Citation Nr: 20005552 Decision Date: 01/23/20 Archive Date: 01/22/20 DOCKET NO. 19-24 660 DATE: January 23, 2020 REMANDED Entitlement to a disability rating in excess of 10 percent for aortic valve insufficiency, status post porcine valve replacement (heart disability), is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1985 to May 2008. This matter comes before the Board of Veterans’ Appeals (Board) on appeal of an April 2016 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). Increased rating for heart disability is remanded The Veteran seeks entitlement to a disability rating in excess of 10 percent for his heart disability. The Veteran was provided a VA examination as to his heart disability in January 2016. VA has a duty to ensure that any medical examination or opinion it provides is adequate. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). A medical opinion is adequate where it is based upon consideration of the full medical history and describes a disability in sufficient detail so that the Board’s evaluation will be fully informed. Stefl v. Nicholson, 21 Vet. App. 120, 123 (2007). Here, the Board finds the January 2016 VA examination relating to the Veteran’s heart disability is inadequate for decision-making purposes because the examination report is internally inconsistent. Upon examination, the January 2016 VA examiner noted the Veteran reported difficulty breathing and dyspnea when he was bent over, bending, squatting, and lifting anything over 25 pounds. The examiner reported an exercise stress test was not performed to determine the Veteran’s functional status because an exercise stress testing is not required as part of the Veteran’s current treatment plan and this test is not without significant risk. The examiner performed an interview-based METs test and reported the Veteran denies experiencing symptoms attributable to a cardiac condition with any level of physical activity. This finding conflicts with the Veteran’s report of difficulty breathing and dyspnea when simply bending. It is not credible that Veteran denied experiencing symptoms due to his cardiac condition with any level of physical activity. Further, in his February 2017 Notice of Disagreement the Veteran stated the January 2016 examiner did not properly record his heart disability symptoms in the January 2016 examination report. The Board notes the January 2016 examiner also did not properly report the Veteran was on continuous medication for his heart disability. As the examination is not adequate for decision-making purposes, the Veteran must be provided a new VA examination to address the current severity of his heart disability. The matter is REMANDED for the following action: (Continued on the next page)   1. Schedule the Veteran for a VA examination to determine the current nature and severity of his heart disability. R. FEINBERG Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. St. Laurent, 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.