Citation Nr: 18155675
Decision Date: 12/04/18	Archive Date: 12/04/18

DOCKET NO. 16-58 085
DATE:	December 4, 2018
REMANDED
1. The issue of entitlement to service connection for a disability manifesting as chest pain, to include as secondary to service-connected depression, is remanded.
2. The issue of entitlement to service connection for heart disease, to include as secondary to service-connected depression, is remanded.
REASONS FOR REMAND
Claims for Chest Pain and Heart Disease are Remanded.
While further delay is regrettable, additional development is necessary prior to adjudication of the Veteran’s service connection claims.  The Veteran claims to experience chest pains and heart disease as the result of her in-service experiences.  Additionally, the Veteran contends that her “cardiac disease stems from the depression and stress.”  Id.  An April 2018 VA mental health treatment note reflects a self report of symptoms including tachycardia, hyperventilation, and shortness of breath.  Further, it is unclear whether the file is missing a copy of the Veteran’s service separation examination, additional VA treatment records were added to the claims file after the last AOJ review of the file, and the record reflects that some private treatment records may be outstanding.  The Board herein remands for the additional records and an examination.
The matters are REMANDED for the following action:
1. Make all appropriate efforts to obtain the Veteran’s complete service treatment records to specifically include a copy of her separation examination.  Document all requests and responses in the claims file; if determining that any such documentation is unavailable, appropriately document that determination.
2. Obtain updated VA treatment records.
3. Ask the Veteran to complete a VA Form 21-4142 for any outstanding private treatment records, to specifically include, but not limited to, records from South Coast Medical Group dated from November 2012 to the Present.  Make two requests for the authorized records unless it is clear after the first request that a second request would be futile. 
4. Schedule the Veteran for a VA medical examination to determine the etiology of any heart/chest disability or other disability manifested by chest pains.  All indicated tests and studies should be conducted and all clinical findings reported in detail.  The entire claims file should be made available to and be reviewed by the examiner in conjunction with this request. Following review of the claims file, the examiner should respond to the following:  
(a)  Please diagnose any heart disability, or other disability manifested by chest pains.  
(b)  For each diagnosis, the examiner should state whether it is at least as likely as not (e.g. at least a 50 percent probability or greater) that the Veteran’s condition(s) began in service or is otherwise related to service, to include secondary to, or aggravated beyond a natural progression by, the Veteran’s service-connected depression.  
Provide rationale for all opinions expressed. If unable to provide the requested opinions, explain why.
5. Subsequently readjudicate the appeal.  If any claim remains denied, issue the Veteran and her representative, if any, a supplemental statement of the case and afford an appropriate period for response.

 
JEBBY RASPUTNIS
Acting Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	I. Altendorfer, Associate Counsel