Citation Nr: 21074324 Decision Date: 12/14/21 Archive Date: 12/14/21 DOCKET NO. 18-15 169 DATE: December 14, 2021 REMANDED Entitlement to service connection for the cause of the Veteran's death is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1951 to December 1952. He died in April 2016 and the appellant is his surviving spouse. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a rating decision issued in December 2017 by a Department of Veterans Affairs (VA) Regional Office. In August 2021, the appellant and her niece testified at a Board hearing before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the record. While the undersigned held the record open for 60 days for the submission of additional evidence, none has been received to date. Entitlement to service connection for the cause of the Veteran's death. The Veteran's original certificate of death, which was completed in May 2016, lists his causes of death as lung cancer and chronic obstructive pulmonary disease (COPD), with hypertension as a contributing condition, and the amended certificate of death, which was completed in August 2017, includes degenerative arthritis as an additional contributing condition. During his lifetime, the Veteran was service-connected for the sole disability of traumatic arthritis of the left ankle due to a gunshot wound. The appellant asserts that the Veteran's service-connected traumatic arthritis of the left ankle progressed over the years into degenerative arthritis, which was listed on the amended certificate of death as a contributory cause of death. Alternatively, she contends that the Veteran's hypertension, which was listed on his certificate of death as a contributory cause of death, had its onset in service as evidenced by elevated in-service blood pressure readings or, in the alternative, was caused or aggravated by psychiatric symptomatology related to his combat service or alcohol use due to chronic pain associated with his service-connected left ankle disability. In a cause of death claim, VA must make reasonable efforts to assist a claimant in obtaining a medical opinion when such opinion is "necessary to substantiate the claimant's claim for a benefit." De La Rosa v. Peake, 515 F.3d 1319, 1322 (Fed. Cir. 2008). Here, the record does not include a medical opinion addressing the appellant's various theories of entitlement. Therefore, the Board finds a remand is necessary to obtain a medical opinion addressing such matters. The matter is REMANDED for the following action: Forward the record, to include a copy of this Remand, to an appropriate clinician for an opinion addressing the cause of the Veteran's death. Following a review of the record, the examiner should address the following inquiries: (A) Is it at least as likely as not (i.e., 50 percent or greater probability) that the Veteran's hypertension, which is listed as a contributory cause of death on the certificate of death, had its onset in, or is otherwise related to, his military service, to include as a result of reported in-service elevated blood pressure readings, or was caused or aggravated by psychiatric symptomatology related to his combat service and/or alcohol use due to chronic pain associated with his service-connected left ankle disability? (B) If not, is it at least as likely as not (i.e., a 50 percent or greater probability) that a disability of service origin, to include traumatic arthritis of the left ankle due to a gunshot wound, was the immediate or underlying cause of the Veteran's death or etiologically related thereto, contributed substantially or materially to the cause of his death, combined to cause death, or aided or lent assistance to the production of death? In offering an opinion in response to (B), the clinician must specifically address whether the Veteran's service-connected left ankle traumatic arthritis progressed to degenerative arthritis, which is listed as a contributory cause of death on the amended certificate of death. A rationale for any opinion offered should be provided. A. JAEGER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. M. Celli, 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.