Citation Nr: 18158485
Decision Date: 12/17/18	Archive Date: 12/17/18

DOCKET NO. 17-00 949
DATE:	December 17, 2018
REMANDED
Entitlement to an initial compensable evaluation for valvular heart disease with cardiac murmur is remanded.
REASONS FOR REMAND
In December 2014, VA afforded the Veteran an examination in connection with his claim for service connection.  Unfortunately, the examination is inadequate for evaluation purposes.  By regulation, METs testing is required in all cases unless medically contraindicated, the left ventricular ejection fraction is 50 percent or less, a 100 percent rating can be assigned on another basis, or congestive heart failure is present or has been present more than once in the past year.  38 C.F.R. § 4.100.  None of these exceptions were met in December 2014. 
Additionally, four years have passed since the examination, and subsequent private and VA treatment records indicate reports of symptoms associated with cardiac problems that raise the possibility of worsening.  Importantly, records refer to the administration of stress testing in October 2015 which is not associated with the claims file.
The matters are REMANDED for the following action:
1. Contact the Veteran and request properly executed, separate VA form 21-4142’s, Authorization and Consent to Release Information to the Department of Veterans Affairs, for any private care providers who have treated him for his heart condition.
Upon receipt of such, VA must take appropriate action to contact the identified providers and request complete treatment records.  The Veteran should be informed that in the alternative he may obtain and submit the records himself.
2. Associate with the claims file complete, updated VA treatment records.
3. Schedule the Veteran for a VA heart examination.  The examiner must describe in detail the current status of the service-connected valvular heart disease with murmur, and must conduct all required testing, to include electrocardiogram and stress testing. If any testing cannot be accomplished, an explanation is required.
 
WILLIAM H. DONNELLY 
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	K. McDermott, Associate Counsel