Citation Nr: 18156323 Decision Date: 12/07/18 Archive Date: 12/07/18 DOCKET NO. 12-33 823 DATE: December 7, 2018 REMANDED Entitlement to service connection for a heart disorder, to include as due to herbicide exposure is remanded. Entitlement to service connection for hypertension, to include as due to herbicide exposure is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1965 to December 1985. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from September 2011 and February 2012 rating decisions of the Department of Veterans Affairs (VA) Regional Office (RO). In March 2014, the Veteran testified at a Board videoconference hearing before the undersigned Veterans Law Judge (VLJ). A transcript of the hearing is of record in the Veteran’s claims folder. In February 2015, the Board remanded the Veteran’s claims. The Veteran’s VA claims folder has been returned to the Board for further appellate proceedings. Heart disorder and hypertension are remanded. The Board initially notes that a Social Security Administration (SSA) inquiry dated December 2016 reveals that the Veteran is in receipt of SSA disability benefits. There is no indication in the record that any attempts have been made to obtain records in conjunction with the Veteran’s claim for SSA disability benefits and, indeed, his SSA records are not currently in the claims file. Therefore, on remand, any determination pertinent to the Veteran’s claim for SSA benefits, as well as any medical records relied upon concerning that claim, should be obtained. See Murincsak v. Derwinski, 2 Vet. App. 363, 369-70 (1992) (where VA has actual notice of the existence of records held by SSA which appear relevant to a pending claim, VA has a duty to assist by requesting those records from SSA). The Veteran contends that he has hypertension that is related to his service. In the Veteran’s August 2018 Informal Hearing Presentation (IHP), the Veteran’s representative contended that the Veteran’s hypertension is due to the Veteran’s in-service exposure to herbicides during service in Vietnam. The Veteran’s service personnel records verify his service in Vietnam. Crucially, the Board notes that the National Academy of Sciences (NAS), in a 2006 and 2008 update, concluded that there was “limited or suggestive evidence of an association” between hypertension and herbicide exposure. See 75 Fed. Reg. 32,540, 32,549 (June 8, 2010); 75 Fed. Reg. 81,332, 81,333 (December 27, 2010). Although the Veteran was provided a VA examination for his hypertension in June 2015 pursuant to the February 2015 Board remand, the VA examiner did not provide an opinion as to whether the Veteran’s hypertension is related to in-service herbicide exposure. There is no medical opinion of record as to whether the Veteran’s current hypertension is related to his in-service herbicide exposure. As the NAS findings suggest a link between herbicide exposure and hypertension, the Board finds that the Veteran should be provided a VA examination in order to determine whether his hypertension is related to in-service herbicide exposure. With regard to the Veteran’s claim of service connection for a heart disorder, the Veteran contends that he has a heart disorder that is related to service. In the Veteran’s August 2018 IHP, the Veteran’s representative contended that the Veteran has a heart disorder to include ischemic heart disease that is presumptively due to in-service herbicide exposure during the Veteran’s service in Vietnam. Pursuant to the February 2015 Board remand, the Veteran was provided a VA examination for his heart disorder in June 2015. After examination of the Veteran and consideration of his medical history, the VA examiner diagnosed the Veteran with valvular heart disease and hypertensive heart disease. The examiner opined that the Veteran’s hypertensive heart disease is caused by the hypertension and the valvular heart disease is of an unknown etiology but “may” be caused by hypertensive heart disease. The Board also notes that the June 2015 VA examiner determined that the Veteran does not currently have ischemic heart disease. VA examination reports dated January 2011 and November 2012 similarly document the absence of such. However, a private treatment record dated September 2015 from C.S., M.D. documents an assessment of chronic ischemic heart disease. Therefore, the Board finds that in providing the Veteran with a VA heart disorder examination, an opinion should be obtained as to whether the Veteran has ischemic heart disease with consideration of the September 2015 assessment by Dr. C.S. The matters are REMANDED for the following action: 1. Request the SSA to provide copies of any records pertaining to the Veteran’s application for SSA disability benefits, in any, to include any medical records obtained in connection with the application. Any materials obtained should be associated with the Veteran’s VA claims folder. If, after continued efforts to obtain Federal records the AOJ concludes that it is reasonably certain they do not exist or further efforts to obtain them would be futile, the Veteran should be notified in accordance with 38 C.F.R. § 3.159(e). The Veteran must then be given an opportunity to respond. 2. Thereafter, schedule the Veteran for a VA examination by an appropriately qualified examiner to determine the likely etiology of his hypertension and heart disorder. The claims file, including a copy of this REMAND, must be made available to the examiner for review. Based on the review and the examination, the examiner should respond to the following: a. Whether the Veteran’s hypertension is at least as likely as not (50 percent probability or greater) related to his service, to include his presumed exposure to herbicides in Vietnam. In making this determination, the examiner should address the NAS 2006 and 2008 updates which concluded that there was “limited or suggestive evidence of an association” between hypertension and herbicide exposure. See 75 Fed. Reg. 32,540, 32,549 (June 8, 2010); 75 Fed. Reg. 81,332, 81,333 (December 27, 2010). b. Whether the Veteran has ischemic heart disease. In making this determination, the examiner must address a finding of chronic ischemic heart disease in September 2015 by C.S., M.D. c. Whether the Veteran’s diagnosed hypertensive heart disease from the June 2015 VA examination is at least as likely as not (50 percent probability or greater) related to his service, to include his presumed exposure to herbicides in Vietnam. A rationale for all opinions expressed should be provided. 3. Review the claims file to ensure that all of the foregoing requested development is completed, and arrange for any additional development indicated. Then readjudicate the claims on appeal. If the benefits sought remain denied, issue an appropriate supplemental statement of the case and provide the Veteran and his representative with the requisite period of time to respond. H. N. SCHWARTZ Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Arif Syed, Counsel