Citation Nr: 18144176 Decision Date: 10/24/18 Archive Date: 10/23/18 DOCKET NO. 14-23 157 DATE: October 24, 2018 ORDER Entitlement to an initial rating in excess of 60 percent for coronary artery disease is denied. FINDING OF FACT For the entire period on appeal, the Veteran’s coronary artery disease has been manifested by a by a workload of greater than 3 METs, but not greater than 5 METs; with dyspnea, fatigue, and dizziness. CONCLUSION OF LAW The criteria for an initial rating in excess of 60 percent for coronary artery disease have not been met. 38 U.S.C. § 1155 (2012); 38 C.F.R. §§ 4.7, 4.104, Diagnostic Code 7005 (2018). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active military service from November 1969 to May 1972. This case comes before the Board of Veterans’ Appeals (Board) on appeal from a January 2012 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Waco, Texas. During the pendency of the appeal, in a June 2018 rating decision, the RO assigned a 60 percent rating for coronary artery disease, effective August 31, 2010, the effective date of service connection. That does not constitute a full grant of the benefit sought on appeal. However, the Board has limited its consideration accordingly. The Board acknowledges that the Veteran has alleged that he is unable to work as a result of his service-connected coronary artery disease, along with other service-connected disabilities. A review of the record shows that the Veteran has been granted entitlement to a total disability rating based on individual unemployability due to service connected disabilities (TDIU), effective March 19, 2018. The Veteran has not yet filed a notice of disagreement with the effective date assigned for entitlement to a TDIU. Therefore, the Board declines jurisdiction of the issue of entitlement to a TDIU despite the decision by the United States Court of Appeals for Veterans Claims (Court) in Rice v. Shinseki, 22 Vet. App. 447 (2009). In this regard, the Board notes that the Veteran had the opportunity to perfect an appeal of that issue and has yet to properly do so. Coronary artery disease The Veteran is currently rated at 60 percent for his service-connected coronary artery disease, effective August 31, 2010. The Veteran provided an Ischemic Heart Disease Disability Benefits Questionnaire in June 2011. At that time, diagnostic exercise testing had not been done. Further, the Veteran denied experiencing dyspnea, fatigue, angina, dizziness, or syncope. The Veteran underwent a VA examination in June 2016. At that time, the examiner noted the diagnosis of coronary artery disease and acute, subacute, or old myocardial infarction. The examiner noted that continuous medication was required for control of the Veteran’s heart condition. The examiner noted that the Veteran had a myocardial infarction in January 2010. An interview based METs test was performed at that time, resulting in a maximum workload of greater than 3 METs, but not greater than 5 METs. The Veteran’s symptoms during activity were dyspnea, fatigue, and dizziness. The examiner noted that the Veteran did not have congestive heart failure, or a cardiac arrhythmia. The Veteran’s left ventricular ejection fraction was 55 percent. A review of the record shows that the Veteran also receives treatment for various disabilities at the VA Medical Center. However, there is no indication from the treatment notes of record that the Veteran has symptoms of his heart disability that are worse than those already reported by the private treatment providers and the VA examiner. Indeed, in a March 2018 statement, the Veteran indicated that his coronary artery disease should be rated at 50 percent. The Board finds that the Veteran is not entitled an initial rating in excess of 60 percent for coronary artery disease. There is no evidence that the Veteran has chronic congestive heart failure; a workload of 3 METs or less resulting in dyspnea, fatigue, angina, dizziness, or syncope; or, left ventricular dysfunction with an ejection fraction of less than 3 percent. 38 C.F.R. § 4.104, Diagnostic Code 7005 (2018). Consideration has been given to assigning staged ratings. However, at no time during the period in question has the disability warranted a higher schedular rating than that assigned. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). Accordingly, the Board finds that the preponderance of the evidence is against the claim and entitlement to an initial rating in excess of 60 percent for coronary artery disease is not warranted. 38 U.S.C. § 5107 (b) (2012); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Kristin Haddock Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD I. Cannaday, Associate Counsel