Citation Nr: 18160320 Decision Date: 12/26/18 Archive Date: 12/26/18 DOCKET NO. 16-38 729 DATE: December 26, 2018 ORDER Entitlement to an initial rating in excess of 60 percent for ischemic heart disease (IHD) from November 26, 2004 is dismissed. Entitlement to an initial rating in excess of 30 percent for IHD from June 28, 2007 is dismissed. Entitlement to an initial rating of 100 percent for IHD is granted effective February 27, 2012. FINDINGS OF FACT 1. At the August 2018 hearing before the Board, the Veteran testified that a grant of 100 percent since 2012 would satisfy his appeal. 2. The Veteran’s IHD resulted in exercise tolerance limited to 1-3 METS, fatigue and dyspnea since February 27, 2012. CONCLUSIONS OF LAW 1. The criteria for withdrawal of an initial rating claim in excess of 60 percent for IHD since November 26, 2004 are met. 38 U.S.C. § 7105(d)(5); 38 C.F.R. § 20.204. 2. The criteria for withdrawal of an initial rating claim in excess of 30 percent for IHD since June 28, 2007 are met. 38 U.S.C. § 7105(d)(5); 38 C.F.R. § 20.204. 3. The criteria for 100 percent for IHD are met as of February 27, 2012. 38 U.S.C. §§ 1155, 5107 (b); 38 C.F.R. §§ 3.102, 4.1, 4.2, 4.3, 4.7, 4.10, 4.21, 4.104, Diagnostic Code (DC) 7005. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Marine Corps from October 1968 to July 1970. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an April 2012 rating decision from the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran presented sworn testimony at a hearing before the undersigned Veterans Law Judge (VLJ) in August 2018. The Board notes that the issue of a TDIU was raised at the August 2018 hearing. See Rice v. Shinseki, 22 Vet. App. 447 (2009). However, pursuant to this decision the Veteran receives a 100 percent rating for his IHD and total disability ratings for compensation may only be assigned where the schedular rating is less than total. 38 C.F.R. 4.16(a). Increased Rating The Veteran asserts that he is entitled to a 100 percent rating for his IHD. The Veteran received a 60 percent rating from November 26, 2004 and a 30 percent rating from June 28, 2007 under DC 7005. The appeal period before the Board begins the effective date of service connection for IHD because the Veteran appealed the initial rating assigned. Fenderson v. West, 12 Vet. App. 119 (1999). Disability ratings are determined by applying the criteria set forth in the VA's Schedule for Rating Disabilities, which is based on the average impairment of earning capacity. Individual disabilities are assigned separate diagnostic codes. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Here, a 30 percent rating is assigned when a workload of greater than 5 METs but not greater than 7 METs results in dyspnea, fatigue, angina, dizziness, or syncope; or, with evidence of cardiac hypertrophy or dilatation on electrocardiogram, echocardiogram, or X-ray. A 60 percent rating is assigned with more than one episode of acute congestive heart failure in the past year; when workload of greater than 3 METs but not greater than 5 METs results in dyspnea, fatigue, angina, dizziness, or syncope; or for left ventricular dysfunction with an ejection fraction of 30 to 50 percent. A 100 percent rating is assigned for chronic congestive heart failure (CHF); or when workload of 3 METs or less results in dyspnea, fatigue, angina, dizziness, or syncope; or for left ventricular dysfunction with an ejection fraction of less than 30 percent. 38 C.F.R. § 4.104, DC 7005. Prior to February 27, 2012 An appeal may be withdrawn by an appellant as to any or all issues involved in the appeal at any time before the Board promulgates a decision. 38 C.F.R. § 20.204. At the August 2018 hearing, the Veteran asserted that a grant of 100 percent since 2012 would fully satisfy his appeal. The Board interprets this statement as a request to withdraw the remaining issues with regard to the period before February 27, 2012. See AB v. Brown, 6 Vet. App. 35, 38 (1993). Accordingly, the Board does not have jurisdiction to review these issues and they are dismissed. Since February 27, 2012 The Board finds the Veteran is entitled to a 100 percent rating since his VA examination dated February 27, 2012. At the February 2012 and March 2016 VA examination, the Veteran had 1-3 METs with dyspnea and fatigue. The Veteran also had heart stents in 2013 and 2012. The Board notes the February 2012 and March 2016 VA examiners’ conclusion that the Veteran’s ejection fraction of 60-65% is more indicative of the current cardiac function secondary to comorbidities of chronic back pain and fatigue. However, the March 2016 VA examiner indicated that it was not possible to accurately estimate the percent of METs limitation attributable to each medical condition. See Mittleider v. West, 11 Vet. App. 181 (1998). The Board observes that in light of the examiner’s statements regarding the Veteran's left ventricular ejection fraction and METs, and the inability to accurately estimate the percent of METs limitation attributable to the Veteran's IHD, the Board cannot conclude that the Veteran's coronary artery disease is not indicative of a 100 percent rating under DC 7005. As such a 100 percent rating is warranted. STEVEN D. REISS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD K.Ijitimehin, Associate Counsel