Citation Nr: 18149550 Decision Date: 11/09/18 Archive Date: 11/09/18 DOCKET NO. 15-06 950 DATE: November 9, 2018 ORDER New and material evidence having been submitted, the claim for service connection for a heart condition is reopened. REMANDED Entitlement to service connection for a heart condition is remanded. Entitlement to service connection for prostate cancer is remanded. FINDINGS OF FACT 1. In a July 2009 rating decision, the RO denied the Veteran’s claim for service connection for a heart condition; the Veteran did not appeal that decision or submit relevant evidence during the appeal period and that decision is final. 2. Some of the evidence received since the July 2009 final denial is new and relates to an unestablished fact necessary to substantiate the claim for service connection for a heart condition. CONCLUSION OF LAW New and material evidence has been received to reopen the claim for service connection for a heart condition. 38 U.S.C. § 5108 (2012); 38 C.F.R. § 3.156 (2018). REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran served on active duty from January 1965 to December 1966. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a March rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In August 2018, the Veteran testified at a videoconference hearing before the undersigned Veterans Law Judge. A transcript of the hearing is of record. This appeal has been advanced on the Board's docket pursuant to 38 C.F.R. §20.900(c) (2018). 38 U.S.C. § 7107(a)(2) (2012). 1. Whether new and material evidence has been received to reopen the claim for entitlement to service connection for a heart condition The RO denied the Veteran’s claim of service connection for condition in a July 2009 rating decision on the basis that the evidence failed to show that the Veteran’s heart condition was related to his active duty service. The Veteran was provided notice of this decision and his appellate rights but did not appeal the decision or submit new and material evidence within one year of the decision. Therefore, the decision is final. See 38 C.F.R. §§ 3.156, 20.302, 20.1103 (2018). Generally, if a claim of entitlement to service connection has been previously denied and that decision became final, the claim can be reopened and reconsidered only if new and material evidence is presented with respect to that claim. 38 U.S.C. § 5108 (2017). New evidence means existing evidence not previously submitted to VA. Material evidence means existing evidence that, by itself or when considered with previous evidence of record, relates to an unestablished fact necessary to substantiate the claim. 38 C.F.R. § 3.156(a) (2017). New and material evidence can be neither cumulative nor redundant of the evidence of record at the time of the last prior final denial of the claim sought to be reopened, and must raise a reasonable possibility of substantiating the claim. Id. The evidence received since the July 2009 rating decision includes evidence that is both new and material to the claim. See 38 C.F.R. § 3.156. For example, the Veteran’s VA physician, Dr. P.G., submitted a statement in December 2011 stating that the Veteran reported exposure to solvents during service, which solvents could have played some role in the etiology of his cardiac pathology. This new evidence addresses the reason for the previous denial; that is, a nexus to service, and raises a reasonable possibility of substantiating the claim. The credibility of this evidence is presumed for purposes of reopening the claim. See Justus v. Principi, 3 Vet. App. 510, 513 (1992). Accordingly, the claim is reopened and must be considered on the merits. REASONS FOR REMAND 1. Entitlement to service connection for a heart condition is remanded. During the Veteran’s hearing, he testified that he received a lot of shots in preparation for deployment and he thereafter became ill and was hospitalized for several months. In his notice of disagreement, he alleged his heart condition was due to a bad reaction to medication/immunizations caused his heart condition. The Board notes that the Veteran’s service treatment records show that during his June through August 1965 in-service hospitalization, physical examination of the heart revealed the point of maximum impulse (PMI) to be in the fourth intercostal space in the midclavicular line. In addition, there was a grade II systolic ejection murmur at the aortic area with radiation into the carotids, P2 was greater than A2, and rhythm was regular. The 2016 examiner provided a negative nexus opinion regarding the etiology of the heart condition as it related to the Veteran’s claim that he was exposed to solvents while working in the motor pool during service. However, examiner did not address the 1965 in-service discharge summary regarding the heart. Accordingly, an addendum medical opinion should be obtained upon remand. 2. Entitlement to service connection for prostate cancer is remanded. The Veteran was diagnosed with prostate cancer and underwent radical peritoneal prostatectomy in May 2000. He contends his prostate cancer is related to service. The Board notes that the Veteran’s service treatment records show complaints of urethral discharge with dysuria beginning in April 1965 with diagnoses of gonorrhea and acute urethritis. Thereafter, in June 1965, the Veteran was hospitalized until August 1965 for an initial complaint of “breaking out and headaches.” The narrative summary reported, in pertinent part, a history of “dark urine three days prior to admission” and laboratory studies revealing that urine on admission was cloudy and amber with a pH of 5 and as specific gravity of 1.022 with no albuminuria or glycosuria present. The Veteran was discharged in August 1976 and the final diagnosis was undiagnosed disease manifested by headache, malaise, myalgia, conjunctivitis, abnormal liver function studies with jaundice and non-specific hepatic inflammatory changes on biopsy, numerous pustular skin lesions; probably a viral illness, but not proven; completely recovered. In December 1965, the Veteran reported urethral discharge and that he had noticed a yellow spot on his shorts without dysuria. The impression included rule out urinary tract infection (UTI). In January 1966, the Veteran reported still having urethral discharge, drip was now yellow, and slight dysuria. In December 1966, the Veteran complained of hematuria. The impression included questionable stone, questionable kidney mass, and questionable non-specific UTI. In light of the above, the Board finds a VA medical opinion would be helpful in adjudicating the Veteran’s claim. Updated treatment records should also be obtained. The matters are REMANDED for the following actions: 1. Ask the Veteran to provide the names and addresses of all medical care providers who have recently treated him for his claimed disabilities. After securing any necessary releases, request any relevant records identified. In addition, obtain updated VA treatment records. If any requested records are unavailable, the Veteran and his representative should be notified of such. 2. After records development is completed, send the claims file to the November 2016 heart examiner, if available, to obtain an addendum opinion as to whether the Veteran’s heart condition is possibly related to service. If that examiner is not available, the file should be provided to another examiner to obtain the opinion. If a new examination is deemed necessary in order to respond to the request, such should be scheduled. Following review of the claims file, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent probability or greater) that any current disability of the heart arose during service or is otherwise related to service. The examiner should explain why or why not, to include addressing the Veteran’s contentions that his heart condition was caused by a bad reaction to immunizations and explaining the significance, if any, of the in-service 1965 hospital admission note concerning irregularities of the heart. 3. Send the claims file to an appropriate examiner to obtain an opinion as to whether the Veteran’s prostate cancer is possibly related to service. If an examination is deemed necessary in order to respond to the request, such should be scheduled. Following review of the claims file, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent probability or greater) that the prostate cancer is related to service. The examiner should explain why or why not, to include explaining the significance, if any, of the in-service treatment for urological symptoms. K. A. BANFIELD Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S. Medina, Associate Counsel