Citation Nr: 18148273 Decision Date: 11/07/18 Archive Date: 11/07/18 DOCKET NO. 16-31 277 DATE: November 7, 2018 ORDER Entitlement to service connection for ischemic heart disease, to include as a result of herbicide exposure, is granted. REMANDED Entitlement to service connection for AL amyloidosis, to include as a result of herbicide exposure, is remanded. FINDING OF FACT The evidence demonstrates that the Veteran was diagnosed with ischemic heart disease and it is presumed that it developed as a result of herbicide agent exposure. CONCLUSION OF LAW The criteria for entitlement to service connection for ischemic heart disease as a result of herbicide agent exposure have been met. 38 U.S.C. §§ 1110, 1116 (2012); 38 C.F.R. §§ 3.303, 3.307, 3.309 (2018). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The appellant is the surviving spouse and recognized substitute of the Veteran who served on active duty from May 1966 to May 1968. The Veteran served in the Republic of Vietnam from November 1967 to May 1968. He died in August 2016. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a March 2016 rating decision by the Nashville, Tennessee, Regional Office (RO) of the Department of Veterans Affairs (VA). In August 2016, the Veteran testified at a telephonic hearing before the undersigned Veterans Law Judge. A copy of the transcript of that hearing is of record. Service Connection Entitlement to service connection for ischemic heart disease, to include as a result of herbicide exposure Under the relevant laws and regulations, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110 (2012); 38 C.F.R. § 3.303 (2018). Generally, the evidence must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Veterans diagnosed with an enumerated disease who, during active service, served in the Republic of Vietnam during the period beginning on January 9, 1962, and ending on May 7, 1975, shall be presumed to have been exposed to an herbicide agent, unless there is affirmative evidence to establish that the Veteran was not exposed to any such agent during that service. 38 C.F.R. § 3.307. Certain disorders may be presumed service connected, including ischemic heart disease, if manifest to a degree of 10 percent or more for an herbicide exposed Veteran. 38 U.S.C. § 1116 (2012); 38 C.F.R. §§ 3.307, 3.309 (2018). It is the policy of VA to administer the law under a broad interpretation, consistent with the facts in each case, with all reasonable doubt to be resolved in favor of the claimant. 38 C.F.R. § 3.102 (2018). The pertinent evidence of record shows that the Veteran had service in the Republic of Vietnam. A March 2016 VA heart examination found diagnoses of coronary artery disease or ischemic heart disease were not warranted. VA correspondence dated in December 2016 sent to the Veteran, however, noted the results of an examination and laboratory testing indicated he had ischemic heart disease. An amended death certificate was received by VA in September 2017 with ischemic heart disease reported as the immediate cause of death. A September 2017 rating decision established service connection for the cause of the Veteran’s death. Based upon the evidence of record, the Board finds the Veteran had ischemic heart disease and that it is presumed to have developed as a result of herbicide exposure during service in Vietnam. The appeal for entitlement to service connection is granted. REASONS FOR REMAND Entitlement to service connection for AL amyloidosis, to include as a result of herbicide exposure, is remanded. The appellant contends that the Veteran developed AL amyloidosis as a result of herbicide exposure during service in Vietnam. The available evidence of record shows a copy of the Veteran’s death certificate was received by VA in January 2017 noting that he died in August 2016 with the immediate cause of death as COPD. No secondary cause was reported. In September 2017, the appellant’s attorney provided a copy of an amended death certificate with COPD marked through and which listed amyloidosis as a secondary cause. No rationale for the amended death certificate was provided and the certifying physician’s signature was not updated. The Board notes that the available VA medical evidence does not include any other diagnosis of amyloidosis. However, there is no indication VA has attempted to obtain the final treatment records associated with the Veteran’s death while in hospice care, which could shed light on how the diagnosis of amyloidosis came to be added to the certificate of death. Therefore, the Board finds that further development is required for an adequate determination. The matters are REMANDED for the following action: 1. Ask the appellate to provide information and authorization sufficient for VA to assist her in obtaining copies of the Veteran’s final medical treatment records. Make two requests for the authorized records from, unless it is clear after the first request that a second request would be futile. 2. Obtain the Veteran’s VA treatment records, to include all examination and laboratory reports. A specific request should be made for records pertaining to the diagnosis of amyloidosis. MICHAEL A. HERMAN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD T. Douglas, Counsel