Citation Nr: 18147528
Decision Date: 11/05/18	Archive Date: 11/05/18

DOCKET NO. 17-50 512
DATE:	November 5, 2018
REMANDED
Entitlement to service connection for a disability manifested by shortness of breath, to include chronic obstructive pulmonary disease (COPD), claimed as secondary to service-connected ischemic heart disease (IHD) is remanded.
Entitlement to a total rating based on individual unemployability (TDIU) is remanded.
REASONS FOR REMAND
The Veteran served on active duty from October 1963 to October 1967.  
The Board finds that a remand is necessary to provide the Veteran with a VA examination for his service connection claim for a disability manifested by shortness of breath, to include COPD, claimed as secondary to service-connected IHD.  In his notice of disagreement, the Veteran clarified that he was claiming shortness of breath secondary to his coronary artery disease (also known as IHD).  Furthermore, the record shows that he is currently diagnosed with COPD; however, he was not provided with a VA examination to determine the nature etiology of his disability and whether it was caused by or aggravated by his service-connected IHD.  Accordingly, a VA examination is necessary prior to making a decision on the merits.
In light of the above, the issue of entitlement to a TDIU is inextricably intertwined with the issue being remanded and adjudication of TDIU must be deferred pending the proposed development.  See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991) (the adjudication of claims that are inextricably intertwined is based upon the recognition that claims related to each other should not be subject to piecemeal decision-making or appellate litigation).
The matters are REMANDED for the following actions:
1.  Ensure that all outstanding VA treatment records since the August 2017 SOC are associated with the claims file. 
2.  Provide the Veteran with a VA examination to determine the nature and etiology of claimed shortness of breath, to include COPD.  The claims file and a copy of this Remand must be made available to the examiner, and the examiner shall indicate that the claims file was reviewed.
After a review of the record and examination of the Veteran, the examiner is asked to respond to the following: 
(a) Identify all currently diagnosed disabilities manifested by shortness of breath, to include COPD during the pendency of the appeal since November 2015.
(b) For each currently diagnosed disability, provide an opinion as to whether it is at least as likely as not (50 percent probability or higher) was caused by or aggravated by the Veteran’s service-connected IHD. 
A complete rationale should be provided for all opinions on causation AND aggravation.  
3.  Thereafter, readjudicate the claims on appeal.
 
ROMINA CASADEI
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	A. Yaffe, Associate Counsel