Citation Nr: 18151297
Decision Date: 11/16/18	Archive Date: 11/16/18

DOCKET NO. 12- 34 903
DATE:	November 16, 2018
REMANDED
Entitlement to an initial evaluation in excess of 10 percent for coronary artery disease (CAD), status post myocardial infarction, prior to September 15, 2014 and in excess of 30 percent thereafter is remanded.
REASONS FOR REMAND
[The Veteran served on active duty in the United States Air Force from June 1967 to June 1971.
This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2011 rating decision from the Department of Veterans Affairs (VA) Regional Office (RO) in Newark, New Jersey.   The Veteran presented sworn testimony at a hearing before the undersigned in October 2014.
Entitlement to an initial evaluation in excess of 10 percent for coronary artery disease (CAD), status post myocardial infarction, prior to September 15, 2014 and in excess of 30 percent thereafter is remanded.
In its October 2015 remand, the Board directed that a retrospective medical opinion be obtained addressing whether the Veteran had left ventricular hypertrophy (LVH) between August 31, 2010 and September 14, 2015.  An opinion was obtained in January 2016 wherein a VA examiner did not address the question posed, but instead opined that the Veteran’s LVH is caused by hypertension, not his service-connected CAD.  No rationale was provided for this opinion.  In August 2016, the Board determined this opinion was inadequate and remanded this issue for an addendum opinion.  In October 2016, a VA physician opined, that for the period in question (August 31, 2010 through September 14, 2015) Veteran does not have LVH that is due to or caused by CAD.  He further reasoned that the record shows the Veteran had hypertension and related LVH long before he developed CAD.  Accordingly, he concluded that LVH is unrelated to his CAD.  The Board finds that the October 2016 opinion does not address the question posed, specifically, whether the Veteran had left ventricular hypertrophy (LVH) between August 31, 2010 and September 14, 2015.  On remand, an addendum opinion should be requested; a physical examination is not necessary unless the examiner deems one necessary.
There has not been substantial compliance with the August 2016 remand directives; as such the matter is REMANDED for the following action:
1. Notify the Veteran that he may submit lay statements from himself and from other individuals who have first-hand knowledge, and/or were contemporaneously informed of the nature, extent and severity of his LVH symptoms during the period from August 31, 2010 through September 14, 2015 and the impact of the condition on his ability to work.  The Veteran should be provided an appropriate amount of time to submit this lay evidence.
2. Obtain an addendum opinion to the retrospective VA opinions provided in January 2016 and October 2016.  The examiner should state whether it was at least as likely as not that there was LVH during the period from August 31, 2010 through September 14, 2015.  
A complete rationale must be provided for all opinions offered.
 
STEVEN D. REISS
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	Jacquelynn M. Jordan, Associate Counsel