Citation Nr: 18151241
Decision Date: 11/16/18	Archive Date: 11/16/18

DOCKET NO. 16-44 195
DATE:	November 16, 2018
REMANDED
Entitlement to service connection due to tricuspid regurgitation is remanded.
REASONS FOR REMAND
The Veteran served on active duty in the United States Air Force from August 1969 to August 1973.
This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a August 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Des Moines, Iowa.
Entitlement to service connection due to tricuspid regurgitation is remanded.
The Veteran contends that his tricuspid regurgitation is a result of herbicide agent exposure during his time stationed at the Nakhon Phanom Royal Thai Air Force Base from September 1970 to September 1971.
In the present case, the evidence establishes a current disability of tricuspid regurgitation.  Based on the evidence of record herbicide exposure is conceded.  However, tricuspid regurgitation is not a presumptive condition based on herbicide exposure and a medical examination and opinion regarding nexus is necessary as there is no nexus opinion in the record.  See 38 U.S.C. § 5103A (d) (2012); 38 C.F.R. § 3.159 (c)(4) (2017); McLendon v. Nicholson, 20 Vet. App. 79, 81-82 (2006); Combee v. Brown, 34 F.3d 1039, 1043-1044 (Fed.Cir.1994).
The matter is REMANDED for the following action:
1. The Veteran must be afforded an appropriate VA examination to determine the nature and etiology of any current cardiac disorder, to include tricuspid regurgitation.  All pertinent symptomatology and findings must be reported in detail and any indicated diagnostic tests and studies must be accomplished.  The claim file must be made available to the examiner, and the examiner must specify in the examination report that these records have been reviewed, in particular the May 2013 disability benefits questionnaire.  The examiner must elicit from the Veteran and record in the examination report a full history.
After a review of the evidence of record, to include the Veteran’s statements, the examiner must provide an opinion as to whether it is at least as likely as not that any currently diagnosed cardiac disorder is related to the Veteran’s military service including his exposure to herbicide agents.
The examiner must provide a complete rationale for all opinions expressed.  If the examiner cannot provide the requested opinion without resorting to speculation, it must be so stated, and the examiner must provide the reasons why an opinion would require speculation.  The examiner must indicate whether there was any further need for information or testing necessary to make a determination.  The examiner must indicate whether an opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the particular examiner.
2. If upon completion of the above actions the claim remains denied, the case should be returned to the Board after compliance with appellate procedures.
 
E. I. VELEZ
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	D. Baronofsky Associate Counsel