Citation Nr: 18145349
Decision Date: 10/26/18	Archive Date: 10/26/18

DOCKET NO. 13-18 791A
DATE:	October 26, 2018
REMANDED
Entitlement to service connection for cardiovascular disability is remanded.
REASONS AND BASES FOR FINDING AND CONCLUSION
The Veteran served on active duty from January 1979 to January 1999. 
1. Entitlement to service connection for cardiovascular disability
The Board concedes that the Veteran has current diagnoses for hypertension, cardiomyopathy/congestive heart failure (CHF), and non-ischemic cardiomyopathy. See August 2017 VA Examination. The Veteran contends that his cardiovascular disabilities were incurred in or are the result of his active duty service. 
During the Veteran’s post-remand August 2017 VA Examination, the examiner opined that the Veteran’s coronary artery disease was less likely than not incurred in or caused by service. The examiner stated they had reviewed all available medical records and that a left heart catheterization showed normal coronary arteries in 2004 and 2011. Based on this information, the examiner concluded that the Veteran did not have coronary artery disease and direct service connection was therefore not warranted. However, medical records from the Medical University of South Carolina (MUSC) suggest a diagnosis for coronary artery disease from June 2014 through January 2015. In light of this evidence in support of the Veteran’s claim, an addendum opinion is necessary as to the nature and etiology of the Veteran’s coronary artery disease.
The matter is REMANDED for the following action:
1. In accordance with the provisions of 38 C.F.R. § 3.159(c)(1), make efforts to obtain all records identified by the Veteran and any new records of VA treatment of the Veteran.
2. After updated records have been obtained, forward the Veteran’s file to a qualified VA medical professional to provide an addendum opinion to determine the nature and etiology of the Veteran’s coronary artery disease. If the examiner determines that an in-person examination of the Veteran is necessary, in light of the facts found, then such should be scheduled.
The examiner is asked to provide an opinion as to whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran’s claimed coronary artery disease had its onset directly during the Veteran’s active duty service or is otherwise related to service. Consideration should be given to the cited Veteran’s medical treatment records from MUSC.
(Continued on the next page)


 
A. C. MACKENZIE
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	Evan Thomas Hicks