Citation Nr: 18150020 Decision Date: 11/14/18 Archive Date: 11/14/18 DOCKET NO. 15-09 815 DATE: November 14, 2018 ORDER Restoration of a rating of 60 percent for coronary artery disease is granted, effective March 1, 2013. VETERAN’S CONTENTIONS The Veteran is seeking reinstatement of a rating of 60 percent for coronary artery disease (CAD) and mitral valve prolapse, status post myocardial infarction and stent placements. The Veteran’s rating for CAD was reduced from 60 percent to 10 percent in a December 2012 rating decision, effective March 1, 2013. The Veteran contends that the rating reduction was improper, and that the 10 percent rating does not accurately reflect the severity of his disability. Specifically, he asserts that private treatment records reflect findings and symptoms warranting a rating higher than 10 percent, such as a calculated ejection fraction of 41 percent in October 2012, and shortness of breath and chest discomfort upon exertion. FINDING OF FACT 1. A December 2012 rating decision reduced the Veteran’s rating for coronary artery disease on the basis of only one VA examination, performed in April 2012. 2. The entire recorded history of the Veteran’s coronary artery disease does not reflect sustained improvement of the disability reasonably certain to be maintained under the ordinary conditions of life. See Private Treatment Records dated July 2008, October 2012; VA Examinations dated April 2012, August 2017. CONCLUSION OF LAW The reduction of the rating from 60 percent to 10 percent for coronary artery disease was improper. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 3.344(a). REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran served on active duty in the Air Force from August 1979 to September 2008. This case is before the Board of Veterans’ Appeals (Board) on appeal from a December 2012 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Winston-Salem, North Carolina. Disability ratings will be reduced only when, upon review of the entire recorded history of a service-connected condition, the preponderance of the evidence reflects sustained improvement of the disability reasonably certain to be maintained under the ordinary conditions of life, and the examination reports reflecting such change are based upon thorough examinations. 38 C.F.R. § 3.344(a); Brown v. Brown, 5 Vet. App. 413, 421 (1993) (citing Schafrath v. Derwinski, 1 Vet. App. 589, 594 (1991)). Furthermore, ratings of diseases subject to temporary and episodic improvement, such as arteriosclerotic heart disease, will not be reduced on the basis of any one examination, unless the evidence of record clearly indicates that sustained improvement has been demonstrated. 38 C.F.R. § 3.344(a). As noted in the above findings of fact, the preponderance of the evidence does not reflect sustained improvement of the Veteran’s CAD reasonably certain to be maintained under the ordinary conditions of life. Rather, there is significant evidence before and after the December 2012 rating reduction indicating that Veteran’s CAD had not stably improved. Principally, as the Veteran indicated, an October 2012 private treatment record reflects a calculated ejection fraction of 41 percent, which supports the Veteran’s original rating of 60 percent disabling. In addition, an August 2017 VA examination yielded a finding on the basis of an interview-based METs test that the Veteran would experience symptoms of dyspnea and fatigue at greater than five to seven METs, due solely to his CAD. On the basis of this examination, the RO awarded an increased rating of 30 percent from August 10, 2017. In short, because this evidence strongly suggests that the Veteran’s CAD had not stably improved at the time of the rating reduction, nor that it did subsequently, the Board finds that the reduction was improper. Furthermore, as noted in the above findings of fact, the December 2012 rating reduction was made on the basis of only one examination, performed in April 2012. However, for diseases subject to temporary and episodic improvement such as CAD, a reduction may only be based on more than one examination. Therefore, the reduction was de facto improper. See 38 C.F.R. § 3.344(a). (Continued on the next page)   For both of these reasons, the Board finds that the December 2012 reduction of the rating for CAD was improper. Accordingly, a rating of 60 percent is restored, effective March 1, 2013. S.C. KREMBS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD P. Timmerman, Associate Counsel