Citation Nr: 18153348
Decision Date: 11/27/18	Archive Date: 11/27/18

DOCKET NO. 14-33 263
DATE:	November 27, 2018
REMANDED
Entitlement to an evaluation in excess of 30 percent for implanted cardiac pacemaker subsequent complication of endocarditis status post aortic valve replacement due to aortic stenosis is remanded.
Entitlement to a total disability rating based on individual unemployability (TDIU) is remanded.
REASONS FOR REMAND
The Veteran had active military service from October 1964 to October 1968 and from August 1972 to August 1974.
The most recent VA examination addressing the service-connected heart valve replacement disability was conducted in February 2012, more than six years ago. In his November 2018 appellate brief, the Veteran’s representative stated that the Veteran’s condition has worsened since then and requested a new VA examination. Given the lapse of time since the most recent VA examination, a more contemporaneous examination is necessary in this case before the Board may consider the rating warranted for this disability. The issue of entitlement to TDIU is inextricably intertwined with the issue being remanded in this case and must be deferred as well. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991).
The matters are REMANDED for the following actions:
1. Obtain all outstanding VA medical records and ask the Veteran to provide authorizations for any private medical records he would like considered in connection with his appeal. 
2. Schedule the Veteran for a VA cardiovascular examination by an appropriate examiner to determine the severity of his heart-valve replacement disability. The claims file must be reviewed, and all appropriate tests and studies should be conducted, as indicated in the most up-to-date Disability Benefits Questionnaire. A complete rationale for all opinions must be provided. 
3. The Regional Office (RO) should consider whether to refer the case to the Director of Compensation for an extraschedular evaluation for TDIU, but is not required to do so.

 
A. C. MACKENZIE
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	Evan Thomas Hicks