Citation Nr: 18143622 Decision Date: 10/19/18 Archive Date: 10/19/18 DOCKET NO. 14-38 304A DATE: October 19, 2018 REMANDED Entitlement to dependents and indemnity compensation for service connection for the cause of the Veteran’s death is remanded. REASONS FOR REMAND The Veteran served honorably with the United States Army Air Corps from February 1943 to November 1945. The Veteran was awarded the Purple Heart for his service during World War II. The Veteran died in December 2011. The Appellant in the present appeal is his surviving widow. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an April 2012 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). The Appellant testified before the undersigned Veterans Law Judge at a Board videoconference hearing in July 2018. A transcript of the hearing has been associated with the record. Entitlement to dependents and indemnity compensation for service connection for the cause of the Veteran's death is remanded. The Appellant contends that the Veteran’s service-connected generalized anxiety disorder (GAD) either caused or aggravated his heart condition which resulted in his death. Although the Board regrets the delay, a remand is necessary to ensure that due process is followed and that there is a complete record upon which to decide the claim for service connection for the Veteran’s cause of death, so that the Appellant is afforded every possible consideration. 38 U.S.C. § 5103A; 38 C.F.R. § 3.159. VA’s duty to assist includes a duty to provide a medical examination or obtain a medical opinion where it is deemed necessary to make a decision on the claim. 38 U.S.C. § 5103A (d); 38 C.F.R. § 3.159 (c)(4); Duenas v. Principi, 18 Vet. App. 512 (2004); Robinette v. Brown, 8 Vet. App. 69 (1995); McLendon v. Nicholson, 20 Vet. App. 79 (2006). The Board finds that a remand is necessary in order to obtain a VA medical opinion regarding the nature and etiology of the Veteran’s death. In this regard, the Veteran’s death certificate documents that he died in December 2011. His cause of death was listed as cardiopulmonary arrest, ischemic cardiomyopathy/congestive heart failure, and coronary artery disease. Other significant conditions contributing to the Veteran’s death were coronary artery bypass graft, pacemaker, aortic stenosis, and pulmonary hypertension. At the time of his death, the Veteran was service-connected for GAD, tinnitus, bilateral hearing loss, and burn scars. During the July 2018 Board hearing, the Appellant asserted that the Veteran monitored his blood pressure frequently. She added that the Veteran’s blood pressure was higher than normal when he became upset. The Appellant called the Veteran’s doctors, as instructed, when his blood pressure was too high. The Appellant believes that high blood pressure due to GAD caused the Veteran’s death. Additionally, the Appellant provided two medical opinions from private providers finding that the Veteran’s service-connected GAD was related to or made his heath condition worse. On February 2013, Dr. D.W. opined that the Veteran’s documented hypertension and service-connected anxiety disorder contributed to his overall cardiac failure in 2011. He added that the Veteran’s serviced-connected GAD should be considered in his cause of death. Dr. D.W.’s opinion was not supported with any rationale. In a March 2013 letter, Dr. U.R. opined that it is as likely as not that the Veteran’s heart condition was related to decades of mental health stress or at least his heart condition was made worse by his mental health condition. While Dr. U.R. was the Veteran’s treating physician for hypertension and heart disease and reviewed the Veteran’s medical records, he failed to provide a rationale for his opinion. The provided opinions should be addressed and reconciled by a VA examiner in order to evaluate whether it is at least likely or not that the Veteran’s GAD either caused or aggravated the underlying etiology of the Veteran’s heart condition. To date, the VA has not obtained a medical opinion regarding the etiology of the Veteran’s death. Accordingly, the Board finds that a VA medical opinion is needed before this claim can be decided on the merits. Accordingly, the case is REMANDED for the following actions: 1. Obtain an opinion from an appropriate medical professional as to the etiology of the Veteran’s heart condition that resulted in his death. Following a review of the claims file, the examiner is asked to furnish an opinion with respect to the following questions: The examiner should offer an opinion as to whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s heart condition was either caused by or aggravated by the Veteran’s service-connected GAD. Specifically, the examiner is asked to address the medical opinions provided by Dr. U.R. and Dr. D.W. and the Appellant’s contentions regarding the Veteran’s blood pressure. The examiner should also discuss the rationale for the opinion, whether favorable or unfavorable, if necessary citing to specific evidence of the record. 2. Readjudicate the appeal. L. M. BARNARD Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Hartford, Associate Counsel