Citation Nr: 18147295
Decision Date: 11/02/18	Archive Date: 11/02/18

DOCKET NO. 16-28 570
DATE:	November 2, 2018
ORDER
New and material evidence has been received and the claim of entitlement to service connection for ischemic heart disease claimed as left ventricular hypertrophy on electrocardiogram (EKG) is reopened.  

REMANDED
Entitlement to service connection for ischemic heart disease claimed as left ventricular hypertrophy on EKG, including as due to herbicide exposure is remanded.
FINDING OF FACT
A March 2011 rating decision denied the Veteran’s claim of entitlement to service connection for ischemic heart disease claimed as left ventricular hypertrophy on EKG, finding a lack of evidence to show any treatment or diagnosis in service and that left ventricular hypertrophy on EKG was related to or caused by ischemia or ischemic heart disease; the Veteran did not appeal that denial or submit new and material evidence within a year of the decision, and the March 2011 decision became final.
CONCLUSIONS OF LAW
New and material evidence has been received, and the claim of service connection for ischemic heart disease claimed as left ventricular hypertrophy on EKG, is reopened.  38 U.S.C. §§ 5108, 7105; 38 C.F.R. § 3.156.  
REASONS AND BASES FOR FINDING AND CONCLUSION
The Veteran had active military service from December 1967 to December 1969, with service in the Republic of Vietnam during the Vietnam Era.
Petition to Reopen
Pertinent evidence received since the March 2011 final unappealed rating decision, regarding the claim for service connection for ischemic heart disease claimed as left ventricular hypertrophy on EKG, includes a January 2014 VA primary care outpatient note, which shows the Veteran reported having intermittent episodes of “heart fluttering.”  Another VA outpatient treatment record, dated in January 2014, shows an assessment of heart palpitations.  A November 2014 VA outpatient note shows the Veteran with a past medical history of ischemic heart disease.  
When viewing this evidence in the light most favorable to the Veteran, and considering the “low threshold” standard for reopening in Shade v. Shinseki, 24 Vet. App. 110 (2010), the Board finds the evidence to be new and material.  This follows because it is not cumulative or redundant of the evidence previously of record, and it tends to show the Veteran’s heart disability may be etiologically related to service.  Accordingly, the claim of entitlement to service connection for ischemic heart disease claimed as left ventricular hypertrophy on EKG is reopened.
REASONS FOR REMAND
First, the Board must remand this case because the Regional Office (RO) has not considered it on its merits to date.  Now that it has been reopened, the reopened claim must be considered by the RO in the first instance.  See Hickson v. Shinseki, 23 Vet. App. 394, 399 (2010).
Second, having served in Vietnam, the Veteran is presumed to have experienced herbicide agent exposure.  Recently, he has had treatment for cardiac-related symptoms.  It is thus appropriate that he be furnished with a VA examination to determine whether he has a diagnosis of ischemic heart disease, which is among the disease found by VA to be linked to herbicide agent exposure.  38 C.F.R. § 3.309.
Accordingly, this case is REMANDED for the following action:
Furnish the Veteran with a VA cardiovascular examination  to determine whether he has a current diagnosis that falls within the category of ischemic heart disease.  The examiner is requested to review the claims file and is reminded that the Veteran served in the Republic of Vietnam during the Vietnam Era.  If there is no basis for an ischemic heart disease diagnosis, this must be explained in the examination report.  
 
A. C. MACKENZIE
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	M. Young, Counsel