Citation Nr: 21076543 Decision Date: 12/27/21 Archive Date: 12/27/21 DOCKET NO. 15-12 533 DATE: December 27, 2021 REMANDED Entitlement to service connection for coronary artery disease, to include as secondary to service-connected disease or injury is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1971 to May 1974. This case is before the Board of Veterans' Appeals (Board) on appeal from a rating decision issued a Department of Veterans Affairs (VA) Regional Office (RO). This matter was previously before the Board in September 2021. 1. Entitlement to service connection for coronary artery disease, to include as secondary to service-connected disease or injury is remanded. Regretfully, the Board must remand this claim for additional development. The Veteran argues that he developed coronary artery disease (CAD) due to his service-connected disabilities, which he contends prevented him from walking and exercising. The Veteran was afforded a VA examination in November 2021. The VA examiner found that his CAD was is less likely than not proximately due to or the result of Veteran's service-connected conditions and was less likely than not aggravated beyond its natural progression by service connected conditions. In part, the examiner's rationale states that "[w]here the determinative issue involves causation or medical diagnosis, competent medical evidence to the effect the claim is possible or plausible is required. The Veteran does not meet this burden by merely presenting his lay opinion because such evidence does not constitute competent medical authority. The Veteran has not been shown to have the requisite medical training as to opine to diagnosis or etiology." The Board finds that this portion of the opinion renders the medical opinion inadequate. The Veteran, while making this claim, has submitted a medical opinion that raises this argument. The examiner has made no indication that he reviewed the private medical opinion associated with the claims file. See Medical Opinion dated February 27, 2015. Claiming that the Veteran's argument is entirely a "lay opinion" is an inaccurate characterization and raises concerns about the review of the medical file. A new medical opinion addressing the medical evidence is necessary prior to adjudication of the Veteran's claim. Therefore, the VA must remand in order to obtain a new medical opinion. The matters are REMANDED for the following action: 1. Undertake appropriate efforts to obtain a VA medical opinion from an examiner of appropriate expertise. The entire claims file must be made available to the examiner for review. The examiner must specifically acknowledge receipt and review of the claims file. An examination of the Veteran is not required, unless deemed necessary by the examiner. The examiner must provide an opinion as to whether it is at least as likely as not (i.e. probability of 50 percent or greater) that the Veteran's CAD is caused or aggravated by any of the Veteran's service-connected disabilities, to include posttraumatic stress disorder, cervical spine degenerative disc disease, degenerative disc disease of the thoracic and lumbar spine, and radiculopathy of all four extremities. (a.) The VA examiner is requested to address the February 2015 private medical opinion. (b.) Separate opinions and rationales should be provided for causation and aggravation. A complete rationale for any opinions expressed should be provided. Patrick M. Johnson Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Jonah Nelson, 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.