Citation Nr: 21074335 Decision Date: 12/14/21 Archive Date: 12/14/21 DOCKET NO. 18-43 486 DATE: December 14, 2021 REMANDED Entitlement to service connection for a heart disability, claimed as coronary artery disease (CAD), is remanded. REASONS FOR REMAND The Veteran had active service from January 1959 to January 1963. This appeal comes to the Board of Veterans' Appeals (Board) from a Department of Veterans Affairs (VA) September 2017 rating decision of the Agency of Original Jurisdiction (AOJ). In August 2021 the Veteran appeared before the undersigned Veterans Law Judge at a Board hearing. A transcript of that hearing has been reviewed by the Board, and has been associated with the claims file. Entitlement to service connection for a heart disability is remanded Unfortunately, a remand is required in this case. Although the Board sincerely regrets the additional delay, it is necessary to ensure the Veteran is given every possible consideration. During his August 2021 Board hearing, the Veteran argued that his CAD, which was diagnosed in 2003, was secondary to asbestos exposure. He testified that as an electrician's mate aboard of the USS Washburn that he had daily contact with asbestos insulated wires, asbestos covered boilers and valves, as well as asbestos gaskets and flooring. In support of his argument, he referenced the Medical National Institute of Medicine PMED 26844169 which noted asbestos exposure significantly increased the risk of cardiovascular related disease in exposed workers. Further, asbestosships.com indicated that the USS Washburn, AKA-108, used significant amounts of asbestos in building the ship. Also, the Veteran indicated that he received private treatment for his CAD. Therefore, these medical records should be obtained. The Board cannot make a fully-informed decision on the issue of service connection for CAD because no VA examiner has opined whether this condition is related to asbestos exposure. The matters are REMANDED for the following action: 1. Request authorization from the Veteran to associate with the claims file all of his treatment records from his private physicians at the hospital in Bigfork, Minnesota and St. Luke's Hospital in Duluth, Minnesota. If the authorization cannot be obtained or the records cannot be located and/or no such records exist, the record should be annotated to reflect this. 2. Schedule the Veteran for a VA examination to determine the etiology of the Veteran's coronary artery disease (CAD). The examiner must review the claims file. The examiner is asked to provide a response to the following: (a.) Is CAD at least as likely as not related to service, including presumed exposure to asbestos? The Veteran contends that his asbestos exposure caused CAD. See August 2021 Board Hearing Testimony. The examiner should review and address the Medical National Institute of Medicine PMED 26844169 which noted asbestos exposure significantly increased the risk of cardiovascular related disease in exposed workers in his/her opinion. (b.) Is it at least as likely as not that CAD (1) began during active service, (2) manifested within one year after discharge from service, or (3) was noted during service with continuity of the same symptomatology since service? The examiner should provide a complete rationale for all opinions expressed and conclusions reached. If it is not possible to provide an opinion regarding symptoms without speculation, the examiner must state whether the need to speculate is due to a deficiency in the state of general medical knowledge (no one could respond given medical science and the known facts), a deficiency in the record (additional facts are required), or the examiner (does not have the knowledge or training). S. L. Kennedy Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Costello, 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.