Citation Nr: 21069020 Decision Date: 11/17/21 Archive Date: 11/17/21 DOCKET NO. 17-14 695 DATE: November 17, 2021 REMANDED Entitlement to service connection for the Veteran's cause of death is remanded. REASONS FOR REMAND The Veteran had active service from April 1968 to April 1970, to include service in the Republic of Korea. He died in September 2016. The Appellant is the Veteran's surviving spouse. She seeks service connection for the Veteran's cause of death. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a November 2016 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Appellant appeared at a hearing before the undersigned in May 2021. A transcript of the hearing is of record. The Board finds a medical opinion is necessary to ensure the decision on the Appellant's claim is fully informed. See 38 U.S.C. § 5103A(a); Wood v. Peake, 520 F.3d 1345, 1347-48 (Fed. Cir. 2008) (explaining VA is required to assist a claimant in obtaining a medical opinion or examination regarding a claim for service connection for cause of death whenever such an opinion is necessary to substantiate the claim). The Veteran's death certificate reflects congestive heart failure was his cause of death. The Appellant seeks service connection for the Veteran's cause of death pursuant to the presumptive provisions for diseases associated with exposure to certain herbicide agents, which are outlined in 38 C.F.R. § 3.309(e), asserting exposure to herbicide agents should be conceded in the Veteran's case due to the nature of his service in the Republic of Korea. The Board notes congestive heart failure is not listed in 38 C.F.R. § 3.309(e), but the record reflects the Veteran was diagnosed as having ischemic heart disease, specifically coronary artery disease, prior to his death. The Agency of Original Jurisdiction (AOJ) apparently declined to obtain an opinion addressing a potential link between ischemic heart disease and the Veteran's cause of death based on a finding that there was insufficient evidence to concede the Veteran was exposed to herbicide agents; however, as explained below, the Board finds there is sufficient evidence to establish the Veteran at least as likely as not operated in or near the Korean demilitarized (DMZ) during the presumptive period outlined in 38 C.F.R. § 3.307(a)(6)(iv). The record establishes the Veteran was stationed at a camp in close proximity to the DMZ, which served as the headquarters of the 2nd Infantry Division. Prior to his death, the Veteran provided testimony at a RO hearing in July 2005 and at Board hearing in November 2011 before a Veterans Law Judge other than the undersigned. During these hearings, the Veteran explained soldiers assigned to his unit, as well as others at the camp, regardless of military occupational specialty, provided support for the 2nd Infantry Division during alerts at the DMZ and described the circumstances surrounding several of these events, many of which have been confirmed by the Joint Services Records Research Center. The Veteran further explained he and other soldiers manned foxholes during these alerts to form a security perimeter at or near the Korean DMZ. As result, the Board finds the Veteran's credible testimony is sufficient to meet the "at least as likely as not" burden of proof, especially in light of the fact that these events were the basis for his award of service connection for post-traumatic stress disorder. See Wise v. Shinseki, 26 Vet. App. 517, 531 (2014). Accordingly, an expert opinion is necessary to determine whether the Veteran's ischemic heart disease was at least as likely as not a principal or contributory cause of his death. See 38 U.S.C. § 1318; 38 C.F.R. § 3.312. The Board further notes it does not appear VA has fulfilled its duty to assist with respect to obtaining records related to the Veteran's final course of treatment. The claims file includes several Veterans Health Administration admission reports for the Veteran during the months leading up to his death, but there are no treatment records associated with these reports in the claims file. These records are necessary to ensure the requisite opinion regarding the issue of service connection for the Veteran's cause of death is fully informed. The matter is REMANDED for the following action: 1. Make reasonable efforts to assist the Appellant with obtaining any relevant private treatment records that may be available for the Veteran. 2. Ensure that all of the Veteran's VA treatment records are associated with the claims file, to include records from the Veteran's final course of treatment at a VA medical facility. 3. Obtain an opinion regarding the Appellant's claim for service connection for the Veteran's cause of death. The selected clinician must address the question of whether the Veteran's ischemic heart disease was at least as likely as not (50 percent probability or greater) a principal or contributory cause of his death. The clinician must be advised a disability will be considered the principal (primary) cause of death when such disability, singly or jointly with some other condition, was the immediate or underlying cause of death or was etiologically related thereto. The clinician must be further advised a disability will be considered a contributory cause of death when it contributed substantially or materially to death, combined to cause death, or aided or lent assistance to the production of death. The clinician must provide a complete rationale to support his or her conclusions. M. HYLAND Veterans Law Judge Board of Veterans' Appeals Attorney for the Board L. S. Kyle, 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.