Citation Nr: 18142003
Decision Date: 10/12/18	Archive Date: 10/12/18

DOCKET NO. 13-20 670
DATE:	October 12, 2018
REMANDED
Entitlement to a rating in excess of 60 percent for coronary artery disease (CAD) is remanded.
Entitlement to total disability rating based on individual unemployability (TDIU) is remanded.
REASONS FOR REMAND
The Veteran served on active duty from May 1969 to July 1970.
These matters come before the Board of Veterans’ Appeals (Board) on appeal from a February 2011 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO).
In March 2015, the Veteran testified at a videoconference hearing before the undersigned Veterans Law Judge.  A copy of the transcript is associated with the evidentiary record.
This matter was remanded in August 2015 for further development.  
Entitlement to a rating in excess of 60 percent for CAD is remanded.
The Veteran contends that his service-connected CAD has worsened to the degree that it warrants a higher disability rating.  At his Board hearing the Veteran testified to increased symptoms of fatigue, shortness of breath and pain.  He reported that an 2012 arteriogram showed 100% blockage of his left artery and testified that as a result of his CAD he stopped working in 2010.  The Veteran also reported difficulty walking 75 feet to his mailbox.  With respect to medication the Veteran testified that he takes nitroglycerin at least once per day, and sometimes multiple times a day.  See March 2015 Hearing Testimony. 
The Veteran’s most recent VA examination for his CAD occurred in September 2015.  However, September 2018 treatment records show the Veteran was recently hospitalized for bilateral pulmonary embolism with left leg pain, sharp chest pain and shortness of breath.  The records also note a diagnosis of heart failure.  See September 2018 CAPRI.  This evidence suggests worsening of the Veteran’s CAD.  However, as the evidence does not address whether the Veteran has chronic heart failure and does not offer current MET measurements a current examination is warranted. 
Accordingly, this matter is remanded. 
Entitlement to TDIU is remanded. 
The Veteran’s claim for TDIU is inextricably intertwined with his claim for an increased rating.  Accordingly, this matter is remanded.  
The matters are REMANDED for the following action:
1. Schedule the Veteran for an examination to determine the current severity of his CAD.  To the extent possible, the examiner should identify any symptoms and functional impairments due to CAD including an assessment of whether the Veteran has chronic heart failure, and measurement of the Veteran’s work load, in METs.  
The examiner should also discuss the effect of the Veteran’s CAD on any occupational functioning.  
2. Thereafter, readjudicate the claims.  If the Veteran’s claims cannot be granted, provide the Veteran and his representative with a supplemental statement of the case and return the case to the Board. 
 
S. HENEKS
Veterans Law Judge
Board of Veterans’ Appeals


ATTORNEY FOR THE BOARD                       A. Wimbish, Associate Counsel