Citation Nr: 18145415 Decision Date: 10/29/18 Archive Date: 10/29/18 DOCKET NO. 13-14 293 DATE: October 29, 2018 REMANDED Entitlement to a rating in excess of 10 percent for ischemic heart disease (IHD) is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1966 to November 1967. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2011 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In June 2017, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the record. In November 2017, the Board dismissed the Veteran’s appeal pertaining to the issue of entitlement to service connection for hypertension, denied a rating in excess of 10 percent for IHD, and remanded the issue of entitlement to a total disability rating based on individual unemployability due to service-connected disability (TDIU) for additional development. Thereafter, the Veteran appealed the Board’s decision only to the extent that it denied a rating in excess of 10 percent for IHD to the United States Court of Appeals for Veterans Claims (Court). In July 2018, the Court granted the parties’ Joint Motion for Partial Remand (JMPR), which vacated the Board’s decision solely with regard to the increased rating claim and remanded it for further consideration. With regard to the issue of entitlement to a TDIU, which was remanded by the Board in November 2017, a review of the record indicates that the Agency of Original Jurisdiction (AOJ) has not completed the requested development and has not recertified it to the Board. As such, it is not currently before the Board. The Board observes that, subsequent to the issuance of the February 2017 supplemental statement of the case, additional evidence, to include updated VA treatment records, was associated with the record. While the Veteran has not waived AOJ consideration of such evidence, his claim is being remanded such that no prejudice results to the Veteran in the Board considering such evidence for the limited purpose of issuing a comprehensive and thorough remand. Entitlement to a rating in excess of 10 percent for IHD. As noted above, in July 2018, the Court granted a JMPR that vacated the Board’s November 2017 decision to the extent that it denied a rating in excess of 10 percent for IHD. In this regard, the parties found that the Board must properly address the rating criteria listed in Diagnostic Code 7006 and determine whether the evidence of record warrants a rating in excess of 10 percent for the Veteran’s service-connected IHD. The parties further found that the Board must reconcile the medical findings with respect to whether cardiac hypertrophy is present. With regard to the latter determination, an August 2011 private treatment record included an echocardiogram that revealed a normal left ventricular ejection fraction and mild left ventricular hypertrophy. However, an October 2012 VA examination, a March 2013 private Disability Benefits Questionnaire (DBQ), and a May 2016 VA examination report noted that testing revealed no evidence of cardiac hypertrophy or dilatation. Consequently, the Board finds that a remand is necessary in order to obtain an opinion as to whether the Veteran’s IHD is manifested by cardiac hypertrophy in light of such conflicting findings. Additionally, while on remand, the Veteran should be given an opportunity to identify any records relevant to the claim on appeal that have not been obtained. Thereafter, all identified records should be obtained. The matter is REMANDED for the following action: 1. The Veteran should be given an opportunity to identify any outstanding private or VA treatment records relevant to the claim on appeal. After obtaining any necessary authorization from the Veteran, all outstanding records should be obtained. For private treatment records, make at least two (2) attempts to obtain records from any identified sources. If any such records are unavailable, inform the Veteran and afford him an opportunity to submit any copies in his possession. For federal records, all reasonable attempts should be made to obtain such records. If any records cannot be obtained after reasonable efforts have been made, issue a formal determination that such records do not exist or that further efforts to obtain such records would be futile, which should be documented in the claims file. The Veteran must be notified of the attempts made and why further attempts would be futile, and allowed the opportunity to provide such records, as provided in 38 U.S.C. § 5103A(b)(2) and 38 C.F.R. § 3.159(e). 2. Forward the record to an appropriate medical professional so as to offer an opinion as to whether the Veteran’s IHD is manifested by cardiac hypertrophy in light of the conflicting medical findings of record. The need for an additional examination of the Veteran is left to the discretion of the clinician selected to write the addendum opinion. Following a review of the record, the examiner should offer an opinion as to whether the Veteran’s IHD is manifested by cardiac hypertrophy. In offering such opinion, the examiner should address the inconsistency between an August 2011 private treatment record noting that an echocardiogram revealed normal left ventricular ejection fraction and mild left ventricular hypertrophy, with an October 2012 VA examination report, a March 2013 private DBQ, and a May 2016 VA examination report that noted that testing revealed no evidence of cardiac hypertrophy or dilatation. A rationale for any opinion offered should be provided. A. JAEGER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Koria B. Stanton, Associate Counsel