Citation Nr: 21070936
Decision Date: 11/27/21	Archive Date: 11/27/21

DOCKET NO. 16-24 513A
DATE: November 27, 2021

REMANDED

Service connection for heart disability, to include supraventricular arrhythmia, ventricular arrhythmia, valvular heart disease, heart valve replacement, cardiomyopathy, implanted cardiac pacemaker, and aortic aneurysm is remanded.

REASONS FOR REMAND

The Veteran served on active duty from February 1967 to February 1969, including service in the Republic of Vietnam.  

Entitlement to service connection for heart disability

The Veteran contends entitlement to service connection for heart disability, to include as due to herbicide agent exposure. VA already determined the Veteran is presumed exposed to herbicide agents during service. Evidence shows the Veteran has been diagnosed with numerous heart disabilities during the appeal period, to include supraventricular arrhythmia, ventricular arrhythmia, valvular heart disease, heart valve replacement, cardiomyopathy, implanted cardiac pacemaker, and aortic aneurysm. 

An August 2021 Board remand requested a medical opinion identifying heart disabilities that clearly and unmistakably pre-existed service; for each heart disability that clearly and unmistakably pre-existed service, whether it was clearly and unmistakably aggravated by service; and for each heart disability not clearly and unmistakably pre-existing service, whether it was at least as likely as not due to service, to include due to herbicide agent exposure.

September 2021 VA medical opinions did not discuss each diagnosed heart disability and provided conclusory opinions without rationale. The Board requests an addendum opinion and rationale addressing the etiology of the Veteran's heart disabilities.

The matters are REMANDED for the following action:

1. Ask the Veteran to complete a VA Form 21-4142 for (a.) Dr. Long from October 2020 and (b.) Duke Cardiology from July 2015. Make two requests for the authorized records, unless it is clear a second request would be futile.

2. Obtain a medical opinion from an appropriate clinician regarding the etiology of the Veteran's heart disabilities. 

(a.) Identify any heart disability found during the appeal period.

(b.) For each heart disability identified, did the disability clearly and unmistakably (undebatable) pre-exist service?

(c.) For each disability found to clearly and unmistakably pre-exist service, was the disability clearly and unmistakably NOT aggravated by service?  

(d.) For each heart disability found to not clearly and unmistakably pre-exist service, is it at least as likely as not (50 percent or greater probability) the disability began during service or is related to service, to include exposure to herbicide agents?

The clinician is advised that a negative opinion cannot be based solely on the fact a disability is not on the list of diseases that are presumptively associated with exposure to herbicide agents.

 

 

KELLI A. KORDICH

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	T. Winkler, 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.