Citation Nr: 18159291 Decision Date: 12/18/18 Archive Date: 12/18/18 DOCKET NO. 14-07 551 DATE: December 18, 2018 REMANDED Entitlement to a disability evaluation greater than 30 percent for service-connected coronary artery disease status post CABG and stent (heart disability) is remanded. Entitlement to a total disability rating due to individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Marine Corps from March 1967 to January 1971. This matter is before the Board of Veterans’ Appeal (Board) on appeal from a March 2011 rating decision issued by the Department of Veteran Affairs (VA) Regional Office (RO) in St. Petersburg, Florida. The Veteran presented testimony at a hearing before the undersigned in January 2018. A transcript of the hearing is associated with the claims file.   1. Entitlement to a disability evaluation greater than 30 percent for service-connected coronary heart disability is remanded. The Board finds that additional development is needed before the Veteran’s claim for entitlement to an increased rating for his heart disability can be decided. At the Veteran’s January 2018 Board hearing, the Veteran contended that his service-connected heart disability has worsen since his last VA examination. The Veteran testified that he suffered a stroke due heart blockage, which led to a stroke that caused his current vertigo. The Veteran reported that he fell several times over the years and suffered several fractures. He also described sudden drops in blood pressure, angina, blurred vision, and dizziness. Under the circumstances, the Veteran should be afforded a new VA examination to determine the current severity of his service-connected heart disability. See 38 U.S.C. § 5103A; 38 C.F.R. § 3.159; see also Green v. Derwinski, 1 Vet. App. 121, 124 (1991) (VA has a duty to provide the veteran with a thorough and contemporaneous medical examination). The Board further finds that it would benefit from a retrospective medical opinion in this case, given the Veteran’s July 9, 2001, effective date, and the record in this case. See Chotta v. Peake, 22 Vet. App. 80, 85-86 (2008) (discussing situations when it may be necessary to obtain a "retrospective" medical opinion to determine the date of onset or severity of a condition in years past). 2. Entitlement to a TDIU is remanded. Turning to the issue of entitlement to a TDIU, the Veteran testified that his service-connected disabilities have also prevented him from maintaining and sustaining gainful employment. In Rice v. Shinseki, 22 Vet. App. 447 (2009), the United States Court of Appeals for Veterans Claims (Court) held that a TDIU claim is part of a claim for a higher rating when such claim is raised by the record or asserted by the Veteran. The Court further held that when evidence of unemployability is submitted during the pendency of a claim for an increased evaluation, the claim for TDIU will be considered part and parcel of the claim for benefits for the underlying disability, when such evidence indicates that unemployability is due, at least in part, to the underlying disability on appeal. The Veteran contends that he is unable to work due to his service-connected disabilities; thus, the Board will consider the issue of entitlement to service connection for a TDIU. With regard to the issue of entitlement to a TDIU, the Board finds that the issue is inextricably intertwined with the Veteran’s claim on appeal. See Harris v. Derwinski, 1 Vet. App. 180, 183 (1991) (issues are “inextricably intertwined” when a decision on one issue would have a “significant impact” on a veteran’s claim for the second issue). Hence, this issue will be remanded with underlying claim on appeal. The matter is REMANDED for the following actions: 1. Schedule the Veteran for a VA examination to ascertain the current severity and manifestations of his coronary artery disease status post CABG and stent (heart disability). The examiner should report all signs and symptoms necessary for rating the Veteran’s disabilities under the rating criteria. Additionally, the examiner should provide a retrospective medical opinion as to the severity of the disability from July 9, 2001. The examiner should also provide a medical opinion as to whether the Veteran’s dizziness, vertigo, angina, blurred vision, and sudden drops in blood pressure, are attributable to his service-connected heart disability and, if so, the examiner should discuss that symptomatology in detail, including the frequency, severity, and duration of such symptomatology. A clear rationale for all opinions would be helpful, and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. As it is important “that each disability be viewed in relation to its history[,]” 38 C.F.R. § 4.1, copies of all pertinent records in the Veteran’s claims file, or, in the alternative, the entire claims file, must be made available to the examiner for review. (Continued on the next page)   2. After undertaking any additional development deemed appropriate, and giving the Veteran full opportunity to supplement the record, adjudicate the Veteran’s pending claim in light of any additional evidence added to the record, including the issue of entitlement to a TDIU. If any benefit sought on appeal remains denied, the Veteran and his representative should be furnished with a Supplemental Statement of the Case and be afforded the applicable opportunity to respond before the record is returned to the Board for further review. ANTHONY C. SCIRÉ, JR Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. R. Higgins, Associate Counsel