Citation Nr: 20006231 Decision Date: 01/24/20 Archive Date: 01/24/20 DOCKET NO. 16-29 548 DATE: January 24, 2020 REMANDED Entitlement to service connection for the Veteran’s cause of death is remanded. (The Appellant’s appeal of her death pension payment rate will be addressed in a separate decision.) REASONS FOR REMAND The Veteran had active service from October 1969 to May 1972. He died in June 2015. The Appellant is his surviving spouse. She has appealed an August 2015 rating decision that denied her claim of entitlement to service connection for the Veteran’s cause of death. In October 2016, the Appellant submitted a VA Form 21-22a purporting to appointment an attorney as her representative; however, this attorney does not appear to be accredited by VA. In December 2019, the Board sent the Appellant notice that it could not recognize the attorney as her representative and provided her thirty days to elect a new representative if she so chooses. The Appellant has not elected a new representative; therefore, the Board will proceed with her being unrepresented. The Board finds a medical opinion is necessary regarding the Appellant’s claim. See 38 U.S.C. § 5103A (a); Wood v. Peake, 520 F.3d 1345, 1347-48 (Fed. Cir. 2008) (explaining VA is required to assist a claimant in obtaining a medical opinion or examination regarding a claim for service connection for cause of death whenever such an opinion is necessary to substantiate the claim). The Veteran was entitled to service connection for diabetes mellitus, type II, and prostate cancer prior to his death due to his presumed herbicide agent exposure in the Republic of Vietnam. Although the Veteran’s death certificate lists anoxic brain injury, cardiac arrest, and hypertensive cardiovascular disease as the cause of his death, diabetes and prostate cancer are listed as “other significant conditions” at the time of his death, raising the possibility that these diseases may have been a contributory cause of his death. Thus, a medical opinion is necessary to make an informed decision on the Appellant’s claim. There also appears to be relevant, outstanding treatment records from a private healthcare facility from which the Veteran was transferred to the Washington D.C. VA Medical Center just before his death. A July 2015 VA treatment record indicates the Veteran was first seen at Washington Adventist Hospital after experiencing the cardiac arrest episode with anoxic brain injury that led to his death. Reasonable efforts should be made to assist the Appellant with obtaining any records that may be available from Washington Adventist Hospital to fulfill VA’s duty to assist. See 38 U.S.C. § 5103A; 38 C.F.R. § 3.159(c); see also Sullivan v. McDonald, 815 F.3d 786 (Fed. Cir. 2016). The matter is REMANDED for the following action: 1. Make reasonable efforts to assist the Appellant with obtaining any records that may be available for the Veteran from Washington Adventist Hospital. 2. Obtain an opinion regarding the Appellant’s claim for service connection for the Veteran’s cause of death. The selected examiner must provide an opinion addressing whether any of the Veteran’s service-connected disabilities, to include diabetes and prostate cancer, was at least as likely as not (50 percent probability or greater) a contributory cause of his death. The examiner must be advised a disability will be considered a contributory cause of death when it contributed substantially or materially to death, combined to cause death, or aided or lent assistance to the production of death. In the context of the opinion, the examiner must discuss the relevance of diabetes and prostate cancer being listed on the Veteran’s death certificate as “other significant conditions” at the time of his death. The examiner must provide a complete rationale to support his or her conclusions. M. HYLAND Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board L. S. Kyle, 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.