond within thirty days, then the Board will assume that he wishes to represent himself. No response has been received from the Veteran, therefore, the Board presumes that the Veteran proceeds pro se. In August 2018, the Veteran withdrew his request for a hearing. Entitlement to an initial evaluation greater than 10 percent disabling for the period prior to March 23, 2016, and greater than 30 percent for the period thereafter, for service-connected CAD status post myocardial infraction is remanded. The Board finds that additional development is needed prior to final adjudication of the issue on appeal. Specifically, the Board finds that an addendum opinion is needed to address lay statements submitted by the Veteran’s spouse. In January 2014, VA received statements from the Veteran’s wife indicating that she has observed things that the Veteran does that are more strenuous than they should be. For example, they had to get a riding lawn mower five-years prior because the Veteran could no longer mow the grass with a walking lawn mower. She also observed that whenever the Veteran goes to work in the yard, he just ends up sitting in the swing and staring. He cannot carry groceries in from the car and he does not exercise. The furthest he walks from the house is to the car and he cannot walk fast. The Veteran was afforded VA examinations in June 2013 and March 2016, and the spouse’s statement was submitted in the interim, in January 2014. However, the March 2016 examiner stated that there was no new evidence to review since the 2013 examination, and did not consider the spouse’s statements. Upon remand, the Board requests that an addendum opinion be obtained that considers her lay statements. In addition, it appears that the Veteran was granted disability benefits by the Social Security Administration (SSA), with a disability onset date of April 15, 1968; however, these records have never been obtained. Although it is unlikely that they still exist, since the issue is being remanded for other reasons, the Board will attempt to obtain these records on remand in order to afford the Veteran full due process. Accordingly, the matter is REMANDED for the following action: 1. After securing any necessary consent forms from the Veteran, obtain any outstanding treatment records, to include any VA and/or private treatment records, pertaining to the issue on appeal. In addition, obtain records from the SSA pertaining to any application or award of disability benefits to the Veteran. The Board points to a disability onset date of April 15, 1968, indicated in the record. All efforts to obtain these records should be documented in the claim file. If any records could not be obtained, this should be noted in the claim file. 2. Upon completion of the above, obtain an addendum opinion, which addresses the Veteran’s spouse’s statements submitted in January 2014. They Veteran may be scheduled for a new examination, if necessary. If possible, the examiner is asked to address how these statements impact, if at all, METs testing. For all examinations, all necessary development should be taken. The VA examiner should be given access to the claim file. The examiner should state that a review of the claim file was completed. The examiner must provide a comprehensive report including complete rationales for all opinions and conclusions reached, citing the objective medical findings leading to the conclusions. A detailed rationale is requested for all opinions provided. 3. If upon completion of the above action the issue is denied, the case should be returned to the Board after compliance with appellate procedures. E. I. VELEZ Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD K. Foster, Associate Counsel