Citation Nr: 20002196 Decision Date: 01/09/20 Archive Date: 01/09/20 DOCKET NO. 14-06 297 DATE: January 9, 2020 REMANDED Entitlement to Dependency and Indemnity Compensation (DIC) on the basis of entitlement to service connection for cause of Veteran’s death is remanded. REASONS FOR REMAND The Veteran served on active duty in the US Army from August 1976 to March 1977 with additional Army National Guard reserve time from February 1978 to April 1982, November 1982 to November 1983 and July 1986 through March 1989. He died in February 2013. The Appellant is the Veteran’s surviving spouse. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a July 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office and Pension Management Center (RO &PMC) in Philadelphia, Pennsylvania. In November 2017, the Board denied the appellant’s claim, and the appellant appealed the Board’s decision to the United States Court of Appeals for Veterans Claims (Court). In an April 2019 Memorandum Decision, the Court set aside the Board’s November 2017 decision and remanded the matter back to the Board for additional development. Entitlement to service connection for cause of the Veteran’s death is remanded. As noted above, the Veteran died in February 2013. According to his death certificate, the causes of death were listed as terminal arrhythmia, congestive heart failure (CHF), diabetes, and hypertension. Other significant conditions were listed as being pacemaker and alcohol abuse. During the Veteran’s lifetime, he was not service-connected for a heart condition. Prior to his death, the Veteran indicated in his VA Form 21-526, that his claimed disabilities began October 25, 1988. See October 2003 Veteran’s Application for Compensation and/or Pension. Additionally, throughout the pendency of this appeal, the appellant has asserted that the Veteran had a heart attack while in the National Guard in Greenwood, South Carolina while participating in drills. As noted in the Court’s April 2019 Memorandum Decision, the Board failed to discuss the appellant’s assertion that the Veteran had a heart attack during his National Guard training. As this contention was not discussed by the April 2012 VA examiner, a remand is warranted for an additional medical opinion discussing the appellant’s contention stated above. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from a cardiologist or other appropriately qualified VA examiner, to consider the Appellant’s contention that the Veteran had a heart attack during drill in Greenwood, South Carolina. The evidentiary record, including a copy of this remand, must be made available to and reviewed by the examiner. The addendum opinion should mention that this record review took place. 2. After the record review, the VA examiner is asked to respond to the following inquiries: (a) Whether it is at least as likely as not that the Veteran suffered a heart attack or cardiac arrest during drill at any time in 1998, but particularly on October 15 through 16, 1998. The examiner should consider the Veteran's October 25, 1998 cardiac catheterization report which revealed a ruptured aortic aneurysm with left to right shunting in the heart after the Veteran sought medical attention for dyspnea. All treatment records and lay statements of the Veteran and his surviving spouse and treatment records should be considered in formulating any opinion. (b) Whether it is as least as likely as not that the Veteran's cardiac condition was caused or aggravated by drill in Greenwood, South Carolina at any time in 1998 but particularly from October 15 through 16, 1998. (c) Is it at least as likely as not (50 percent probability or more) that the Veteran's fatal terminal arrhythmia, congestive heart failure (CHF), diabetes, and hypertension had its onset in service, is related to the claimed heart attack during drill time, or was otherwise the result of a disease or injury in service? The term "at least as likely as not" does not mean within the realm of medical possibility, but rather that the medical evidence both for and against a certain conclusion is so evenly divided that it is as medically sound to find in favor of such a conclusion as it is to find against it. The complete rationale for all opinions should be set forth and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. 3. After the above development has been completed, readjudicate the claim. If any benefit sought remains denied, provide the appellant and her representative with a supplemental statement of the case (SSOC), and return the case to the Board. The Appellant has the right to submit additional evidence and argument on the matter or matters the Board has remanded. Kutscherousky v. West, 12 Vet. App. 369 (1999). KRISTI L. GUNN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Denise Adams Hill, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.