Citation Nr: 20005285 Decision Date: 01/22/20 Archive Date: 01/22/20 DOCKET NO. 17-64 839 DATE: January 22, 2020 ORDER Entitlement to service connection for heart disease, to include coronary artery disease (CAD), myocardial infarction, and congestive heart failure (CHF), claimed as secondary to service-connected Type II diabetes mellitus (DM), is granted. FINDING OF FACT Resolving all doubt in the Veteran’s favor, CAD, myocardial infarction, and CHF are proximately due to or aggravated by service-connected DM. CONCLUSION OF LAW The criteria for entitlement to service connection for CAD, myocardial infarction and CHF, to include as secondary to service-connected DM, have been met. 38 U.S.C. §§ 1110, 1131, 5103A, 5107 (2012); 38 C.F.R. §§ 3.303, 3.310 (2019). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from June 1983 to January 1997. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from rating decisions rendered in May 2015 and November 2015. In October 2019, the Veteran testified at a Travel Board hearing before the undersigned Veterans Law Judge (VLJ). A transcript of that hearing is of record. 1. Entitlement to service connection for CAD, myocardial infarction and CHF, to include as secondary to service-connected DM During his October 2019 Board hearing, the Veteran asserted that his VA primary care physician had indicated his DM of disabling severity had likely caused his CAD. A disability which is proximately due to or the result of a service-connected disease or injury shall be service connected. 38 C.F.R. § 3.310(a) (2019). Any increase in severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice-connected disease, will be service connected. However, VA will not concede that a nonservice-connected disease or injury was aggravated by a service-connected disease or injury unless the baseline level of severity of the nonservice-connected disease or injury is established by medical evidence created before the onset of aggravation or by the earliest medical evidence created at any time between the onset of aggravation and the receipt of medical evidence establishing the current level of severity of the nonservice-connected disease or injury. 38 C.F.R. § 3.310(b) (2019). Here, evidence of record showed the Veteran was awarded of service connection for DM as well as had post-service findings of CAD during the appeal period. In an August 2017 VA examination report and medical opinion, the examiner was asked to provide the etiology, if known, of each of the Veteran’s heart conditions, including the relationship/causality to other heart conditions, particularly the relationship/causality to the Veteran’s ischemic heart disease conditions. The examiner then opined that the etiology of CAD was hyperlipidemia and DM. It was further noted that the Veteran was diagnosed with DM and hyperlipidemia in 2003 and with CAD in 2013. The Board further notes that the examiner indicated that the etiology of the Veteran’s congestive heart failure included the myocardial infarction and COPD. The myocardial infarction was in turn attributed to the coronary artery disease. In view of the totality of the evidence, including the award of service connection for DM, the findings of CAD during the appeal period, the favorable findings contained in the August 2017 VA examination report and medical opinion, and the competent and credible lay assertions of record, the Board finds that the evidence is at least in relative equipoise as to whether the Veteran’s current CAD was secondary to (proximately caused or aggravated by) his service-connected DM. Further inquiry could be undertaken with a view towards development of the claim so as to obtain an additional medical opinion with a more complete rationale. However, to do so in this case would only serve the purpose of obtaining negative evidence. See Mariano v. Principi, 17 Vet. App. 305, 312 (2003) (noting that VA may not order additional development for the sole purpose of obtaining evidence unfavorable to a veteran). As the Board finds that the Veteran’s current CAD, myocardial infarction and CHF cannot be reasonably disassociated from his service-connected DM, it has determined that the evidence is at least in equipoise and, therefore, applying the benefit-of-the-doubt doctrine, service connection for CAD, myocardial infarction and CHF is warranted. 38 U.S.C. § 5107(b) (2012); 38 C.F.R. § 3.102 (2019); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). MICHAEL MARTIN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. D. Deane, 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.