Citation Nr: 18158024 Decision Date: 12/14/18 Archive Date: 12/13/18 DOCKET NO. 11-32 937 DATE: December 14, 2018 REMANDED Entitlement to service connection for the residuals of a heart attack is remanded. Entitlement to service connection for hypertension is remanded. Entitlement to service connection for a hernia is remanded. REASONS FOR REMAND The Veteran had active duty service for training (ACDUTRA) from August 1976 to November 1976 and had additional periods of ACDUTRA or inactive duty for training (INACDUTRA) in the Alabama Air National Guard and National Reserves. This matter comes before the Board of Veterans’ Appeals (Board) from a June 2010 rating decision issued by a Regional Office (RO) of the Department of Veterans Affairs (VA). The Board previously considered and remanded this matter in November 2013 and July 2017. Entitlement to service connection for the residuals of a heart attack, hypertension, and a hernia is remanded. Although the Board sincerely regrets the additional delay, the Veteran’s appeal must again be remanded for further evidentiary development. As noted above, the Board previously remanded this matter in July 2017 for further evidentiary development, to include verifying the Veteran’s periods of ACDUTRA and INACDUTRA and attempting to secure all outstanding personnel and pertinent records relating to those periods. The Board also instructed that the Veteran should be afforded a medical examination to determine the etiology of the disabilities currently on appeal. Although VA did obtain leave and earning statements with respect to 2001 and 2002, there is no indication that VA attempted to obtain all pertinent personnel records relating to that service period. The record also indicates that VA had previously attempted to obtain records from the Alabama Air National Guard in March 2010. VA ultimately issued a formal finding in June 2010 that service treatment records were unavailable for review. However, there is no response from the Alabama Air National Guard stating that such records are unavailable and the June 2010 finding appears to reference a different Veteran. Given that there are contentions that both a heart attack and hernia treatment occurred during 2001 when the Veteran was a member of the Alabama Air National Guard and his statements that a medical examination conducted by the National Guard revealed the presence of a hernia, the Board does not find that there is sufficient evidence that VA has satisfied its duty to assist the Veteran in ensuring that all obtainable service records are included in the claims file. In addition, the record also indicates that the Veteran did undergo a medical examination in September 2017. Although the examiner did comment upon the medical history documented in the record, there does not appear to be any significant rationale supporting the negative nexus opinion provided. Instead, the report appears to include only a bare recitation of the medical facts followed immediately by an assertion that no nexus exists between any period of ACDUTRA or INACDUTRA and the claimed disabilities. The Board does not find that this rationale is adequate for VA’s purposes and must remand the claim for corrective action. The matters are REMANDED for the following action: 1. Contact the Alabama Air National Guard or any other appropriate source to ensure that all obtainable service treatment and personnel records relating to the Veteran’s service are associated with the claims file, to include the Veteran’s claimed National Guard examination which he states revealed a hernia. Any negative reply must be documented in the claims file. 2. Obtain an addendum opinion from a qualified medical professional other than the clinician who examined the Veteran in September 2017 to obtain an opinion addressing the likely etiology of the claimed disabilities. The clinician is asked to provide an opinion regarding the following items: (a.) With respect to the Veteran’s claimed heart attack, is it at least as likely as not that the Veteran sustained a heart attack during any period of ACDUTRA or INACDUTRA or that any heart attack was etiologically related to a period of ACDUTRA or INACDUTRA, to include the Veteran’s contention that he sustained a heart attack during a weekend training while ascending stairs? (b.) With respect to the Veteran’s claimed hernia, is it at least as likely as not that the Veteran’s hernia arose in or is otherwise etiologically related to any period of ACDUTRA or INACDUTRA? (c.) With respect to the Veteran’s hypertension, is it at least as likely as not that this condition arose during any period of ACDUTRA or is otherwise etiologically related to any event or circumstance of ACDUTRA or INACDUTRA? The examiner is explicitly asked to consider the contention that this condition first arose during the Veteran’s initial period of ACDUTRA in the 1970s and should also consider any pertinent clinical records from that period, to include medical examination reports from October 1976, March 1980, and March 1981. Matthew Tenner Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD B. Whitelaw, Associate Counsel