Citation Nr: 18152800 Decision Date: 11/27/18 Archive Date: 11/26/18 DOCKET NO. 16-52 706 DATE: November 27, 2018 REMANDED Entitlement to an initial rating in excess of 10 percent for ventricular arrhythmia and valvular heart disease is remanded. Entitlement to an initial rating in excess of 10 percent for lumbar strain and thoracic degenerative disc disease (DDD) is remanded. Entitlement to an initial rating in excess of 10 percent for right lower extremity radiculopathy is remanded. REASONS FOR REMAND The Veteran had active service in the United States Coast Guard from June 1989 to September 1989, from December 1989 to July 1990, from February 1991 to July 1991, from June 1995 to September 1995, from March 1996 to September 1996, and from March 1997 to November 2012. This case comes before the Board of Veterans’ Appeals (Board) on appeal from a November 2013 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Roanoke, Virginia. The Board finds that additional development is required before the claims on appeal are decided. Ventricular Arrhythmia and Valvular Heart Disease In February 2013, the Veteran was afforded a VA examination with regard to the etiology of her heart disability. As such, the Board observes that it has been over five years since the Veteran has been afforded a VA examination with regard to her ventricular arrhythmia and valvular heart disease. Further, the Board notes that the February 2013 VA examination was associated with the Veteran’s initial claim for service connection, and there is limited information with regard current level of severity of the symptomatology associated with the Veteran’s disability. In this regard, a review of the February 2013 VA examination shows that an exercise stress test was not performed. Rather, the Veteran’s METs level was measured by an interview-based METs test. However, no reason was provided as to why an exercise stress test was not administered, and the examiner commented that an exercise stress test, as opposed to the interview-based METs test, would most accurately reflect the Veteran’s current cardiac functional ability. As a result, the Board is without adequate information to decide the issue of entitlement to an increased rating for the claimed disability. Therefore, a new VA examination is warranted to determine the current level of severity of all impairment resulting from her service-connected ventricular arrhythmia and valvular heart disease. Lumbar Strain and Thoracic DDD and Lower Extremity Radiculopathy In February 2013, the Veteran was afforded a VA examination to access the severity of his service-connected lumbar strain and thoracic spine DDD disability, and lower extremity radiculopathy. A review of that examination report shows that the findings reported are not in compliance with the requirements outlined in Correia v. McDonald, 28 Vet. App. 158 (2016) or Sharp v. Shulkin, 29 Vet. App. 26 (2017). Therefore, the Veteran should be afforded a new VA examination(s) to determine the currently level of severity of all impairment resulting from her lumbar strain and thoracic spine DDD disability, and right lower extremity radiculopathy. Additionally, current treatment records should be identified and obtained before any decisions are made in this case. The matters are REMANDED for the following action: 1. Identify and obtain any pertinent, outstanding VA and private treatment records and associate them with the claims file. 2. Then, schedule the Veteran for an appropriate VA examination to determine the current level of severity of all impairment resulting from her service-connected heart disability. Any indicated studies should be performed. The examiner is requested to provide diagnostic METs testing results. If the appropriate tests cannot or should not be undertaken, the examiner should provide an explanation of such finding, as well as an estimation of the level of activity (expressed in METs and supported by specific examples) that results in dyspnea, fatigue, angina, dizziness, or syncope. It is insufficient for the examiner to only note that the Veteran does not experience symptoms with any level of physical activity as a reason for not providing METs scores. Moreover, the examiner should conduct whatever test deemed necessary to measure the Veteran’s left ventricular ejection fraction. If such tests cannot be performed, the examiner must explain why such testing could not be performed. 3. Schedule the Veteran for an appropriate VA examination to determine the current level of severity of all impairment resulting from her lumbar strain and thoracic spine DDD. Any indicated studies should be performed. The examiner should provide all information required for rating purposes, to include all information required by Correia and Sharp. 4. Schedule the Veteran for an appropriate VA examination to determine the current level of severity of all impairment resulting from the Veteran’s right lower extremity radiculopathy. Any indicated studies must be performed. The examiner should provide all information required for rating purposes. 5. Confirm that the VA examination reports comport with this remand and undertake any other development determined to be warranted. 6. Then, readjudicate the issues on appeal. If a decision is adverse to the Veteran, issue a supplemental statement of the case and allow appropriate time for response. Then, return the case to the Board. Kristin Haddock Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD C. O’Donnell, Associate Counsel