Citation Nr: 21061902 Decision Date: 10/05/21 Archive Date: 10/05/21 DOCKET NO. 15-03 651A DATE: October 5, 2021 REMANDED Entitlement to service connection for cause of death is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1951 to February 1954. He received the Korean Service Medal with 2 bronze service stars among other awards. The Veteran died in June 2013. The appellant is the Veteran's surviving spouse. This matter initially came before the Board of Veterans' Appeals (Board) on appeal from a September 2014 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) that denied the appellant's claim of service connection for the cause of the Veteran's death. In February 2019, the appellant testified at a Board hearing in Washington, D.C. before the undersigned Veterans Law Judge (VLJ). A transcript of that hearing is of record. In April 2020 and March 2021, the Board remanded the claim for further development, to include VA opinions. Regrettably, another remand is required to comply with the Board's March 2021 remand directives. Stegall v. West, 11 Vet. App. 268, 271 (1998). Entitlement to service connection for the cause of the Veteran's death The Board greatly regrets the additional delay, but for the following reasons, the case must be remanded. When he died, the Veteran was in receipt of service connection for left anterior femur myositis ossicans, left hip arthritis, and left knee degenerative joint disease. The death certificate lists the cause of death as hypertension, due to or as a consequence of end stage renal disease, due to or as a consequence of profound anemia. Other significant conditions contributing to death were coronary artery disease, failure to thrive, peripheral vascular disease (PVD), chronic obstructive pulmonary disease (COPD). There is another acronym on the death certificate, which the RO referenced in the January 2015 statement of the case as "DWR." The precise letters in this notation are not clear to the Board, as the acronym DWR is not self-defining and the letters could be "DNR," which could stand for "do not resuscitate." The appellant contends that the Veteran's coronary artery disease, for which he was not in receipt of service connection, was related to his service in the Korean War. She also contends that the Veteran's service-connected left hip and knee arthritis disabilities caused him to fall and fracture his hip in approximately February 2013, which led to surgery from which he never fully recovered, and his death. Both of these are valid theories of entitlement under 38 C.F.R. § 3.312. In March 2021, a VA physician found that it was less likely than not that the Veteran's service-connected left hip and knee disabilities were a contributory cause of the Veteran's death as the conditions would not cause debilitating effects to the Veteran rendering him less capable of resisting the effect of disease that led to his death. However, this opinion did not substantially comply with the Board's March 2021 remand directives in that it did not discuss the severity of the Veteran's left hip and knee disabilities nor whether the effects of the surgery on his fractured hip rendered him less capable of resisting the effects of disease. Thus, remand for an additional opinion is warranted. Stegall, 11 Vet. App. at 271. Accordingly, the matter is REMANDED for the following action: Obtain a medical opinion from an appropriate physician to opine whether it is at least as likely as not that the Veteran's service-connected left hip and knee disabilities were a contributory cause of the Veteran's death. The physician should discuss the severity of the Veteran's left hip and knee arthritis disabilities when providing an opinion on the impact of the Veteran's service-connected left hip and knee arthritis disabilities on his cause of death, and discuss whether these disabilities, to include the effects of the surgery on his fractured hip, rendered him less capable of resisting the effects of disease. The claims file should be provided to and reviewed by the physician. A complete rationale should accompany any opinion provided. Jonathan Hager Veterans Law Judge Board of Veterans' Appeals Attorney for the Board H. Styer, Associate 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.