Citation Nr: 18149929 Decision Date: 11/14/18 Archive Date: 11/14/18 DOCKET NO. 17-23 410 DATE: November 14, 2018 REMANDED Entitlement to service connection for the cause of the Veteran's death is remanded. REASONS FOR REMAND The Veteran served on active duty from November 2000 to June 2006. He died in April 2016. The appellant is the mother and guardian of D.D.C. and K.M.C., who are the minor children of the Veteran. Entitlement to service connection for the cause of the Veteran’s death. During his lifetime, the Veteran was service-connected for posttraumatic stress disorder (PTSD) (rated 70 percent), bilateral pes planus (rated 50 percent), right shoulder degenerative joint disease status post surgery (rated 20 percent), right shoulder glenohumeral instability and malunion of the humerus (rated 20 percent), and right shoulder scar status post surgery (rated 0 percent), for a combined evaluation for compensation of 90 percent as of March 26, 2015. He was also in receipt of a total disability rating based on individual unemployability due to service-connected disabilities (TDIU rating) as of December 28, 2014. The Veteran’s death certificate documents that his immediate cause of death in April 2016 was multiple gunshot wounds and that the nature of his death was a homicide. During the course of the current appeal, the appellant has indicated that the Veteran’s symptoms of, and medications for, his service-connected PTSD may have caused him to be involved in the situation wherein he was fatally shot. On her April 2017 VA Form 9, the appellant noted the Veteran’s psychiatric difficulties following his military service and that the medications prescribed by VA for such difficulties had made him hallucinate at times (and “at one point I thought he was losing his mind because of all of the side-effects”). She went on to note that, on the day the Veteran was shot multiple times “for absolutely no reason at all, something happened with him as shots were fired before he was actually hit. Naturally a person that notices a gun and can see it go off would think to take cover. When I yelled his name for him to do so, it was too late. Within minutes he was shot multiple times.” She further stated that “while servicing this country he was affected in a way that I believe cost him his life.” The medical evidence of record prior to the Veteran’s death documents the following pertinent findings. A September 2013 VA mental health treatment record noted that he was involved in a “near-altercation.” At an April 2014 VA psychiatric examination, he reported that after his service discharge he began to fight others with little provocation; he also reported that, since his service discharge, he had been arrested numerous times for fighting. A February 2015 VA mental health treatment record noted his report that he was easily irritated with others and had recently almost gotten into a fight with his brother’s friend. A March 2015 VA mental health treatment record noted his report that anger was a huge longstanding problem and that he was frequently getting in fights; this report was reiterated in an April 2015 VA mental health treatment record. At a May 2015 VA psychiatric examination, his symptoms were noted to include irritable behavior and angry outbursts (with little or no provocation) typically expressed as verbal or physical aggression toward people or objects. Regarding the circumstances surrounding the Veteran’s fatal shooting, the Reporting Officer Narrative from the Albany Police Department documents that, on April [redacted], 2016, the Veteran was found shot and lying on the ground and was transported by ambulance to [redacted]. [Another man was also found lying on the ground in the same location and was pronounced dead at the scene.] The Reporting Officer Narrative concluded by stating: “This case is active and turned over to the Investigations Bureau.” The Veteran’s death certificate documents that he died on April [redacted], 2016 as an inpatient at [redacted]. As outlined above, his immediate cause of death was documented on his death certificate to be multiple gunshot wounds by homicide. It was also noted on his death certificate that no autopsy was performed but that the case was referred to a medical examiner. On remand, all outstanding pertinent records should be obtained and associated with the claims file, including: any VA treatment records for the Veteran dating from July 2015 (i.e., the date of the most recent VA treatment record currently in the claims file) until his death; the Veteran’s terminal treatment records from [redacted]; all additional records available from the Albany Police Department and Investigations Bureau; and all records and/or reports from the medical examiner to whom the case had been referred (as noted on the Veteran’s death certificate). Thereafter, a medical opinion should be obtained to address whether the Veteran’s service-connected PTSD was the principal cause or a contributory cause of his death. The matter is REMANDED for the following actions: 1. Obtain all VA treatment records for the Veteran for the period from July 2015 until his death in April 2016. 2. Ask the appellant to complete a VA Form 21-4142 to authorize VA to obtain the Veteran’s terminal treatment records from [redacted]. Make two requests for the authorized records from this private provider, unless it is clear after the first request that a second request would be futile. 3. Request all additional records available from the Albany Police Department and Investigations Bureau, as well as all records and/or reports from the medical examiner to whom the case had been referred (as noted on the Veteran’s death certificate). 4. After all requested records have been associated with the claims file, request a records review and medical opinion from an appropriate clinician as to whether it is at least as likely as not that the Veteran’s service-connected PTSD was the principal cause or a contributory cause of his death. A complete rationale for all opinions must be provided. If the clinician cannot provide a requested opinion without resorting to speculation, it must be so stated, and the clinician must provide the reasons why an opinion would require speculation. The clinician must indicate whether there was any further need for information necessary to make a determination. Additionally, the clinician must indicate whether any opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular clinician. M. SORISIO Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD L. B. Yantz, Counsel