Citation Nr: 21001455 Decision Date: 01/08/21 Archive Date: 01/08/21 DOCKET NO. 20-04 461A DATE: January 8, 2021 REMANDED Issue of entitlement to service connection for aortic sclerosis with mild pulmonary and tricuspid regurgitation (claimed as ischemic heart disease) as a result of herbicide agent exposure is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1969 to September 1973. The Board notes that the Veteran was awarded the distinction of the Bronze Star Medal. This appeal to the Board of Veterans’ Appeals (Board) arose from a November 2018 rating decision issued by the Department of Veterans Affairs (VA). See November 2019 Notice of Disagreement (NOD); February 2020 Statement of the Case (SOC); February 2020 Substantive Appeal (VA Form 9). This appeal has been advanced on the Board’s docket pursuant to 38 C.F.R. § 20.900(c). 38 U.S.C. § 7107(a)(2). Issue of entitlement to service connection for aortic sclerosis with mild pulmonary and tricuspid regurgitation (claimed as ischemic heart disease) as a result of herbicide agent exposure is remanded. The Board cannot make a fully-informed decision on the issue of entitlement to service connection for aortic sclerosis with mild pulmonary and tricuspid regurgitation, claimed as ischemic heart disease, because an addendum opinion is needed from a VA examiner. The evidence shows that the Veteran served in the Republic of Vietnam from August 1970 to August 1971 and is, thus, presumed to have in service exposure to an herbicide agent. See September 1973 DD Form 214; 38 C.F.R. § 3.307(a)(6)(iii). The Veteran was afforded an October 2018 VA examination for heart conditions. The VA examiner found the Veteran to have current heart conditions of aortic sclerosis, mild pulmonary regurgitation, and mild tricuspid regurgitation. Id. The VA examiner opined that the Veteran’s heart conditions do not qualify within the generally accepted medical definition of ischemic heart disease. Id. The conditions are, thus, not entitled to presumptive service connection under 38 C.F.R. § 3.309(e) as a disease associated with exposure to herbicide agents. However, it is unclear if the Veteran’s heart conditions were incurred in or otherwise due to service, to include as due to exposure to herbicide agents on a direct basis. Accordingly, the Board finds that a remand is warranted to obtain an addendum opinion from a VA examiner. The matters are REMANDED for the following action: 1. If possible, obtain an addendum opinion from the same medical professional who provided the October 2018 VA examination for heart conditions. If not possible, then obtain an addendum opinion from an appropriate medical professional to determine the nature and cause of the Veteran’s aortic sclerosis, mild tricuspid regurgitation, and mild pulmonary regurgitation. The medical professional should respond to the following: (a) Is it at least as likely as not (a 50 percent or greater probability) that the Veteran’s aortic sclerosis, mild tricuspid regurgitation, and mild pulmonary regurgitation began in (or is otherwise related to) the Veteran’s military service? The medical professional should opine as to whether the Veteran’s heart conditions are at least as likely as not due to in service exposure to herbicide agents on a direct basis (i.e. if the medical evidence and/or literature supports that the condition or conditions are caused by herbicide agent exposure). The medical professional should consider and discuss the Veteran’s statement during the January 2012 Agent Orange Registry Examination that he “was thought to have an enlarged heart in the service during a flight physical although he is not sure how the dr came to that conclusion.” A rationale is requested. 2. Readjudicate. R. FEINBERG Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Lin 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.