Citation Nr: 20006058 Decision Date: 01/24/20 Archive Date: 01/24/20 DOCKET NO. 17-28 449A DATE: January 24, 2020 REMANDED Entitlement to service connection for aortic stenosis is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from November 1950 to November 1952. This matter comes before the Board from an October 2016 rating decision. The Veteran died in June 2017. A request for substitution was approved in September 2017. The Appellant appeared before the undersigned Veterans Law Judge at a Board hearing in September 2019. The transcript is in the record. 1. Entitlement to service connection for aortic stenosis is remanded. While he was in the military, the Veteran recalled being told that he had an enlarged heart. He said he was diagnosed with heart arrhythmia and palpitations in the service. The Veteran’s service treatment records (STRs) are largely unavailable except for his entrance and separation examinations; the remainder of the STRs were likely lost in the 1973 fire in the National Personnel Records Center. A review of what is left of the Veteran’s STRs reveals that he endorsed high blood pressure, dizziness and fainting spells, and frequent headaches on his pre-induction examination. He denied heart palpitations or pounding heart. His blood pressure was 120/76. No defect or diagnosis was identified with the exceptions of headaches. At the Veteran’s exit examination, it was noted that his vascular system was abnormal and that he suffered from hypertension for several years. The Appellant testified that she had known the Veteran for approximately 35 years and that he had been complaining of headaches and passing out since she had known him. She indicated that the Veteran had been diagnosed with aortic stenosis in 1985. In a June 2017 statement to the VA, the Appellant argued cardiovascular problems noted on the Veteran’s entrance examination were aggravated by his military service. In brief, there is an indication the Veteran’s aortic stenosis could have been related to or aggravated by his military service. There is likewise insufficient evidence in the file to make a decision. As such, a medical opinion should be obtained regarding the etiology of the Veteran’s aortic stenosis. See McLendon v. Nicholson, 20 Vet. App. 79 (2006); 38 U.S.C. § 5103A (d)(2) 38 C.F.R. § 3.159 (c)(4)(i). The matters are REMANDED for the following action: 1. Provide the Veteran’s claims file to an appropriate clinician to determine the nature and etiology of any heart condition. The examiner should opine as to: (a.) Identify/diagnose any heart disorder that existed during the appeal period. (b.) For each identified heart disorder, state whether it clearly and unmistakably (undebatable) that it existed prior to the Veteran’s service. (c.) If the examiner finds it did clearly and unmistakably preexist service, the examiner must address whether there was an increase in severity; and, if there was an increase, opine whether it was clearly and unmistakably not aggravated by service. (d.) For any heart disorder not found to have preexisted active service, the examiner must opine whether it is at least as likely as not related to an in-service injury, event, or disease, including the heart and vascular conditions noted in-service. MICHAEL A. HERMAN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E. Rekowski 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.