Citation Nr: 20011272 Decision Date: 02/11/20 Archive Date: 02/11/20 DOCKET NO. 18-49 552 DATE: February 11, 2020 REMANDED Entitlement to service connection for the cause of the Veteran’s death. Entitlement to Dependency and Indemnity Compensation under 38 U.S.C. § 1318. REASONS FOR REMAND The Veteran served on active duty from February 2001 to September 2004. He died in July 2018. The appellant is the custodian of his dependent surviving daughter. The appeal was remanded by the Board in July 2019 for additional development. The Agency of Original Jurisdiction (AOJ) was directed to obtain a VA opinion to determine the cause of the Veteran’s death. Unfortunately, the appeal must be remanded again. The additional delay of a final decision is regrettable; however, review of the record reveals that additional development is needed to ensure that due process is followed and that there is a complete record upon which to decide the appellant’s claim so that she is afforded every possible consideration. 38 U.S.C. § 5103A; 38 C.F.R. § 3.159. 1. Entitlement to service connection for the cause of the Veteran’s death The appeal was remanded by the Board in July 2019 for an opinion regarding the cause of the Veteran’s death. A VA opinion was obtained in November 2019. The examiner indicated that the Veteran was service connected for Grave’s disease with exophthalmos. He was treated with radioactive iodine in 2004 and became hypothyroid. He was treated with levothyroxine replacement but had a history of poor adherence and his TSH was elevated in January 2017 to 36.93, indicating hypothyroid status. The examiner indicated that the Veteran died in July 2018 at B.M.C. Hospital; but there were no hospital records available. He further noted that, without those hospital records, it is not possible to give an opinion on etiology; but he noted that hypothyroidism is not a cause of a spontaneous intracerebral hemorrhage. Additionally, he indicated that the service treatment records (STRs) show no evidence of a condition that would lead to an intracerebral hemorrhage. The cause of the Veteran’s death was intracerebral hemorrhage, per the death certificate. The Veteran was hypothyroid in January 2017. His thyroid status at time of death is not known. Hypothyroidism is not a cause of intracerebral bleed; and there is no evidence that the thyroid condition caused, contributed to, or hastened the death. However, the examiner stated again that there were no hospital records available to determine the circumstances of the Veteran’s death or to determine if there were any unusual circumstances. The examiner concluded that hospital records would help to determine the etiology of the intracerebral hemorrhage. The Board notes that VA medical treatment records associated with the claims file in August 2018 indicated that, in June 2018, VA obtained documentation from B.M.C. Hospital indicating that the Veteran was admitted to B.M.C. Hospital in June 2018, presenting with back pain. VA also noted in their records that B.M.C. documentation indicated that the Veteran later developed an intraparenchymal hemorrhage and, per neurology, an “unsurviveable event” in July 2018. Later, VA received information from B.M.C. that the Veteran died in July 2018. The Board notes that this notation demonstrates that VA has access to private medical records created during the Veteran’s last days. Remand is necessary so that these records can be associated with the claims file, and an addendum opinion obtained. 2. The issue of entitlement to Dependency and Indemnity Compensation under 38 U.S.C. § 1318 If a Veteran died of non-service-connected causes, VA will still pay DIC to the surviving spouse or children in the same manner as if the Veteran’s death were service-connected, under certain circumstances. 38 U.S.C. § 1318; 38 C.F.R. § 3.22. However, the threshold criterion for evaluating whether other DIC criteria are met is whether the Veteran died of non-service-connected causes. As discussed above, the appeal to determine entitlement to service connection for the Veteran's cause of death is ongoing. As VA must settle the cause of death claim before adjudicating the DIC claim, the Board finds these issues to be inextricably intertwined. Harris v. Derwinski, 1 Vet. App. 180 (1991). The matters are REMANDED for the following action: 1. Provide the appellant an opportunity to identify any additional outstanding private treatment records relevant to the claim. After obtaining necessary authorizations, (to include the authorizations received in December 2019 and January 2020), all outstanding records should be obtained to include all updated VA treatment records, and all records from B.M.C. demonstrating the Veteran’s admittance to B.M.C. hospital in or around June 2018 up to the date of his death in July 2018. 2. After obtaining any outstanding records, obtain an addendum opinion to the November 2019 opinion. The claims file should be made available to and reviewed by the November 2019 examiner. The examiner is then asked to provide answers to the following: (a.) Is it at least as likely as not (a probability of 50 percent or greater) that any of the conditions listed on the Veteran’s death certificate (brain tissue herniation and left intraparenchymal brain hemorrhage) had its onset during service or is otherwise causally related to the Veteran’s active service, to include his in-service diagnosis of Grave’s disease? (b.) Is it at least as likely as not (a probability of 50 percent or greater) that any of the service-connected disabilities, alone or in combination, caused or contributed substantially or materially to his death? At the time of his death, he was service-connected for status post Grave’s disease with left exophthalmus. A complete rationale should be given for all opinions and conclusions expressed. 3. Readjudicate the appeal. J. GALLAGHER Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board I. Warren 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.