Citation Nr: 21073844 Decision Date: 12/10/21 Archive Date: 12/10/21 DOCKET NO. 19-38 090 DATE: December 10, 2021 REMANDED Entitlement to an initial rating in excess of 30 percent for the service-connected ischemic heart disease status post coronary artery disease (CAD) is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1957 to August 1977. This matter comes before the Board of Veterans' Appeals (BVA or Board) on appeal from a September 2017 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In August 2021, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge. A transcript of the hearing has been associated with the claims file. Entitlement to an initial rating in excess of 30 percent for the service-connected CAD is remanded. The evidence shows that the Veteran received a VA examination for his CAD in October 2019. At the August 2021 Board hearing, the Veteran testified that his CAD had worsened. Specifically, the Veteran reported worsening shortness of breath that prohibited him from walking more than several steps at a time. Therefore, as the evidence suggests the Veteran's service-connected CAD may have worsened, a remand is warranted to obtain an examination to determine the current severity of the Veteran's CAD. See Snuffer v. Gober, 10 Vet. App. 400 (1997) (noting that a veteran is entitled to a new VA examination where there is evidence that the condition has worsened since the last examination). Additionally, the Veteran has raised concerns regarding the competency of the VA examiner who completed the July 2017 VA heart examinations. The Veteran requested that VA provide the curriculum vitae and other information regarding the qualifications of the examiner that demonstrates that she was competent to provide an opinion regarding the severity of the Veteran's CAD. Since the examiner's competency has been challenged, that person's qualifications will be sought. See Francway v. Wilkie, 930 F.3d 1377 (2019). The matter is REMANDED for the following action: 1. The Veteran should be given an opportunity to identify any outstanding private or VA treatment records relevant to his claim. After obtaining any necessary authorization from the Veteran, all outstanding records should be obtained. 2. Attempt to obtain and provide the Veteran information regarding the qualifications of the July 2017 VA examiner. This may include a curriculum vitae and other information regarding the qualifications of the examiner. Copies of the information provided to the Veteran should be included in the claims file. 3. After the above development has been completed, and after any additional records have been associated with the evidentiary record, schedule the Veteran for a VA examination by a qualified clinician to determine the current severity and extent of his service-connected CAD. A complete history should be elicited directly from the Veteran and any tests and studies deemed necessary by the examiner should be conducted, to include an exercise stress test. All findings should be reported in detail. If a determination of METs by exercise testing cannot be done for medical reasons, that fact must be documented in the examination report, and the examiner's estimation of the level of activity, an interview-based METs test, expressed in METs and supported by examples of specific activities, that result in cardiac symptoms, is acceptable. Also, if exercise testing cannot be done for medical reasons, the examiner should provide an explanation as to why an exercise stress test was not conducted or why exercise stress testing was inappropriate to determine this Veteran's METs. MICHAEL KILCOYNE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Erin J. Trojanowski, 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.