Citation Nr: 20021160 Decision Date: 03/24/20 Archive Date: 03/24/20 DOCKET NO. 15-36 277 DATE: March 24, 2020 REMANDED Entitlement to service connection for the Veteran's cause of death is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1990 to August 1991. He passed away in November 2011. The appellant is the Veteran’s surviving spouse. In December 2018, a videoconference hearing was held before the undersigned Veterans Law Judge. A transcript is of record. This matter was remanded by the Board in May 2019. As an initial matter, the Board notes that the appellant was recognized as a valid substitute in the claim for service connection for a heart condition that was pending at the time of the Veteran’s death. The appellant was provided written notice of her right to file a Notice of Disagreement (NOD) regarding the aforementioned service connection claim. The Board notes that there is still time remaining to file this NOD, if she wishes. See December 2019 VA correspondence. Entitlement to service connection for the Veteran's cause of death is remanded. Unfortunately, remand is again necessary. Although the Board sincerely regrets the additional delay, it is necessary to ensure that there is a complete record upon which to decide the appellant’s claim so that she is afforded every possible consideration. See Stegall v. West, 11 Vet. App. 268 (1998). The Board remanded the appellant’s claim in May 2019 for a medical opinion regarding whether the Veteran’s in-service parvovirus and associated surgical and medical treatment required to address it caused or aggravated the Veteran’s heart disease and his listed cause of death of myocardial infarction with underlying causes of cardiomyopathy and hypertension. The VA examiner was also asked to address the significance of the medical journal article that the appellant submitted that discusses the relationship between parvovirus, cardiomyopathy, and heart disease. In February 2020, the Veteran’s claims file was forwarded to a VA examiner for review and medical opinion. While the VA examiner addressed whether the Veteran’s in-service parvovirus caused or aggravated his heart disease, as well as the medical journal that the appellant submitted, the VA examiner did not opine as to whether the associated surgical and medical treatment required to address the in-service parvovirus caused or aggravated the Veteran’s heart disease and his listed cause of death of myocardial infarction with underlying causes of cardiomyopathy and hypertension. As such, remand for an addendum opinion is warranted. The matters are REMANDED for the following action: Obtain an addendum opinion from the examiner who performed the February 2020 VA examination. If the February 2020 VA examiner is no longer available, the claims file should be forwarded to another qualified examiner for a medical opinion. The examiner is asked to opine as to whether the associated surgical and medical treatment required to address the in-service parvovirus caused or aggravated the Veteran’s heart disease and his listed cause of death of myocardial infarction with underlying causes of cardiomyopathy and hypertension. If the examiner is unable to provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation stating why this is so. A. ISHIZAWAR Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Griffin, 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.