Citation Nr: 18157807
Decision Date: 12/13/18	Archive Date: 12/13/18

DOCKET NO. 15-12 105A
DATE:	December 13, 2018
REMANDED
Entitlement to service connection for the cause of the Veteran’s death is remanded.
REASONS FOR REMAND
The Veteran served on active duty from March 1943 to December 1945 and from September 1950 to April 1951.  The Veteran died in September 2011 and his surviving spouse is the appellant in this case.  This matter comes before the Board of Veterans’ Appeals (Board) from a January 2013 rating decision.  In November 2018, the appellant’s representative cancelled on the appellant’s behalf a hearing that had been scheduled before a Veterans Law Judge.
Entitlement to service connection for the cause of the Veteran's death is remanded.
The Veteran died in September 2011.  The certificate of death identifies the immediate cause of death as congestive heart failure and the underlying cause as idiopathic cardiomyopathy.  The appellant asserts that the Veteran’s service-connected residuals of cold injury to his right and left lower extremities contributed to his death.  In support of the claim, the appellant and her representative have submitted or cited articles and studies suggesting that an increased risk of heart failure due to hypothermia or overexertion in cold weather, cardiac disease in mice enhanced by cold environmental temperatures, and increased mortality during the winter season from cardiovascular complications.  The appellant also asserted that the Veteran had a “long bout with pneumonia” during military service, “which caught up with him more drastically in the last 12 to 15 years of his life.”  She indicated that “doctors who were treating him during his final days were not definitive as to the contributing cause of death, but it was partly due to fluid in his lungs caused by recurring pneumonia.”
In summary, the appellant appears to assert that a cardiovascular or recurrent pneumonia disability was caused by cold weather exposure during the Veteran’s active duty service and caused or contributed to his death.  The agency of original jurisdiction (AOJ) should obtain a VA medical opinion as to whether a service-connected disability was either a principal or contributory cause of the Veteran’s death.
In addition, the Board notes that the Veteran’s terminal treatment records are not associated with the claims file and VA treatment records from years prior to his death indicate he was followed by a private cardiologist for hypertension and coronary artery disease.  The AOJ also should obtain outstanding VA and private treatment records pertinent to the appellant’s claim for the cause of the Veteran’s death.
The matter is REMANDED for the following action:
1. With any necessary assistance from the appellant, obtain the Veteran’s treatment records from the Viera VA Outpatient Clinic dated from January 2006 to September 2011, any treatment records from the Veteran’s private cardiologist, and any other terminal treatment records.
2. Provide the Veteran’s electronic claims file and a complete copy of this REMAND to an appropriate VA clinician to obtain a medical opinion addressing the etiology of the Veteran’s congestive heart failure and underlying idiopathic cardiomyopathy, which was the cause of his death in September 2011 according to his certificate of death.  
Following a review of the claims file, the reviewing clinician should provide an opinion as to whether it is at least as likely as not (a 50 percent or greater probability) 
(a) that congestive heart failure and/or underlying idiopathic cardiomyopathy had its clinical onset in service or is otherwise related to service, including the Veteran’s exposure to cold weather conditions in 1945 or complaints in February 1951 of right-sided and retro-sternal chest pain; 
(b) that any recurrent pneumonia had its clinical onset in service or is otherwise related to service, and if so, whether any recurrent pneumonia either caused or contributed substantially or materially to the cause of his death; or 
(c) whether service-connected residuals of cold injury to the right and left lower extremities caused or contributed substantially or materially to the cause of his death.  
 
A complete medical analysis and rationale are to be included with all opinions expressed. 
 
K. Conner
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	L. Kirscher Strauss, Counsel