Citation Nr: 21003755 Decision Date: 01/22/21 Archive Date: 01/22/21 DOCKET NO. 13-01 082 DATE: January 22, 2021 REMANDED Entitlement to service connection for a heart disability to include ischemic heart disease, claimed as due to herbicide exposure, is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1969 to April 1972. Service in the Republic of Vietnam is indicated by the records. He is the recipient of the Combat Infantryman Badge (CIB). This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2011 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO), which denied entitlement to service connection for a heart disability. In January 2018, the Veteran presented sworn testimony during a Board videoconference, which was chaired by the undersigned Veterans Law Judge. A transcript of the hearing has been associated with the Veteran’s VA claims file. In an April 2018 Board decision, the claim was remanded for further evidentiary development. The Board denied the Veteran’s heart disability claim in a September 2019 decision. The Veteran appealed to the United States Court of Appeals for Veterans Claims (Court). In an August 2020 Order granting an August 2020 Joint Motion for Remand (Joint Motion), the Court vacated the Board’s September 2019 decision and remanded the above-identified matters for further development in compliance with the directives specified in the Joint Motion. 1. Entitlement to service connection for a heart disability to include ischemic heart disease, claimed as due to herbicide exposure, is remanded. The Veteran has asserted entitlement to service connection for a heart disability, which he contends is due to herbicide exposure during his active duty service. See, e.g., the Board hearing transcript dated January 2018. To this end, it is undisputed that the Veteran served in the Republic of Vietnam during the Vietnam era. As such, he is entitled to the legal presumption of herbicide exposure based on service in Vietnam during the requisite time period. See 38 C.F.R. § 3.307(a)(6)(iii). In a September 2019 decision, the Board denied the Veteran’s claim of entitlement to service connection for a heart disability. However, in the August 2020 Joint Motion, the parties agreed that the Board erred by relying on the February 2019 VA examination report, which failed to adequately address the Veteran’s heart conditions, as was required by the Board’s April 2018 remand decision. The parties explained that the February 2019 VA examiner failed to address the Veteran’s right bundle branch block and asymmetric left ventricular hypertrophy, as well as their potential links to his military service. The parties additionally agreed that the VA examiner failed to provide a medical opinion as to whether the Veteran’s congestive heart failure could be linked to his military service. The parties therefore determined that, upon remand, the Board must ensure that a new examination be ordered, which (1) fully addresses the Veteran’s right bundle branch block, asymmetric left ventricular hypertrophy, and congestive heart failure, and (2) provides an expert opinion as to whether any of these three conditions are linked to the Veteran’s military service. The parties additionally stated that, on remand, the examiner should provide a more detailed explanation as to whether the Veteran has ischemic heart disease. Accordingly, in light of the Joint Motion, the Board finds that this matter must be remanded to provide the Veteran with a VA examination that: (1) addresses the Veteran’s right bundle block, asymmetric left ventricular hypertrophy, and congestive heart failure; (2) provides a medical opinion as to whether any of these three conditions are related to the Veteran’s military service; and (3) provides a clear medical opinion as to whether the Veteran has ischemic heart disease. Upon remand, the AOJ should also obtain any outstanding VA treatment records. The matters are REMANDED for the following action: 1. Obtain all outstanding records of VA evaluation and/or treatment of the Veteran. Follow the procedures set forth in 38 C.F.R. § 3.159(c) with respect to requesting records from Federal facilities. All records/responses received should be associated with the claims file 2. Schedule the Veteran for an examination by an appropriately qualified clinician to determine the nature and etiology of the claimed heart disability. The examiner is requested to review the claims file in its entirety including all service treatment records, VA, and private treatment records. All appropriate testing should be performed. (a). The examiner should explain whether the Veteran has ischemic heart disease (IHD). (Continued on the next page)   (b). The examiner should provide an opinion as to whether it is at least as likely as not that each of the Veteran’s diagnosed cardiac disabilities, to include right bundle block, asymmetric left ventricular hypertrophy, and congestive heart failure, had their onset in service or are otherwise the result of a disease or injury in service, to include legally presumed in-service exposure to herbicides? All examination findings/testing results (if any), along with complete, clearly-stated rationale for the conclusions reached, must be provided. K. Conner Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. K. Buckley, 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.