Citation Nr: 20028811 Decision Date: 04/23/20 Archive Date: 04/23/20 DOCKET NO. 14-22 169 DATE: April 23, 2020 REMANDED Entitlement to service connection for a heart disability, to include ischemic heart disease and irregular heartbeat, to include as due to herbicide exposure, is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1967 to March 1969. The appeal was previously before the Board of Veterans’ Appeals (Board) in February 2016 when it was remanded for additional development. Considering the Veteran’s statements, the Board has recharacterized the claim to include irregular heartbeat. Brokowski v. Shinseki, 23 Vet. App. 79 (2009). Entitlement to service connection for a heart disability, to include ischemic heart disease, to include as due to herbicide exposure, is remanded. A June 2016 treatment record noted the Veteran was going to rescind his appeal for ischemic heart disease and put in a claim for irregular heartbeat, per his civilian doctor’s diagnosis. However, the Veteran did not respond to June 2016 letter from VA that he confirm whether he wished to withdraw his appeal. Absent his response, and as detailed in the June 2016 letter, the claim is still before the Board. The lack of clarification from the Veteran about whether he was going to withdraw his claim impacted the development ordered in the previous remand. Pursuant to the Board’s directives, the Veteran was scheduled for a VA examination. A memorandum associated with the record indicates that the Veteran refused the examination because he was dropping his claim for ischemic heart disease, that a civilian doctor has diagnosed him with an irregular heartbeat, and that he planned to put in a claim for the irregular heartbeat. However, as noted, the Veteran has not confirmed his intention to withdraw and has not otherwise withdrawn the claim. Further, the claimed irregular heartbeat is contemplated by the appeal of service connection for a heart disability. The claim is remanded to attempt another examination. VA treatment records indicate that the Veteran received medical treatment outside of VA and indicate that outside medical treatment records have been scanned into VISTA Imaging. See VA Treatment, October 2017 and December 2017. A November 2018 VA treatment record noted the Veteran was followed by a cardiologist. The record does not include any current private treatment records or show that records scanned into VISTA have been associated file. The claim is remanded for attempts to obtain additional private treatment records and obtain any treatment records scanned into VISTA Imaging. See 38 C.F.R. § 3.159. The matters are REMANDED for the following action: 1. Obtain the Veteran’s VA treatment records for the period from January 2019 to the present. 2. Ask the Veteran to complete a VA Form 21-4142 for all providers who have treated him for heart disabilities, including irregular heartbeat. Make two requests for the authorized records from all identified providers, unless it is clear after the first request that a second request would be futile. 3. Obtain and associate with the claims file all treatment records scanned into VISTA Imaging. 4. Thereafter, schedule the Veteran for a VA examination to determine the nature and etiology of his current heart disability. Copies of all pertinent records must be made available to the examiner for review. Based on the examination and review of the record, the examiner must address the following: (a) Is the Veteran diagnosed with ischemic heart disease? (b) Identify all currently diagnosed heart disabilities. (c) Is it at least as likely as not that any currently diagnosed heart disability related to the Veteran’s service, to include conceded exposure to herbicides. A complete rationale must be provided for all opinions offered. If an opinion cannot be offered, the examiner must indicate why. 5. Notify the Veteran that it is his responsibility to report for any scheduled examination and to cooperate in the development of the claim, and that the consequences for failure to report for a VA examination without good cause may include denial of the claims. If the Veteran does not report for any scheduled examination, documentation must be obtained which shows that notice scheduling the examination was sent to the last known address. It must also be indicated whether any notice that was sent was returned as undeliverable. M.E. LARKIN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Robert J. Burriesci, 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.