Citation Nr: 21074796 Decision Date: 12/16/21 Archive Date: 12/16/21 DOCKET NO. 16-55 488 DATE: December 16, 2021 ORDER Entitlement to a 100 percent rating for coronary artery disease (CAD) from May 1, 2011 for substitution purposes is granted. FINDING OF FACT The most probative evidence reflects that the Veteran's CAD was manifested by a workload of less than 3 METs and results in dyspnea, fatigue, angina, dizziness. CONCLUSION OF LAW The criteria for a 100 percent rating for CAD have been met from May 1, 2011. 38 U.S.C. § 1155 (2018); 38 C.F.R. §§ 4.7, 4.104, Diagnostic Code 7005 (2020). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served in the United States Marine Corps from February 1966 to August 1969. This matter is before the Board of Veterans' Appeal (Board) on appeal from an August 2012 rating decision issued by the Department of Veteran Affairs (VA) Regional Office (RO). In his November 2016 substantive appeal (VA Form 9) the Veteran requested a Board videoconference hearing. The Veteran died in May 2018, and his surviving spouse applied to continue this appeal as his substitute. The RO subsequently adjudicated her as an appropriate substitute, and thus, she is the appellant in this matter. The appellant was scheduled to appear for a Board hearing in October 2021. However, she failed to appear at the scheduled hearing, and has not since asked for it to be rescheduled. As such, the hearing request is deemed withdrawn. 38 C.F.R. § 20.704. The Board notes that the Veteran has been assigned a temporary 100 percent rating for his myocardial infraction from January 7, 2011, to April 30, 2011. That grant of a temporary total rating does not constitute a complete grant of the benefit sought on appeal. However, the Board has limited its consideration accordingly, and the period on appeal excludes that in which a temporary 100 percent has been granted. Entitlement to an initial evaluation in excess of 10 percent for service-connected CAD from May 1, 2011 The Veteran asserted that an initial evaluation in excess of 10 percent for service-connected CAD was warranted, as his symptoms were worse than those contemplated by the currently assigned rating. Since his demise, the appellant has reiterated those contentions. At an April 2021 VA examination, the Veteran was noted to require continuous medication for control of his CAD. The Veteran did not have congestive heart failure. His most recent diagnostic exercise test showed a METs level of 1-3, however there was no evidence of cardiac hypertrophy and the Veteran had a left ventricular ejection fraction (LVEF) that was greater than 65 percent (%). An August 2013 DBQ submitted by Dr. C.M. notes that the Veteran takes continuous medication for control of his CAD. The Veteran's LVEF was 55% in June 2013 and 65% in August 2013. His most recent diagnostic exercise test showed a METs level of 1-3 and he reported dyspnea, angina, and dizziness as symptoms. There was no evidence of cardiac hypertrophy. The Veteran was not found to have congestive heart failure. A November 2015 DBQ submitted by Dr. C.M. notes that the Veteran takes continuous medication for control of his CAD. The Veteran's LVEF was 65% in July 2015. His most recent diagnostic exercise test showed a METs level of 1-3 and he reported dyspnea and fatigue as symptoms. There was no evidence of cardiac hypertrophy. The Veteran was not found to have congestive heart failure. At a May 2016 VA examination, the Veteran was noted to require continuous medication for control of his CAD. The Veteran did not have congestive heart failure, arrhythmia, heart valve conditions, or pericardial adhesions. Upon physical examination, the Veteran's heart rhythm was regular, heart sounds were normal, auscultation of the lungs was clear, peripheral pulses were normal, and there was no evidence of peripheral edema. There was no evidence of cardiac hypertrophy or cardiac dilatation. The examiner noted that a July 2015 echocardiogram revealed a left ventricular ejection fraction (LVEF) of 65 percent. The Veteran's most recent stress test was May 2016 and did not show ischemia. However, the test was terminated due to symptoms that are not related to the cardiac condition. The examiner concluded that the Veteran's heart disability did not impact his ability to work. A review of the record shows that the Veteran received treatment at the VA Medical Center for various disabilities, to include his CAD. However, a review of the treatment notes of record does not show the Veteran to have symptoms of CAD that is worse than that reported in his VA examinations of record. The Board finds that the Veteran is entitled to a rating of 100 percent for CAD throughout the entirety of the appeal period for consideration. In this regard, according to the VA and private examinations of record, the Veteran was noted to have a METs workload of less than 3 or less, with additional symptoms of dyspnea, fatigue, and dizziness. As such, a rating of 100 percent is warranted for the entire period on appeal (since May 1, 2011). 38 C.F.R. § 4.104, Diagnostic Code 7005. Accordingly, the Board finds that the preponderance of the evidence is for the claim and entitlement to an initial rating of 100 percent for CAD for the entire period on appeal is warranted. 38 U.S.C. § § 5107 (b); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). SCOTT W. DALE Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board I. Umez-Eronini, Associate 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.