Citation Nr: 18144983 Decision Date: 10/25/18 Archive Date: 10/25/18 DOCKET NO. 16-55 593 DATE: October 25, 2018 REMANDED Entitlement to service connection for a cardiovascular disorder (other than hypertension) also claimed as cardiac impairment, to include atrial fibrillation, is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1982 to June 1987, and from May 2000 to July 2010. In a November 2014 rating decision, the Regional Office (RO) denied service connection for a cardiac impairment, to include atrial fibrillation. The Veteran filed a notice of disagreement (NOD) in April 2015. A statement of the case was issued in August 2016 and the Veteran filed a substantive appeal (VA Form 9) in October 2016. The Veteran indicated that she did not want a Board hearing. The appeal was certified to the Board in November 2016. In October 2017, the Board remanded the claim for further development. The Board recharacterized the claim as entitlement to service connection for a cardiovascular disorder (other than hypertension). In its decision, the Board indicated that the Veteran testified before a Veterans Law Judge in June 2016. While the Veteran testified before a Veterans Law Judge for the other issues included in the October 2017 Board decision, the Veteran did not testify in regard to the issue of entitlement to service connection for a cardiovascular disorder (other than hypertension) on appeal. The Board notes that no hearing on the issue on appeal is necessary as the Veteran specifically indicated that she did not want a hearing in the August 2016 substantive appeal and no hearing request has been submitted. However, additional development is required for compliance with the Board’s remand directives to decide the claim on appeal See Stegall v. West, 11 Vet. App. 268 (1998). Entitlement to service connection for a cardiovascular disorder (other than hypertension) also claimed as cardiac impairment, to include atrial fibrillation, is remanded. The October 2017 Board remand directives relating to the issue on appeal have not been fulfilled. These directives include obtaining any outstanding VA and private treatment records and affording the Veteran with a VA examination for her claimed cardiovascular disorder (other than hypertension). Thus, a remand is necessary for compliance with such instructions. The matter is REMANDED for the following action: 1. Obtain any outstanding VA treatment records and associate them with the claims file. 2. Ask the Veteran to identify any outstanding private treatment records that she wishes VA to obtain, and advise her that she may submit any additional evidence or information she might have to support her claim, to include lay statements. After obtaining any necessary authorization forms from the Veteran, obtain any pertinent records identified, and associate them with the claims file. Any negative responses should be in writing and should be associated with the claims file. 3. Schedule the Veteran for an appropriate examination to determine the etiology of her claimed cardiovascular disorder (other than hypertension), to include atrial fibrillation. The entire claims file must be made available to and be reviewed by the examiner. Any indicated tests and studies must be accomplished and all clinical findings must be reported in detail and correlated to a specific diagnosis. The examiner is asked to accomplish the following with respect to each cardiovascular disability diagnosed on examination: Provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that the diagnosed cardiovascular disability (other than hypertension): a) had its onset during the Veteran’s service. b) was manifested to a compensable degree within a year of the Veteran’s discharge from service in July 2010. c) is otherwise caused by or related to service. The examiner must address an April 2009 service treatment record reflecting that the Veteran had complained of heart palpitations and post-service diagnosis of atrial fibrillation. See VBMS entry with document type, “STRs – Medical,” receipt date 07/14/2016, on pages 54-58 (the complaint of heart palpitations is on page 55) and VBMS entry with document type, “Medical Treatment Record - Non-Government Facility,” receipt date 12/19/2016, on pages 1-3 (the diagnosis of atrial fibrillation is on page 2). The examiner must also discuss any lay statements of cardiovascular symptoms beginning during active duty that have persisted. A full rationale must be provided for all medical opinions given. If the examiner is unable to provide an opinion without resorting to mere speculation, he or she should explain why this is so. The examiner shall then explain whether the inability to provide a more definitive opinion is the result of a need for more information and indicate what additional evidence is necessary, or whether he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question(s). A. P. SIMPSON Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD D. Cheng, Associate Counsel