Citation Nr: 20056791 Decision Date: 08/27/20 Archive Date: 08/27/20 DOCKET NO. 13-04 636 DATE: August 27, 2020 REMANDED The appeal for entitlement to service connection for an acquired cardiovascular disorder is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1973 to November 1991, when he was placed on the temporary disability retired list. He was awarded the Combat Action Ribbon, among other decorations related to his service. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a June 2011 rating decision by the Department of Veterans Affairs (VA). The case was remanded by the Board in November 2015 and August 2017. In January 2019, the Board denied service connection for a heart disability. The Veteran appealed the Board’s January 2019 decision to the United States Court of Appeals for Veterans Claims (Court). In February 2020, the Court granted a Joint Motion for Remand filed by both parties to the case, vacated the January 2019 Board decision, and remanded the matter to the Board for further development and analysis consistent with the terms of the Joint Motion. In March 2020, the Board informed the Veteran and his representative that the Board would be reviewing the Court’s Order and invited the Veteran to submit further evidence and argument. The Veteran’s representative submitted written appellate argument in July 2020. In the January 2019 decision, the Board denied service connection for a heart disability on the basis that the only heart disability the Veteran had was an atrial septal defect which was congenital in nature. Prior to reaching this conclusion, the Board developed the record, extensively, obtaining multiple medical opinions as to whether the atrial septal defect had worsened during service beyond the natural progression of the disability, or whether the Veteran had experienced any superimposed injury during service. In the Joint Motion for Remand, however, the authors noted the report of a December 2012 echocardiogram which showed a Grade I diastolic dysfunction, which was not shown on prior tests and was not discussed by the Board or by the several medical experts who had reviewed the file. It is unclear whether the Veteran manifests any symptoms of the Grade I diastolic dysfunction or whether the Veteran has a cardiac disability related to the Grade I diastolic dysfunction. It is also unclear whether there is any connection to service. Neither the Veteran’s representative nor the Veteran have postulated such. Therefore, upon remand, additional medical interpretation of the evidence must be obtained. As the appeal must be remanded, the Veteran’s VA medical records should be updated for the claims file. The matters are REMANDED for the following action: 1. Obtain the Veteran’s VA treatment records for the period from March 2019 to the present. 2. Obtain an addendum opinion from a physician with appropriate expertise as to whether the Veteran’s Grade I systolic dysfunction noted during a December 2012 echocardiogram is at least as likely as not (50 percent or greater probability) related to service in any way, or in the alternative, at least as likely as not caused or aggravated by a service-connected disability. The examiner is requested to discuss the Veteran’s medical history, to include his congenital atrial septal defect in this explanation, as well as any relationship to the Veteran’s service-connected delusional disorder, hearing loss and tinnitus, malaria residuals, and tinea cruris. If a clinical examination and/or further tests and studies are deemed helpful, then such examination, tests, and studies should be accomplished in connection with this informed opinion. V. Chiappetta Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Heather J. Harter, 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.