Citation Nr: 21074468
Decision Date: 12/15/21	Archive Date: 12/15/21

DOCKET NO. 18-38 387A
DATE: December 15, 2021

REMANDED

Entitlement to service connection for a cardiovascular (CV) disorder.

REASONS FOR REMAND

The Board originally denied the appeal in August 2019. In October 2020, the Veterans Claims Court Clerk granted a Joint Motion for Remand. In March 2021, the Board remanded the issue.

In the subsequent July 2021 VA examination, the examiner cited to a March 2016 VA opinion that was relevant only to a previous claim for shortness of breath but did not address a March 2016 CV opinion. In addition, the examiner noted a valve replacement in 2011, but no other CV disorders although several are documents in the record, including the atrial fibrillation, congestive heart failure, and ischemic heart disease. Further, the examiner relied, in part, on a finding that a CV disorder was not diagnosed until 2004; however, atrial fibrillation was diagnosed in 1991.  

Thus, the July 2021 VA opinion does not reflect that the examiner's opinion was based on the Veteran's complete and accurate medical history.  Further, the examiner did not provide an opinion for each CV disorder diagnosed as requested by the Board.  Therefore, a remand for another opinion is necessary.

The matter is REMANDED for the following actions:

1. Undertake appropriate development to associate with the claims file any outstanding, relevant treatment notes.

2. Direct the claims file to a clinician for review and an opinion as to the following:

For each CV/heart disorder diagnosed in treatment notes and VA examinations, is it at least as likely as not (i.e., a 50 percent or more probability) that the disorder started during service or is otherwise etiologically a result of service, particularly the episode of pleuritic chest pain?

The rationale for any opinion expressed must be provided. It would be of assistance to the Board if the clinician could explain why the in-service pleuritic chest is or is not related to a current CV disorder. If the clinician is unable to provide the required opinion, he or she should explain why. 

3. If the clinician determines that an examination is necessary in order to provide the requested opinion, then one should be scheduled. 

 

L. HOWELL

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	K. M. Schaefer, 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 This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.