Citation Nr: 21073719
Decision Date: 12/10/21	Archive Date: 12/10/21

DOCKET NO. 16-27 482
DATE: December 10, 2021

REMANDED

The claim for service connection for a bicuspid aortic valve condition (claimed as heart condition), to include as secondary to service-connected hypertension, is remanded.

REASONS FOR REMAND

The Veteran served on active duty from September 1983 to August 1987, and from March 2003 to May 2003.  

This case comes before the Board of Veterans' Appeals (Board) on appeal from an April 2015 rating decision of the Department of Veteran's Affairs (VA) Regional Office (RO). 

In October 2018 and April 2021, the Board remanded this claim for additional development.  

The Board's 2018 and 2021 remands requested that an examiner determine whether or not the Veteran's service-connected hypertension resulted in a superimposed disease or injury to the bicuspid aortic valve.  Service connection may be granted for additional disability from aggravation (i.e., a permanent worsening) of a congenital or developmental defect during service due to a superimposed disease or injury.  VAOPGCPREC 82-90; 56 Fed. Reg. 45711 (1990).  

In August 2021, a medical opinion was obtained.  The examiner concluded that the Veteran's bicuspid aortic valve disorder was less likely than not aggravated by his service-connected hypertension.  However, the opinion is insufficiently in compliance with the Board's remand.  The Board had requested a more precise opinion that fully addresses the language in VAOPGCPREC 82-90, and which includes an opinion as to whether the Veteran has a superimposed injury to his bicuspid aortic valve due to his hypertension.  In this case, the August 2021 opinion does not state whether the Veteran's hypertension resulted in a superimposed disease or injury to the bicuspid aortic valve.  Accordingly, remand is required to obtain an adequate opinion.  Stegall v. West, 11 Vet. App. 268, 271 (1998).

The matters are REMANDED for the following action:

1.  Return the file to the examiner who conducted the August 2021 VA opinion, or if not available to another examiner (if an opinion cannot be provided without a physical examination, an examination should be scheduled).  The examiner must be notified that service connection is in effect for hypertension, that the term "superimposed disease or injury" has a specific legal meaning, and that the opinion must include use of this term.

The examiner should state whether the Veteran's service-connected hypertension resulted in aggravation causing a superimposed disease or injury to his bicuspid aortic valve.

2.  It should be noted that the Veteran is competent to attest to factual matters of which he had first-hand knowledge, including observable symptomatology.  If there is a medical basis to support or doubt the history provided by the Veteran, the examiner should provide a fully reasoned explanation.  A complete rationale should be provided for any opinion rendered.  If the examiner is unable to offer the requested opinions, it is essential that the examiner offer a rationale for the conclusion that an opinion could not be provided without resorting to speculation, together with a statement as to whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge.

 

 

T. Stephen Eckerman

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	C. Orie, 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.