Citation Nr: 21072093 Decision Date: 12/02/21 Archive Date: 12/02/21 DOCKET NO. 16-29 125 DATE: December 2, 2021 REMANDED Entitlement to service connection for cause of death is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1951 to January 1971. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a January 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Philadelphia, Pennsylvania. The Appellant requested a hearing before the Board on his June 2016 VA Form 9 (substantive appeal). A hearing was scheduled for October 14, 2021. However, the Appellant did not appear for the scheduled hearing or subsequently request that a new hearing be scheduled based on good cause. The hearing request is thus considered withdrawn. Entitlement to service connection for cause of death is remanded. The Veteran's death certificate lists the immediate cause of death as congestive heart failure and coronary artery disease, with contributory factors including chronic obstructive pulmonary disease and obstructive sleep apnea. To warrant service connection for the cause of the Veteran's death, the evidence must show that a service-connected disability was either a principal or contributory cause of death. A disability will be considered the principal 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. 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. 38 U.S.C. § 1310; 38 C.F.R. § 3.312. The appellant primarily contends that the Veteran's death is causally related to his service-connected kidney disease. In support of this contention, the appellant cites medical treatise evidence which indicates kidney disease is a risk factor for heart failure. See July 2015 Notice of Disagreement. Despite this positive etiological evidence, there is no medical opinion of record which addresses the possible etiological link between the Veteran's kidney disease and his heart failure. Here, the Board finds that a medical opinion is necessary to make a determination in this case. The Board notes that VA is obligated to obtain a medical opinion when there is a reasonable possibility that such would aid in substantiating the claim. Wood v. Peake, 520 F.3d 1345, 1348 (Fed. Cir. 2008). The matters are REMANDED for the following action: 1. Any outstanding VA treatment records should be obtained and associated with the claims file. 2. The AOJ should contact the Appellant to request any outstanding evidence, including private medical records, which may contain information relating to the Veteran's kidney disease. 3. After completing the above, forward the claims file to an appropriate VA clinician to address the cause of the Veteran's death. After reviewing the claims file, the clinician is to provide the following opinions: Is it at least as likely as not (50 percent or greater probability) that the Veteran's service-connected kidney condition directly caused OR contributed to the Veteran's death? Specifically, the examiner should address the appellant's contentions that the Veteran's service-connected kidney disease is a risk factor for heart failure, which is listed as the immediate cause of death. The clinician is advised to address the medical treatise evidence of record. (Continued on the next page) The examiner must provide a comprehensive report including complete rationales for all opinions and conclusions reached, based on his or her clinical experience, medical expertise, and established medical principles, and citing the objective medical findings leading to the conclusions. If any of the above requested opinions cannot be made without resort to speculation, the examiner must state this and specifically explain whether there is any potentially available information that, if obtained, would allow for a non-speculative opinion to be provided. A. J. Spector Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Comninos, Georgio 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.