Citation Nr: 21002516 Decision Date: 01/13/21 Archive Date: 01/13/21 DOCKET NO. 16-63 775 DATE: January 13, 2021 REMANDED Entitlement to service connection for the cause of the Veteran's death is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Army from April 1948 to May 1952 and from August 1954 to August 1960. He died in February 2014. The appellant is the Veteran’s surviving spouse. This appeal arises from a September 2014 rating decision, denying service connection for cause of the Veteran’s death and dependency and indemnity compensation (DIC) benefits under 38 U.S.C. § 1318. Then, in February 2019, the Board issued a decision denying the appeal for entitlement to service connection for the cause of the Veteran’s death and DIC benefits under 38 U.S.C. § 1318. The Veteran appealed the Board’s decision to the Court of Appeals for Veterans Claims (“Court” or CAVC), which issued a memorandum decision in May 2020 that set aside that part of the Board’s decision that denied service connection for the cause of the Veteran’s death, and remanded the matter to the Board. However, the Court dismissed the balance of the appeal, so that it did not disturb the Board’s February 2019 denial of DIC benefits under 38 U.S.C. § 1318. The appeal has been returned the Board for further adjudication and consideration of entitlement to service connection for the cause of the Veteran’s death. Entitlement to service connection for the cause of the Veteran's death. In this case, the Veteran died in February 2014. At the time of death, the Veteran was service connected for residuals of cold injury of the bilateral lower and upper extremities with osteoporosis and degenerative changes, recurrent perirectal cyst with scar residuals and posttraumatic stress disorder (PTSD). According to his death certificate, the cause of death was interstitial lung disease, COPD, and rheumatic arthritis. The death certificate also lists contributory causes as septic shock and pneumonia. The appellant asserted that the Veteran’s death was related to service or a service-connected disability. See March 2017 VA Form 9. Notably, the appellant argues that the Board should consider whether any of the contributory causes of the Veteran’s death, including septic shock, were related to his service-connected cold injury residuals. The May 2020 CAVC Memorandum Decision indicated that the October 2016 VA medical opinion against the claim did not consider whether the septic shock contributing to the Veteran’s death was related to his service-connected cold injury residuals. When VA undertakes to examine a Veteran, VA is obligated to ensure that that examination is adequate. See Barr v. Nicholson, 21. Vet. App. 303 (2007). Inadequate medical examinations include examinations that contain only data and conclusions, do not provide an etiological opinion, are not based upon a review of medical records, or provide unsupported conclusions. Nieves- Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). Per the CAVC memorandum decision, the Board finds it necessary to remand the appellant’s claim to obtain a medical opinion on the etiology of the Veteran’s causes of death; and whether contributory causes of death, of septic shock and pneumonia, were related to his service-connected cold injury residuals. The matters are REMANDED for the following action: 1. Obtain a medical opinion from a qualified VA clinician, different from the October 2016 VA physician, as to the etiologies of the Veteran’s causes of death. Specifically, the examiner should opine as to: (A) whether it is at least as likely as not (a 50 percent or greater probability) that any immediate cause of death (interstitial lung disease, COPD, or rheumatic arthritis) was (i) related to service, or (ii) is related to and/or aggravated by service-connected cold injury residuals or any other service-connected disability. (B) whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran’s contributory cause of death of septic shock was (i) related to service, or (ii) is related to and/or aggravated by service-connected cold injury residuals or any other service-connected disability. (C) whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran’s contributory cause of death of pneumonia was (i) related to service, or (ii) is related to and/or aggravated by service-connected cold injury residuals or any other service-connected disability. (D) whether it is at least as likely as not (a 50 percent or greater probability) that any of the Veteran’s service-connected disabilities, to include cold injury residuals, caused, contributed substantially or materially to cause, or aided or lent assistance to the production of the Veteran’s death.   A complete rationale should be provided for any opinion rendered. C. CRAWFORD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Biswajit Chatterjee, 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.