Citation Nr: 21069417 Decision Date: 11/18/21 Archive Date: 11/18/21 DOCKET NO. 17-05 799A DATE: November 18, 2021 REMANDED Entitlement to service connection for cardiovascular renal disease is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from July 1965 to May 1969. In March 2020, the RO determined that the Veteran was exposed to Agent Orange based on the Veteran's nautical service offshore the coast of the Republic of Vietnam. This matter is on appeal from a July 2013 rating decision. In February 2019, a video hearing was held before the undersigned. This claim was remanded in May 2019. In December 2020, the RO granted service connection for coronary artery disease and atrial fibrillation. In February 2014, the Veteran testified before a different Veterans Law Judge (VLJ) regarding several other issues, but not service connection for cardiovascular renal disease. The appeal of those other issues shall be addressed in a separate decision. 1. Service connection for cardiovascular renal disease is remanded. A December 2020 VA medical opinion concludes that service connection is not warranted because the Veteran does not have a current kidney disorder. An addendum opinion is required to address two medical records. First, a June 2015 VA medical record stating that the Veteran was "admitted for observation due to hypotension and acute renal failure." Contemporaneous medical records suggest that the Veteran was on dialysis at this time. Second, a November 2015 VA medical record states: "They did entertain the idea of renal consult due to his continuous drop in Mg but renal was not notified." Additionally, on remand the RO should obtain all relevant VA treatment records dated from August 2021 to the present before the issues on appeal are decided on the merits. Bell v. Derwinski, 2 Vet. App. 611 (1992). The matters are REMANDED for the following action: 1. Obtain all VA treatment records from August 2021 to the present. If no records are available, the claims folder must indicate this fact. Any additional records identified by the Veteran during the course of the remand should also be obtained, following the receipt of any necessary authorizations from the Veteran, and associated with the claims file. 2. After obtaining any additional records to the extent possible, afford the Veteran an in-person VA examination. Based on the results of diagnostic testing and a clinical examination, the examiner must respond to the following questions: (a.) Whether the Veteran has any kidney impairment. (b.) Whether it is at least as likely as not that any kidney impairment was incurred in the Veteran's service, including but not limited to as a result of exposure to herbicide agents and asbestos. (c.) Whether the Veteran has any kidney impairment that is proximately due to PTSD, coronary artery disease, diabetes, hypertension, or any medication used to treat these disorders. Please address all disorders and medications individually and collectively. (d.) Whether the Veteran has any kidney impairment that was aggravated by PTSD, coronary artery disease, diabetes, hypertension, or any medication used to treat these disorders. This must be addressed in a separate opinion from the "proximately due to" opinion. Please address all disorders and medications individually and collectively. In rendering these opinions, the examiner should consider the June 2015 VA medical record stating that the Veteran was "admitted for observation due to hypotension and acute renal failure," as well as records indicating dialysis around this time period. The examiner should also consider the November 2015 VA medical record, which states: "They did entertain the idea of renal consult due to his continuous drop in Mg but renal was not notified." The examiner should provide a complete rationale for any opinions offered. If the examiner is unable to provide any requested opinion without resort to speculation, he or she should explain why this is so. STEVEN D. REISS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Cannon, Brian 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.