Citation Nr: 18146707
Decision Date: 11/01/18	Archive Date: 10/31/18

DOCKET NO. 16-24 325
DATE:	November 1, 2018
REMANDED
Entitlement to an initial rating in excess of 10 percent for coronary artery disease from January 1, 2015 is remanded.
REASONS FOR REMAND
The Veteran served in the United States Navy from December 1967 to August 1972.
This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a January 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Lincoln, Nebraska, which in pertinent part granted service connection for coronary artery disease with a 10 percent evaluation from October 8, 2015.
In March 2016, the RO determined that there was clear and unmistakable error in the January 2016 rating decision in the assignment of the effective date for service connection for coronary artery disease finding that a 100 percent evaluation was appropriate effective October 8, 2014, and a 10 percent evaluation effective January 1, 2015.  Because the increase in evaluation of the Veteran’s coronary artery disease does not represent the maximum evaluation available for the condition, the Veteran’s claim remains in appellate status.  See AB v. Brown, 6 Vet. App. 35, 38 (1993).
1. Entitlement to an initial rating in excess of 10 percent for coronary artery disease from January 1, 2015 is remanded.
The Veteran seeks an initial rating in excess of 10 percent for his service connected coronary artery disease.  In February 2016, the Veteran stated that he had a stent placement and currently only maintained a MET level of three to five.
The Veteran was afforded a VA examination in January 2016, which revealed a diagnosis of coronary artery disease.  The examiner noted that an interview based METs test was provided, and the Veteran denied experiencing symptoms attributable to a cardiac condition with any level of physical activity.  The examiner did not provide an estimate of the Veteran’s METs level and did not provide a rationale regarding why the Veteran’s METs level could not be estimated.  In the March 2016 statement of the case, the RO noted that the Veteran had been scheduled for an exercise stress test in March 2016 but was unable to tolerate it due to hip pain.  Subsequently, in the Veteran’s May 2016 VA Form 9, the Veteran noted that he was unable to complete the March 2016 stress test, but now was requesting that another stress test be scheduled as soon as possible.  In the alternative, the Veteran requested that a 60 percent rating be assigned.  The Veteran also asserted that he has daily shortness of breath, requires the use of a CPAP machine at night, and has been prescribed oxygen.  It thus, also appears that the Veteran’s service-connected coronary artery disease may have increased in severity since he was last examined by VA.
Therefore, the Board finds that a new examination is necessary to determine the current severity of the Veteran’s coronary artery disease.
The matter is REMANDED for the following action:
1. Schedule the Veteran for a VA examination to ascertain the current severity of the Veteran’s service-connected coronary artery disease.  All necessary tests should be conducted.  The claims file should be made available to and be reviewed by the examiner in conjunction with the examination.
The examiner should determine the Veteran’s METs level due to his cardiac condition.  If the examiner is unable to perform an exercise stress test, then the examiner should provide the estimated METs level.
If the examiner is unable to conduct the required testing or concludes that the required testing is not necessary in this case, the examiner should clearly explain why that is so.
The examiner should provide a complete rationale for all opinions expressed and conclusions reached.
 
S. L. Kennedy
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	G. Johnson, Associate Counsel