Citation Nr: 18157862
Decision Date: 12/13/18	Archive Date: 12/13/18

DOCKET NO. 17-18 060
DATE:	December 13, 2018
REMANDED
Entitlement to an initial rating in excess of 30 percent for atrial flutter/atrial fibrillation is remanded.
REASONS FOR REMAND
The Veteran had active duty from September 1955 to September 1957.
Entitlement to an initial rating in excess of 30 percent for atrial flutter/atrial fibrillation is remanded.
Unfortunately, a remand is required for the claim listed above. Although the Board sincerely regrets the additional delay, it is necessary to ensure that there is a complete record upon which to decide the Veteran’s claim so that he is afforded every possible consideration.
The record reflects that the Veteran was last evaluated in March 2017 regarding his service-connected heart disability. He, however, has indicated that the VA examinations of record do not adequately address the severity of this service-connected disability. See VA Form 9 dated April 2017. In addition, the record indicates that not all of the Veteran’s medical treatments have been obtained and associated with the claims. For instance, a December 2014 VA medical treatment record revealed that the Veteran was hospitalized for four days in July 2014 for an episode of atrial flutter with rapid ventricular rate with 2-1 conduction. This record also noted that the Veteran received care for this condition not only with VA but with his primary care provider, Dr. Webber, and his cardiologist, Dr. Kranik. Further, the March 2017 VA examiner observed that the Veteran also received care for his heart condition from Dr. Talbert, a cardiologist at Barnes Hospital in Cape Girardeau, Missouri; Dr. Phillips, cardiologist at St. Lukes Hospital; and most recently, Dr. Piotrowski of Advanced Heart and Vascular in Farmington, Missouri. None of these records, however, have been obtained and associated with the claims file. As such, the claim must be remanded for a new VA examination and retrieval of these outstanding medical treatment records. 
The matter is REMANDED for the following action:
1. Obtain the Veteran’s VA medical treatment records from March 2017 forward.
2. Obtain the Veteran’s private treatment records, including from Dr. Webber; Dr. Kranik; Dr. Talbert, a cardiologist at Barnes Hospital in Cape Girardeau, Missouri; Dr. Phillips, cardiologist at St. Lukes Hospital; and Dr. Piotrowski of Advanced Heart and Vascular in Farmington, Missouri.
3. After any newly obtained medical treatment records have been associated with the claims file, schedule the appropriate VA examination to assess the current level of severity of the Veteran’s service-connected atrial flutter/atrial fibrillation. The entire claims file, to include a complete copy of this remand, should be made available to, and reviewed by, the designated examiner. Any indicated testing should be conducted. If possible, the appropriate Disability Benefits Questionnaire should be completed.
The examiner must provide a comprehensive report including complete rationales for all opinions and conclusions reached.
4. After undertaking any other development deemed appropriate, readjudicate the issue on appeal. If any benefit sought is not granted, furnish the Veteran and his representative with a supplemental statement of the case and afford them an opportunity to respond before the record is returned to the Board for further review.
 
LESLEY A. REIN
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	N. Sangster, Counsel