Citation Nr: 21071482 Decision Date: 11/30/21 Archive Date: 11/30/21 DOCKET NO. 12-00 874 DATE: November 30, 2021 REMANDED Entitlement to service connection for a heart condition, to include as secondary to Meniere's disease, is remanded. REASONS FOR REMAND The Veteran served on active duty with the United States Army from January 1970 to January 1973 and from August 1974 to December 1979. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an October 2011 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge (VLJ) at a hearing in February 2016. This case was most recently before the Board in September 2019, when service connection for a heart condition was denied. The Veteran appealed the case to the United States Court of Appeals for Veterans Claims. In May 2021, the Court issued a memorandum decision, vacating the portion of the Board decision denying service connection for a heart condition as secondary to Meniere's disease and remanding the case for further proceedings. The case has been returned to the Board at this time for further appellate review. Entitlement to service connection for a heart condition, to include as secondary to Meniere's disease, is remanded. The Court found that the Board had failed to consider whether the Veteran's service-connected Meniere's disease causes a racing heartbeat and, if so, whether that symptom is compensable, either as a secondarily service-connected disability or as a manifestation of Meniere's disease. The Board notes the April 2019 VA examiner opined that none of the diagnosed heart conditions, including non-obstructive coronary artery disease, tachyarrhythmia, and concentric left ventricular hypertrophy, are related to service or to the service-connected Meniere's disease. However, the record lacks an opinion regarding whether the reported racing heartbeat during episodes of Meniere's disease is caused by the Meniere's disease or whether the racing heartbeat amounts to a disability caused or aggravated by Meniere's disease. Therefore, a remand is necessary to obtain an additional opinion. The matter is REMANDED for the following action: Forward the claims file to an appropriate clinician to determine whether the racing heartbeat during episodes of Meniere's disease reported by the Veteran is related to his military service. Following review of the claims file, the examiner should first opine whether a racing heartbeat during episodes of Meniere's disease is a separate disability, or whether it is a symptom of the Meniere's disease. If the examiner opines that the racing heartbeat is a separate disability, the examiner should also opine whether it is at least as likely as not (50 percent or greater probability) that the racing heartbeat disability is (a) caused by; or (b) aggravated (i.e., worsened beyond the normal progression of the disease) by the Veteran's service-connected Meniere's disease. Please note, causation and aggravation are separate concepts and must be addressed independently. If aggravation is found, the examiner must attempt to establish a baseline level of severity of the racing heartbeat disability prior to aggravation by the service-connected Meniere's disease. The examiner should specifically address the Veteran's lay statements regarding racing heartbeat during attacks of Meniere's disease, and any other evidence of record pertinent to the racing heartbeat. It would be helpful to the Board if the examiner were to discuss the racing heartbeat in the context of and/or in comparison to the tachyarrhythmia heart condition identified in the record. All findings must be reported in detail and all opinions must be accompanied by a clear rationale. If any of the above issues cannot be resolved without resorting to speculation, then a detailed medical explanation as to why this is so must be provided. M. HYLAND Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. Josey, 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.