Citation Nr: 21075193 Decision Date: 12/17/21 Archive Date: 12/17/21 DOCKET NO. 18-37 250 DATE: December 17, 2021 ORDER The petition to reopen the claim for entitlement to service connection for osteoporosis is denied. REMANDED Entitlement to service connection for coronary artery disease, including as secondary to steroid use in service and after from his service-connected histoplasmosis is remanded. Entitlement to a compensable disability rating for histoplasmosis is remanded. FINDING OF FACT 1. The Veteran was denied service connection for osteoporosis in an October 2014 rating decision. He did not perfect an appeal during the requisite time period, and the decision became final. 2. Evidence associated with the record since the October 2014 rating decision does not relate to unestablished facts or raise a reasonable possibility of substantiating the claim for service connection for osteoporosis. CONCLUSION OF LAW New and material evidence has not been received since the October 2014 rating decision and the claim seeking entitlement to service connection for osteoporosis is not reopened. 38 U.S.C. §§ 5108, 7105; 38 C.F.R. § 3.156 REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from August 1965 to March 1969. This matter comes before the Board of Veterans' Appeals (Board) from a March 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). 1. The petition to reopen the claim for entitlement to service connection for osteoporosis If a claim of entitlement to service connection has been previously denied and that decision became final, the claim can be reopened and reconsidered only if new and material evidence is presented with respect to that claim. 38 U.S.C. § 5108. New evidence means existing evidence not previously submitted to agency decision-makers. Material evidence means existing evidence that, by itself or when considered with previous evidence of record, relates to an unestablished fact necessary to substantiate the claim. New and material evidence can be neither cumulative nor redundant of the evidence of record at the time of the last prior final denial of the claim sought to be reopened, and must raise a reasonable possibility of substantiating the claim. 38 C.F.R. § 3.156(a). The credibility of the evidence is presumed for purposes of reopening the claim. See Justus v. Principi, 3 Vet. App. 510, 513 (1992). The threshold for reopening is low. Shade v. Shinseki, 24 Vet. App. 110, 117 (2010). The RO denied the Veteran's claim of service connection for osteoporosis in an October 2014 rating decision, finding that the Veteran did not have osteoporosis. The Veteran was provided notice of this decision and his appellate rights but did not appeal the decision or submit new and material evidence within one year of the decision. Therefore, the decision is final. See 38 C.F.R. §§ 3.156, 20.302, 20.1103. The evidence received since the October 2014 rating decision does not include includes evidence that is both new and material to the claim. See 38 C.F.R. § 3.156. The evidence does not demonstrate that the Veteran has osteoporosis. Because new and material evidence has not been received, the Veteran's claim for service connection for osteoporosis is not reopened and service connection remains denied. 38 U.S.C. § 5108; 38C.F.R. §3.156 (a). REASONS FOR REMAND 1. Entitlement to service connection for coronary artery disease, including as secondary to steroid use in service and after from his service-connected histoplasmosis The Veteran has contended that the steroids he took in service and shortly after for his histoplasmosis led to the development of his coronary artery disease. A VA opinion has not addressed whether the steroid use in service and shortly after could have caused his coronary artery disease. Additionally, there has not been an opinion to determine if the Veteran's histoplasmosis aggravated his coronary artery disease. As such, remand is necessary to obtain an opinion addressing aggravation. 2. Entitlement to a compensable disability rating for histoplasmosis In the Veteran's March 2017 Notice of Disagreement, the Veteran reported that he still has lesions and damage to his lungs from his histoplasmosis. The last VA examination was in November 2016. A new VA examination is necessary to determine the current symptoms and their severity associated with his histoplasmosis. The matters are REMANDED for the following action: 1. Ask the Veteran to identify all outstanding treatment records relevant to treatment for coronary artery disease and histoplasmosis. All identified VA records should be added to the claims file. All other properly identified records should be obtained if the necessary authorization to obtain the records is provided by the Veteran. If any records are not available, or the Veteran identifies sources of treatment but does not provide authorization to obtain records, appropriate action should be taken (see 38 C.F.R. § 3.159(c)-(e)), to include notifying the Veteran of the unavailability of the records 2. After records development is completed, the claims file should be sent to an appropriate examiner to offer an opinion as to whether it is at least as likely as not (50 percent probability or greater) that the current coronary artery disease onset during service or is otherwise related to an in-service injury, event, or disease, to include due to steroid use in service for his histoplasmosis. The examiner should also address whether any current disability of coronary artery disease is at least as likely as not related to or aggravated by (worsened beyond natural progression) service-connected histoplasmosis, to include due to steroid use. The need for an examination is left to the discretion of the examiner. A rationale for all opinions offered is requested as adjudicators are precluded from making any medical findings. 3. After records development is completed, schedule the Veteran for a VA respiratory examination to determine the current symptoms, level of severity, and functional impairment associated with his histoplasmosis. The claims file should be reviewed by the examiner. All necessary tests should be performed, and the results reported. LESLEY A.REIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Hofmeister 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.